Schizophrenia and other psychotic disorders

Question 1

what are positive psychosis symptoms

Answer 1

new or added symptoms to the patient
ex. hallucinations, delusion or disorganized speech

Question 2

what are the stages or phases of psychotic disorders?

Answer 2

prodromal
Acute (active) - most visible stage
Residual (Recovery) - not recognized by DSM-5

Question 3

what are the Four D’s of psychosis

Answer 3

Deviance from cultural or societal norms
Disruption or Dysfunction of an individuals life
Personal Distress
Danger to oneself or others

Question 4

what are delusions

Answer 4

fixed beliefs that may be false or irrational
a false belief that persists despite evidence to the contrary
categorized based on content of the belief

Question 5

what are the different types of delusions (10)

Answer 5

Persecutory
paranoid
reference
control
somatic
Grandiose
nihilistic
romantic
jealous
delusions of doubles

Question 6

what are persecutory delusions

Answer 6

being threatened, mistreated, or harmed. form of paranoia

Question 7

what is paranoid delusions

Answer 7

someone or somethng is out to get the person

Question 8

what if reference delusions

Answer 8

messages to the person embedded in media

Question 9

what are control delusions

Answer 9

others are tying to control thoughts and behaviors

Question 10

what are somatic delusions

Answer 10

belief that there is something wrong with body (bugs, odor, ugly)

Question 11

what are Grandiose delusions

Answer 11

special powers, wealth, mission, identiy

Question 12

what are Nihilistic delusions

Answer 12

delusions of being dead, not existing, losing body or organs

Question 13

what are romantic delusions

Answer 13

aka erotomania
belief that they are loved from afar

Question 14

what are jealous delusions

Answer 14

certain that partners have been unfaithful

Question 15

what are delusions of doubles

Answer 15

aka Capgras syndrome
someone important to the patient has been replaced by an identical duplicate/imposter

Question 16

what is capgras syndrome

Answer 16

another name for delusions of double

Question 17

what are hallucinations

Answer 17

perceptions in the absence of external stimuli
patient may or may not be aware
different types (auditory, visual and tactile,etc)

Question 18

what are the different types of hallucinations

Answer 18

auditory
visual
olfactory
gustatory
tactile
somatic

Question 19

what is thought disorder

Answer 19

thinking process impairments - general thinking process, language, speech or communications
several different types of disordered thinking can lead to disorganized speech or writing

Question 20

what are negative symptoms

Answer 20

emotional and behavioral deficits
indicative of the loss of normal mental functions
examples: apathy or anhedonia, diminished affect, social withdrawal, poverty of speech

Question 21

what are cognitive symptoms

Answer 21

impairment or change in cognitive function
patients may experience more than one concurrently
ex. executive dysfunction, memory and attention problems

Question 22

what are the two major categories of negative symptoms

Answer 22

diminished emotional expression and diminished volition

Question 23

what are concurrent Mood symptoms

Answer 23

comorbid disorders can cause overlap of symptoms
overtime psychotic symptoms pattern may change in relation to mood symptoms
ex. depression, anxiety, demoralization, suicide

Question 24

what are first-generation psychotics

Answer 24

useful in positive symptom treatment
Phenothiazine (chlopromazine)
Thioxanthenes (thothixene)
Haloperidol

Question 25

what are second-generation antipsychotics

Answer 25

useful in positive and negative symptoms treatment clozapine, risperidone, aripiprazole (abilify), olanzapine, quetiapine(seroquel)

Question 26

what are the common side effects of antipsychotics

Answer 26

anticholinergic SE autonomic side effects - BP, tremor electrocardiographic changes involuntary movement disorders metabolic and endocrine effects

Question 27

when are acute dystonia effects seen after antipsychotic medication start

Answer 27

hours to days

Question 28

when is akathesia effects seen after starting an antipsychotic medication is started

Answer 28

days

Question 29

when is Parkinsonism effects typically seen after starting an antipsychotic medication

Answer 29

weeks to months

Question 30

when are tardive dyskinesia effects typically seen after starting an antipsychotic medication

Answer 30

months

Question 31

what does ECT treat

Answer 31

catatonia, schizophrenia and MDD

Question 32

what is schizophrenia

Answer 32

characterized by "loss of contact with reality"

Question 33

what are the different schizophrenic disorders

Answer 33

brief psychotic disorder schizophreniform disorder schizophrenia schizoaffective disorder delusional disorder

Question 34

how are the schizophrenia disorders differentiated

Answer 34

by duration and types of psychotic symptoms and the presence or absence of concurrent mood symptoms

Question 35

when is schizophrenia usually diagnosed

Answer 35

men: 18-25 years old Women: 25 to mid-30s and after age of 40 years children (early presentation; rare)

Question 36

what are risks of schizophrenia

Answer 36

biopsychosocial influences (genetic, perinatal, neuroanatomic, neurochemical, other biologic abnormalities) psychological factors socio-environmental factors increased paternal age brain and neurotransmitter abnormalities

Question 37

what are the theories of schizophrenia

Answer 37

abnormalities in neurotransmission - excess or deficiency of specific neurotransmitters neurochemical imbalance abnormalities affecting brain tissue or structure

Question 38

what are the sings and symptoms of schizophrenia

Answer 38

at least 6 months onset may be abrupt or insidious symptoms (continuous or intermittent) - positive symptoms (hallucinations, delusions, disorganized speech - negative symptoms (diminished sociability, restricted affect, poverty of speech)

Question 39

what is the most likely imbalance in schizophrenia

Answer 39

dopamine either excess or decrease and abnormalities at receptor sites

Question 40

how is schizophrenia diagnosed

Answer 40

psychiatric interview and use of diagnostic criteria no specific lab tests DSM-5 criteria

Question 41

what are the subtypes of schizophrenia

Answer 41

paranoid type disorganized type catatonic undifferentiated type residual type

Question 42

what is the treatment for schizophrenia

Answer 42

goal is to optimize function, prevent suicide and manage complications psychosocial treatment and antipsychotic medications

Question 43

what are adjective treatments for schizophrenia

Answer 43

antidepressants psychosocial interventions (CBT, Family psychoeducation, social skills training, assertive community treatment, crisis intervention)

Question 44

what is an inadequate response to initial treatment, dose adjustments or changes in type of antipsychotics of schizophrenia

Answer 44

treatment resistant schizophrenia

Question 45

what is schizoaffective disorder

Answer 45

rare criteria is met for schizophrenia with addition of affective symptoms - present prior to or during psychosis must have at least two weeks of psychotic symptoms without mood symptoms timing of symptoms can help to differentiate schizoaffective vs mood disorder

Question 46

what are affective symptoms of schizophrenia

Answer 46

major depressive episodes, manic episodes or hypomanic episodes

Question 47

what is the treatment of schizoaffective disorder

Answer 47

antipsychotic drugs - paliperidone adjunctive treatment: meds, psychotherapy, patient education treatment of co-morbidities

Question 48

what is schizophreniform disorder

Answer 48

criteria for schizophrenia are met but the duration si less than 6 months duration typically longer than 1 month and less than 6 months symptoms similar to schizophrenic disorders

Question 49

what is the treatment of schizophreniform disorder

Answer 49

antipsychotis - commonly second-generation psychotherapy

Question 50

what is delusional disorder

Answer 50

psychosis delusion is present in the absence of the schizophrenia diagnosis criteria duration is at least one month of duration predominant symptoms are persistent delusions daily functioning is minimally impaired