Schizophrenia Flashcards
what is Schizophrenia
Delusions / Hallucinations / Disorganized Thinking/ Disorganized Behavior / Negative Symptoms
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Significant Social or Occupational deterioration
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Period of One Month
The Criteria
The presence of at least two of the following five items, each present for a clinically
significant portion of time during a 1-month period (or less if successfully treated), at least one of these most be 1), 2), or 3):
Delusions.
Hallucinations.
Disorganized speech.
Grossly disorganized or catatonic behavior.
Negative symptoms.
B. Must cause significant social or occupational functional deterioration.
C. Continuous signs of the disturbance persist for a period of at least 6 months, which must include at least 1 month of symptoms (or less if successfully treated); prodromal symptoms often precede the active phase, and residual symptoms may follow it.
D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out.
E. The disturbance is not attributable to the physiological effects of a substance.
F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms or schizophrenia, are also present for at least 1 month (or less if successfully treated).
according to duration
if less than 1 month called …
1-6 month
more than 6 month
<1 month—brief psychotic disorder
1–6 months—schizophreniform disorder
>6 months—schizophrenia
schizophrenia types
Paranoid Type (Best prognosis, older age of onset) No predominance of disorganized speech, disorganized or catatonic behavior, or inappropriate affect Disorganized Type Poor functioning type, early onset -Disorganized speech -Disorganized behavior - Flat or inappropriate affect Catatonic Type
Motor immobility - Excessive purposeless motor activity
- Echolalia or echopraxia -Extreme negativism or mutism
- Peculiar voluntary movements or posturing
Undifferentiated Type
Characteristic of more than one subtype or
none of the subtypes
Residual Type
Mainly the presence of negative symptoms
Echolalia
meaningless repetition of another person’s spoken words as a symptom of psychiatric disorder.
echopraxia
meaningless repetition or imitation of the movements of others as a symptom of psychiatric disorder.
Pathophysiology and Etiology
Genetic Factors Biochemical Factors Psychosocial factors and environmental factors Neurotransmitter imbalance: DA, NE, 5-HT Reduced hippocampal volumes Thalamic abnormalities White-matter abnormalities Schizophrenia 1 gene (DISC) on chromosome 1q42
dopamine system
Prefrontal cortical Responsible for negative symptoms Mesolimbic Excessive dopaminergic activity responsible for positive symptoms Tuberoinfundibular Blocked by neuroleptics, causing Hyperprolactinemia (gynecomastia, galactorrhea, and menstrual irregularities Nigrostriatal Blocked by neuroleptics, causing extrapyramidal side effects such as tremor, akathisia, dystonia
Positive Symptoms
Delusions Hallucinations Disorganized Speech Disorganized Behavior Formal Thought Disorder
Negative Symptoms
Flat Affect Decreased Emotional Reactivity Poverty of Speech Lack of purposeful actions Anhedonia
Cognitive deficits
Slower processing speed.
Impairment in declarative and working memory.
Abnormalities in sensory processing.
Reductions in attention.
Social cognition deficits such as inaccuracy in inferring the intentions of other people.
Good prognostic factors for schizophrenia:
later age of onset Good premorbid functioning Affective symptoms (mood syptoms) bipolar or depression Family history of mood disorder Acute onset Married Good support system Positive symptoms
poor prognosis
Younger age at onset. Poor premorbid functioning. No precipitating factors. Negative symptoms. Being single/divorced. Family history of schizophrenia. Negative symptoms.صعب تروح بالادوية History of perinatal trauma. Multiple relapses. Longer duration of untreated illness.
