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MHD > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Schizophrenia

Signs and Symptoms

A

Delusions

Hallucinations

Disorganized thinking

Disorganized behavior

Negative symptoms (flat affect, alogia, avolution, anhedonia)

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2
Q

What are the negative symptoms of Schizophrenia?

A

Affective flattening (no discernable emotion)

Alogia (not speaking a lot)

Anhedonia (does not derive pleasure from anything)

Avolution (not much motivation)

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3
Q

How might you screen for delusions in a patient with Schizophrenia?

A

Get a collateral history from someone who came with pt

Ask “Are you having any conflicts in your life? Tell me about them.” (They will have had conflicts with those who don’t believe their delusions)

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4
Q

What are delusions?

A

Unusual thoughts, suspiciousness
Strange thoughts out of touch with reality

May be bizarre (aliens)

May be about marital affairs, neighbors watching them

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5
Q

What are the most and least common hallucinations in Schizophrenia?

A

Most common: Auditory
2nd most common: Visual

Least common: Gustatory and Olfactory

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6
Q

What is disorganized thinking?

A

Trouble thinking clearly and understanding others, which impairs good communication

Tangential thought process
Incoherence
Word salad

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7
Q

What is disorganized behavior?

A

Childlike silliness
Agitation
Inappropriate sex behavior
Shouting, swearing

Catatonic behavior (assuming many postures)

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8
Q

What are the criteria for Schizophrenia A?

A

2/5 symptoms (delusions, hallucinations, disorganized thinking/behavior, negative symptoms)

One must be a delusion, hallucination, or disorganized thinking

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9
Q

Describe the Downward Drift Hypothesis of Schizophrenia

A

Because of their sociooccupational dysfunction, Schizophrenia pts lose their other supports (jobs, friends, family, money).

They gradually shift down on the socioeconomic spectrum.

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10
Q

Schizophrenia

Time/Duration

A

Signs/symptoms for at least 6 months

For diagnosis, need to have met A criteria for at least 1 month

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11
Q

If you have symptoms of Schizophrenia for ____, what do you have?

Less than 1 month–

1-6 months–

Over 6 months–

A

Less than 1 month– Brief psychotic reaction

1-6 months– Schizophreniform disorder

Over 6 months– Schizophrenia

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12
Q

Schizoaffective Disorder

What are the criteria?

A

MDD or Bipolar + Schizophrenia A criteria met

Needs a period of time in which they had a psychotic episode with no mood symptoms for at least 2 weeks

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13
Q

Delusional Disorder

What are the criteria?

A

Delusions, bizarre or not, for 1 month

Schizophrenia A Criteria are NOT MET

(Outside of the delusion, they are doing fine!)

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14
Q

What is psychosis due to a substance?

A

Psychosis caused by intoxication or withdrawal from a substance

Should resolve fairly quickly

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15
Q

High doses of ___ can results in a clinical picture that looks like Schizophrenia, depression, or a manic episode

A

Steroids

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16
Q

In a child who comes in with poor communication skills or reciprocal social skills, what are they likely to have?

A

50x more likely to have Autism, Rhett’s, Asperger’s than Childhood Schizophrenia

17
Q

Schizophrenia

Prevalence (Males v Females)

A

M = F

More prevalent than Alzheimers, T1DM, MS

18
Q

Schizophrenia

Three Phases in the Course of Disease

A

Prodromal phase- months to years before active

Active Phase- meets criteria A

Residual phase- remission

19
Q

Schizophrenia

Peak age of Onset for Males and Females

A

Males: late teens/early 20s

Females: late 20s (also have a small pear after 40)

20
Q

Schizophrenia

Suicide Risk

A

20% attempt

Higher risk in those who are well functioning and have good insight about their disease

21
Q

Schizophrenia

How can Cognitive Impairment be measured?

A

SMART- Speed, Memory, Attention, Reasoning, Tact

Wisconsin Card sort

22
Q

Schizophrenia

What is Anosognosia?

A

Lack of partial awareness or insight, varying with phase of illness

23
Q

Schizophrenia

Good Prognostic Predictors

A
  • Responds well to first course of antipsychotics
  • Older age
  • Female
  • No family history
  • No negative symptoms
24
Q

Schizophrenia

Outcome

A

Most don’t work or marry. Only 1/3 live independently. Most have limited social contact.
Low quality of life

Life expectancy is 48-53 years

25
Q

Neurochemical Theory of Schizophrenia Cause

A

Too much dopamine leads to psychosis and Schizophrenia symptoms

Anti-psychotics are dopamine antagonists

26
Q

Genetics Theory of Schizophrenia Cause

A
  • 50% risk if identical twin has it
  • 40% risk if both parents have it
  • 10% risk if parent or sibling has it
27
Q

What is the leading theory of what causes Schizophrenia?

A

Genetic predisposition with environmental exposures/stresses during pregnancy or early life

MHD (57 decks)

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