Schizophrenia Flashcards

1
Q

What is the Definition of Schizophrenia?

A

One or more of :

1) Delusions
2) Halucinations
3) Disorganized thinking and speech
4) Grossly Disorganized Motor Behavior incl Catatonia
5) Negative Symptoms

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2
Q

What are delusions?

A

Fixed beliefs that are NOT amenable to change in light of conflicting evidence

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3
Q

What are hallucinations?

A

Perception-like experiences that occur without external stimuli

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4
Q

What is disorganized thinking (Speech)?

A

Inferred from the individual’s speech and must impair communication. Less severe in prodromal and residual phase of schizophrenia

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5
Q

What is Grossly Disorganized Motor Behavior incl Catatonia

A

Silliness to unpredictable agitation. Problems in any form of goal directed behavior including ADLs.

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6
Q

What is Schizotypal Disorder?

A

Discomfort with close relationships. Cog and perceptual distortions and eccentricities of behavior.

  • Odd belief or magical Beh
  • Unusual perceptual experiences, body illusions
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7
Q

What is the Criteria for diagnosing Delusional Disorders?

A

One or more delusions for 1 month or longer

Hallucinations are not prominent and related to the delusion

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8
Q

What are the Associated features supporting a Dx of Delusional disorders?

A

Anger and violence w/ persecutory, jealous, or erotomanic types

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9
Q

What are the criteria for Brief Psychotic Disorder?

A
>1 of:
Delusions 
Hallucinations
Disorganized speech
Grossly disorganized or Catatonic behavior
1 day to 1 month => return to normal
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10
Q

What is the Criteria for Schizophreniform Disorder?

A
>2 of the following 1-6 months
*Delusions 
*Hallucinations
*Disorganized speech
Grossly disorganized or Catatonic behavior
Negative Symptoms
One must be in first 3
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11
Q

What is the difference between Schizophrenia and SD?

A

Schizo: Cont signs of Disturbance for >6 mon w/ 1 month active symptoms

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12
Q

What are the Associated Features supporting Dx of Schizophrenia?

A
LACK OF INSIGHT INTO THEIR ILLNESS! => Non-adherence to Treatment
Innapropriate Affect
Dysphoric Mood
Sleep Pattern Disturbance
Lack of eating/food refusal
Depersonalization
Anxiety and phobias
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13
Q

Who is at a higher risk of Negative symptoms and longer duration of illness.

A

Males (poorer outcome)

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14
Q

What are the traits of Male Schizophrenia?

A

Early to Mid 20s: Earlier onset, poorer premorbid adjustment, Brain structural abn, Neg S and S, more cog imp, worse outcomes, 90% before 30yo
Do not marry, limited social

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15
Q

What are the traits of FemaleSchizophrenia?

A

Late 20s: Later onset, lower incidence, less brain struct abn, Better outcome, less cog imp, 25% before 30yo
More psychotic symp, worsen later in life

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16
Q

What are the Related comorbidities with Schizophrenia?

A

Anxiety, OCD, Schizotypal or paranoid personality often preceed onset
SUBSTANCE ABUSE: TOBACCO

17
Q

What is Schizoaffective Disorder?

A

Uninterrupted period of illness w/ a major mood epidode: Comb with Crit A for Schiz

18
Q

What is substance/Med induced psychotic Disorder?

A

Delusions and Hallucinations

Criterion A for Schiz Devt During or soon after intoxication or withdrawl of a substance/med

19
Q

What are other disorders that can cause Psychosis?

A

MS, Epilepsy, Hyper/Hypothyroid, etc

20
Q

What is the Clinical picture of Catatonia?

A

> 3 of: Stupor, Cataplexy, Waxy flexibility, Mutism, negativism, mannerism, Steriotypy, agitation, grimacing, echolalia(speech) , echopraxia(movements)

21
Q

Whatr are the histopathological Changes associated with psychotic illness?

A

Dec volume of hippocampus, thalamus, temporal, and prefrontal cortex. Dec total Gray matter vol.

22
Q

What are findings on Neuroimaging?

A

Lateral and 3rd Ventricle Enlargement
Hypofrontality at rest
Can’t activate prefrontal cortex during performance of cog tasks

23
Q

What is acute Psychosocial Tx?

A

Containment, reduce stim, devt alliance, Avoid medication SA and involve Pts in Med selection
Educate and Support family and SO

24
Q

What is long term Psychosocial Tx?

A

1) Assertive Community Tx
2) Int Tx for Co-occurring Disorders
3) Supported Employment
4) Illness Mngt and Recovery
5) Family Psycho-Ed
6) Perm supportive Housing
7) Med-TEAM
8) Consumer-Op Services
9) Intervent for Disrpt Beh Dis
10) Tx of Dep in Older Adults
11) Supported Education

25
Q

What is the sole risk factor for violence in the Delusional population?

A

Auditory Command hallucinations