Schizophrenia and Other Psychotic Disorders

Question 1

What are positive symptoms for schizophrenia?

Answer 1

psychotic behaviors NOT seen in healthy people – DELUSIONS, HALLUCINATIONS, DISORGANIZED THINKING, ABN MOTOR BEHAVIOR (CATAPLEXY)

**these can come and go

Question 2

people with positive symptoms often ….

Answer 2

lose touch with reality

Question 3

time frame needed to make a diagnosis of schizophrenia

Answer 3

must have symptoms for 6 mos or longer

*active phase with prominent psychotic symptoms > 1 month

Question 4

what are negative symptoms of schizophrenia

Answer 4

disruptions of normal behavior and emotions–
flat affect
lack of pleasure
lack of ability to begin and sustain planned activites
speaking little

Question 5

What is avolition

Answer 5

dec in motivation and self-sustained purposeful activity

Question 6

What is schizoaffective disorder. relevant time frames

Answer 6

major mood disorder concurrent with schizophreania-like psychosis

psychotic symptoms are present for >2 weeks (when the mood disorder absent)

Question 7

what is alogia

Answer 7

diminished speech output

Question 8

pts who recover faster after being given the diagnosis of schizophrenia are called

Answer 8

schizophreniform disorder

i.e. LESS THAN 6 MONTH DURATION OF SYMPTOMS

Question 9

what is delusional disorder

Answer 9

normal appearing person with bizzare delusions

>1mo

Question 10

What is a brief psychotic disorder?

Answer 10

transient psychosis that is brought on by stress

<1mo

Question 11

what are 5 common psychotic disorders common in medical setting

Answer 11

1. substance/medication induced psychotic disorder
2. psychotic disorder due to general medical condition
3. catatonia
4. delerium
5. dementia

Question 12

when after admin of meds or abuse of drugs can a substance/medication induced psychotic disorder

Answer 12

during or soon after intoxication or withdrawal from substance/med

Question 13

what are examples of medical conditions that can induce a psychotic disorder

Answer 13

malignant lung CA
MS
brain injury
hypothyroidism

Question 14

dementia tbales 44.1 and 44.2

*DIDN’t ADD THESE BC THIS WOULD BE 100 SLIDES

Answer 14

ch 44 pg 352 to 58

Question 15

name of abnormal thought form in which there is a loss of meaning due to random connections/loose association between ideas

Answer 15

derailment

Question 16

name of abnormal thought form in which there is responses to questions are only partially or remotely connected to the topic

Answer 16

tangential

Question 17

name of abnormal thought form in which there is a excessively detailed speech or circuitous speech, yet still response to the question

Answer 17

circumstantial

Question 18

name of abnormal thought form in which there is a creation of words with unique meaning only understood by the individual

Answer 18

neologism

Question 19

name of abnormal thought form in which the person loses track of the goals of speech and are not able to return to the topic

Answer 19

blocking

Question 20

name of abnormal thought form in which there is a complete disregard for conventions of word usage, grammar (= incoherence)

Answer 20

word salad

Question 21

name of abnormal thought form in which the sounds of words, instead of meanings or conventions determine the flow of speech

Answer 21

clanging

Question 22

name of abnormal thought form in which there is a repetition of words or phrases

Answer 22

perservation

Question 23

What are the phases of schizophrenia

Answer 23

prodromal –> active –> residual

Question 24

in which phase of schizophrenia are delusions common

Answer 24

active

**absent in residual

Question 25

which phase of schizophrenia are negative symptoms prominent?

Answer 25

residual

Question 26

is delerium run a persistant or fluctuating course

Answer 26

fluctuating | **must observe for multiple days bc periods of transient improvement may be mistaken for resolution

Question 27

cardinal feature of delerium

Answer 27

distractibility

Question 28

Cognitive symptoms associated with schizophrenia?

Answer 28

- impaired focus & attention - marked deficits in working memory - impaired decision makes (higher functions)

Question 29

When is schizophrenia usually treated?

Answer 29

ctive phase, when psychotic symptoms appear

Question 30

When does schizophrenia typically present?

Answer 30

adolescence or young adulthood

Question 31

Diagnostic criteria for schizophrenia?

Answer 31

Need two criteria to be met: i. Active phase w/ prominent psychotic symptoms lasting > 1 month, unless symptoms are interrupted by treatment ii. A total duration of symptoms, regardless of phase >6 months

Question 32

Neuroanatomical changes in schizophrenia?

Answer 32

- ↓ BF to frontal lobes - Thinning of medial temporal lobe cortex, frontal cortex, & small ant. portions of hippocampus - Enlarged lateral and 3rd ventricles

Question 33

What is schizoaffective disorder?

Answer 33

Major mood disorder concurrent w/ schizophrenia-like psychosis

Question 34

What are the clinical features of delirium? (TABLE 45.1)

Answer 34

- acute - fluctuating (may be "sundowning") - impaired attention (distracted) - altered level of consciousness - memory deficits (autobiogr usually ok) - disoriented - disorganized thoughts - perceptual disturbances (usually vision/hearing) - paranoid/bizarre delusions - abn speech + psychomotor - sleep abn - abn affect (anxiety, depr, flat, etc) **sorry, I dont know what to do with this

Question 35

Risk factors for delirium?

Answer 35

- extremes of age - Preexisting medical conditions - Baseline poor health or disability - Environmental conditions (sensory deprivation, meaningless stim., overstimulation)

Question 36

Frontal lobe/prefrontal cortex changes associated with clinical features of delirium?

Answer 36

- inattention + thought disorganization - delusions, perceptual disturbances - disorientation/memory deficits - language impairments, psychomotor disturbances

Question 37

Basal ganglia/thalamus/hippocampus changes associated with clinical features of delirium?

Answer 37

- inattention, thought disorganization - delusions, perceptual disturbances - disorientation/memory deficits - disturbances in affect - psychomotor disturbances

Question 38

Cingulate gyrus changes associated with clinical features of delirium?

Answer 38

psychomotor disturbances | language impairments

Question 39

Temporal lobe changes associated with clinical features of delirium?

Answer 39

- delusions, perceptual disturbances | - memory deficits

Question 40

Parietal lobe changes associated with clinical features of delirium?

Answer 40

- inattention | - delusions, perceptual disturbances, disorientation

Question 41

Occipital lobe changes associated with clinical features of delirium?

Answer 41

perceptual disturbances

Question 42

Brainstem changes associated with clinical features of delirium?

Answer 42

inattention, altered level of consciousness, sleep disturbances

Question 43

NT increased/decreased in delirium?

Answer 43

- deficiency of ACh - excess of DA, NE, GC, cytokines (IL1, IL6, TNFa) - incr/decr of 5HT, histamine, GABA, glutamate

Question 44

Management of Delirium?

Answer 44

- treat underlying - modification of risk factors - environmental (relaxing conditions, etc) - meds (antipsychotics, short-acting benzo’s & nonbenzo hypnotics)