Schizophrenia Flashcards
What is the Definition of Schizophrenia?
One or more of :
1) Delusions
2) Halucinations
3) Disorganized thinking and speech
4) Grossly Disorganized Motor Behavior incl Catatonia
5) Negative Symptoms
What are delusions?
Fixed beliefs that are NOT amenable to change in light of conflicting evidence
What are hallucinations?
Perception-like experiences that occur without external stimuli
What is disorganized thinking (Speech)?
Inferred from the individual’s speech and must impair communication. Less severe in prodromal and residual phase of schizophrenia
What is Grossly Disorganized Motor Behavior incl Catatonia
Silliness to unpredictable agitation. Problems in any form of goal directed behavior including ADLs.
What is Schizotypal Disorder?
Discomfort with close relationships. Cog and perceptual distortions and eccentricities of behavior.
- Odd belief or magical Beh
- Unusual perceptual experiences, body illusions
What is the Criteria for diagnosing Delusional Disorders?
One or more delusions for 1 month or longer
Hallucinations are not prominent and related to the delusion
What are the Associated features supporting a Dx of Delusional disorders?
Anger and violence w/ persecutory, jealous, or erotomanic types
What are the criteria for Brief Psychotic Disorder?
>1 of: Delusions Hallucinations Disorganized speech Grossly disorganized or Catatonic behavior 1 day to 1 month => return to normal
What is the Criteria for Schizophreniform Disorder?
>2 of the following 1-6 months *Delusions *Hallucinations *Disorganized speech Grossly disorganized or Catatonic behavior Negative Symptoms One must be in first 3
What is the difference between Schizophrenia and SD?
Schizo: Cont signs of Disturbance for >6 mon w/ 1 month active symptoms
What are the Associated Features supporting Dx of Schizophrenia?
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
Who is at a higher risk of Negative symptoms and longer duration of illness.
Males (poorer outcome)
What are the traits of Male Schizophrenia?
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
What are the traits of FemaleSchizophrenia?
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
What are the Related comorbidities with Schizophrenia?
Anxiety, OCD, Schizotypal or paranoid personality often preceed onset
SUBSTANCE ABUSE: TOBACCO
What is Schizoaffective Disorder?
Uninterrupted period of illness w/ a major mood epidode: Comb with Crit A for Schiz
What is substance/Med induced psychotic Disorder?
Delusions and Hallucinations
Criterion A for Schiz Devt During or soon after intoxication or withdrawl of a substance/med
What are other disorders that can cause Psychosis?
MS, Epilepsy, Hyper/Hypothyroid, etc
What is the Clinical picture of Catatonia?
> 3 of: Stupor, Cataplexy, Waxy flexibility, Mutism, negativism, mannerism, Steriotypy, agitation, grimacing, echolalia(speech) , echopraxia(movements)
Whatr are the histopathological Changes associated with psychotic illness?
Dec volume of hippocampus, thalamus, temporal, and prefrontal cortex. Dec total Gray matter vol.
What are findings on Neuroimaging?
Lateral and 3rd Ventricle Enlargement
Hypofrontality at rest
Can’t activate prefrontal cortex during performance of cog tasks
What is acute Psychosocial Tx?
Containment, reduce stim, devt alliance, Avoid medication SA and involve Pts in Med selection
Educate and Support family and SO
What is long term Psychosocial Tx?
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
