Schizophrenia and Other Psychotic Disorders Flashcards
What are positive symptoms for schizophrenia?
psychotic behaviors NOT seen in healthy people – DELUSIONS, HALLUCINATIONS, DISORGANIZED THINKING, ABN MOTOR BEHAVIOR (CATAPLEXY)
**these can come and go
people with positive symptoms often ….
lose touch with reality
time frame needed to make a diagnosis of schizophrenia
must have symptoms for 6 mos or longer
*active phase with prominent psychotic symptoms > 1 month
what are negative symptoms of schizophrenia
disruptions of normal behavior and emotions–
flat affect
lack of pleasure
lack of ability to begin and sustain planned activites
speaking little
What is avolition
dec in motivation and self-sustained purposeful activity
What is schizoaffective disorder. relevant time frames
major mood disorder concurrent with schizophreania-like psychosis
psychotic symptoms are present for >2 weeks (when the mood disorder absent)
what is alogia
diminished speech output
pts who recover faster after being given the diagnosis of schizophrenia are called
schizophreniform disorder
i.e. LESS THAN 6 MONTH DURATION OF SYMPTOMS
what is delusional disorder
normal appearing person with bizzare delusions
>1mo
What is a brief psychotic disorder?
transient psychosis that is brought on by stress
<1mo
what are 5 common psychotic disorders common in medical setting
- substance/medication induced psychotic disorder
- psychotic disorder due to general medical condition
- catatonia
- delerium
- dementia
when after admin of meds or abuse of drugs can a substance/medication induced psychotic disorder
during or soon after intoxication or withdrawal from substance/med
what are examples of medical conditions that can induce a psychotic disorder
malignant lung CA
MS
brain injury
hypothyroidism
dementia tbales 44.1 and 44.2
*DIDN’t ADD THESE BC THIS WOULD BE 100 SLIDES
ch 44 pg 352 to 58
name of abnormal thought form in which there is a loss of meaning due to random connections/loose association between ideas
derailment
name of abnormal thought form in which there is responses to questions are only partially or remotely connected to the topic
tangential
name of abnormal thought form in which there is a excessively detailed speech or circuitous speech, yet still response to the question
circumstantial
name of abnormal thought form in which there is a creation of words with unique meaning only understood by the individual
neologism
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
blocking
name of abnormal thought form in which there is a complete disregard for conventions of word usage, grammar (= incoherence)
word salad
name of abnormal thought form in which the sounds of words, instead of meanings or conventions determine the flow of speech
clanging
name of abnormal thought form in which there is a repetition of words or phrases
perservation
What are the phases of schizophrenia
prodromal –> active –> residual
in which phase of schizophrenia are delusions common
active
**absent in residual
which phase of schizophrenia are negative symptoms prominent?
residual
is delerium run a persistant or fluctuating course
fluctuating
**must observe for multiple days bc periods of transient improvement may be mistaken for resolution
cardinal feature of delerium
distractibility
Cognitive symptoms associated with schizophrenia?
- impaired focus & attention
- marked deficits in working memory
- impaired decision makes (higher functions)
When is schizophrenia usually treated?
ctive phase, when psychotic symptoms appear
When does schizophrenia typically present?
adolescence or young adulthood
Diagnostic criteria for schizophrenia?
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
Neuroanatomical changes in schizophrenia?
- ↓ BF to frontal lobes
- Thinning of medial temporal lobe cortex, frontal cortex, & small ant. portions of hippocampus
- Enlarged lateral and 3rd ventricles
What is schizoaffective disorder?
Major mood disorder concurrent w/ schizophrenia-like psychosis
What are the clinical features of delirium? (TABLE 45.1)
- 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
Risk factors for delirium?
- extremes of age
- Preexisting medical conditions
- Baseline poor health or disability
- Environmental conditions (sensory deprivation, meaningless stim., overstimulation)
Frontal lobe/prefrontal cortex changes associated with clinical features of delirium?
- inattention + thought disorganization
- delusions, perceptual disturbances
- disorientation/memory deficits
- language impairments, psychomotor disturbances
Basal ganglia/thalamus/hippocampus changes associated with clinical features of delirium?
- inattention, thought disorganization
- delusions, perceptual disturbances
- disorientation/memory deficits
- disturbances in affect
- psychomotor disturbances
Cingulate gyrus changes associated with clinical features of delirium?
psychomotor disturbances
language impairments
Temporal lobe changes associated with clinical features of delirium?
- delusions, perceptual disturbances
- memory deficits
Parietal lobe changes associated with clinical features of delirium?
- inattention
- delusions, perceptual disturbances, disorientation
Occipital lobe changes associated with clinical features of delirium?
perceptual disturbances
Brainstem changes associated with clinical features of delirium?
inattention, altered level of consciousness, sleep disturbances
NT increased/decreased in delirium?
- deficiency of ACh
- excess of DA, NE, GC, cytokines (IL1, IL6, TNFa)
- incr/decr of 5HT, histamine, GABA, glutamate
Management of Delirium?
- treat underlying
- modification of risk factors
- environmental (relaxing conditions, etc)
- meds (antipsychotics, short-acting benzo’s & nonbenzo hypnotics)
