Schizophrenia and other Psychotic disorders (Hill) Flashcards
Onset of schizophrenia? Precipitating events? Role of marijuana?
Onset: peak time of onset at late adolescence and early adulthood
Precipitating: Psychosocial stressors, traumatic events, drug and alcohol abuse
Cannabis use increases risk 6x (esp adolescents)
Prognosis with Positive symptoms? Prognosis with Negative symptoms?
Positive symptoms: Better prognosis
Negative symptoms: Poor prognosis
Delusions, hallucinations, catatonia, and agitation are what kind of symptoms in schizophrenia?
positive
Schizophrenia FORM of thought?
- Loosening of associations –> Preoccupation with invisible forces
- Poverty of content and speech
- Thought blocking –> internal interruption in pts speech/thoughts
Schizophrenia CONTENT of thought?
Delusions of persecution/reference/influence
Schizophrenia PERCEPTUAL DISORDERS?
Hallucinations (auditory/visual-shadows)
Affective flattening, apathy, social withdrawal, anhedonia, poverty of thought, and content of speech are what type of symptoms in schizophrenia?
Negative
How long must symptoms be present for dx of schizophrenia?
6 months
For DSM 5 dx criteria “A” for schizophrenia, you must have 2 or more of what for most of 1 month?
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms
Single leading cause of death in schizophrenia pts?
Suicide –> attempts occur in 20-50% of pts
What drug may reduce risk of suicide attempt in schizophrenia?
Clozapine (watch for neutropenia)
What drug type for tx of catatonic disorder in schizophrenia pts?
Benzos
IM injx of these drugs for acute psychosis:
1st gen antipsychotics
Adverse effects of 1st gen antipsychotics?
- EPS symptoms
- Neuroleptic malignant syndrome
Concerning side effect of 2nd gen antipsychotic Clozapine?
Agranulocytosis
Concerning side effect of 2nd gen antipsychotic Ziprasidone?
QTc prolongation
This disorder characterized by:
- UNINTERRUPTED period of illness with either a major depressive episode or manic episode concurrent with symptoms that meet criterion A for schizophrenia
- Same period of illness, have been delusions or hallucinations for AT LEAST 2 WEEKS in the absence of prominent mood symptoms
Schizoaffective disorder
This disorder dx by presence of at least the following:
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or Catatonic behavior
-Also, duration of an episode of the disturbance is AT LEAST 1 DAY and NO MORE THAN 1 MONTH, with eventual return to premorbid level of functioning
Brief psychotic disorder
This disorder characterized by:
- Meets criteria A, D, and E for schizophrenia
- An episode of the disorder lasts AT LEAST 1 MONTH but LESS THAN 6 MONTHS
Schizophreniform
This disorder characterized by:
- Delusions (not always “non bizarre”, i.e. involving situations that could occur in real life such as being followed, poisoned, or infected, having a disease, being loved at a distance) of AT LEAST 1 MONTHS DURATION
- Has never met criterion A for Schizophrenia (for more than a few hrs)
- Apart from impact of delusion, functioning is not impaired and behavior is not odd or bizarre
Delusional disorder
If Schizophrenia, think __ months
If Schizophreniform, think __ months
If Brief Psychotic Disorder, think __ months
Schizophrenia= > 6 months
Schizophreniform= 1-6 months
Brief psychotic disorder= <1 month
On the schizo Spectrum, this one is a pt who is very introverted and voluntarily withdraws from social interactions
Schizoid
On the Schizo spectrum, this one is a pt with schizoid symptoms + magical thinking and odd behavior
Schizotypal
On the Schizo spectrum, this one is a pt with Schizotypal + Psychosis
Schizophrenia
On the Schizo spectrum, this one is a pt with Schizophrenia + Mood disorder
Schizoaffective
When is hospitalization necessary?
If pt is threatening
Which SGA’s can cause weight gain?
the “-pines”
- ClozaPINE
- OlanzaPINE
