Schizophrenia and Other Psychotic Disorders Flashcards
When is the peak onset time for schizophrenia?
- late adolesence and early adulthood
- negative sx have a poor prognosis
+ sx of schizophrenia
- sx added to the presentation
- typically present in the active phase
- Delusions
- Hallucinations
- Catatonia
- Agitation
What is loosening of associations
- when connections among the pts ideas are absent or obscure
- listeners may feel as if understanding of the pts thoughts had been suddenly lost
What does the form of though look like in schizo ppl?
- loosening of associations
- poverty of content and speech
- thoguht blocking: internal interruption in pts speech/thoughts
What does the content of thought llok like in schizo ppl?
- delusions of persecution, reference, influence
- thought broadcasting
- grandiose delusions, somatic delusions
what is the schizo affect like?
-blunted/flat/inappropriate
Negative sx of schizophrenia
- sx that appear missing from the presentation
- typically present in the residual phase
- affective flattening
- apathy
- social withdrawal
- anhedonia: they don’t have any fun
- poverty of thought
- content of speech
How long do the sx for schizo have to be present?
-6 months!!!!!!***** importante
What are some things we have do be able to rule out when making the dx of schizo?
- seizure disorders
- metabolic disorders
- thyroid df
- brain tumor
- neurosyphillis
- street drug use****
psychiatric ddx for schizo
- delusional disorder
- mood disorders
- OCD
- personality disorders
- “normal adolescence”
When are ppl with schizo born?
-higher rates in pts born in winter and early spring months
What will schizo eyes look like?
-saccadic eye movements, not smooth when reading over something
What will brain imaging look like in schizo?
- structural volume reduction in cortical structures
- enlarged ventricles (3rd and 4th)
What were some of the big sx that they have to have for most of 1 month?
- delusions
- Hallucinations
- Disorganized speech
are schizos more likely to commit homicide?
-nah
What is the single leading cause of death in schizos?
-suicide
What drug to we give suicidal ppl?
- clozapine
- be sure to check for neutropenia
What things do we have to look for in the schizophrenia, Catatonic type?
- motoric immobility as evidenced by catalepsy or stupor
- excessive motor activity (apparently puroposeless and not influenced by external stimuli)
- extreme negativism or mutism
- peculiarities of voluntary movement such as posturing, stereotyped movements, prominent mannerisms or prominent grimacing
- Echolalia or echopraxia
Schizophrenia treatments
- hospitalization
- group therapy
- individual psychotherapy
- community treatment
- self-help programs
- pharmacology
- ECT
- Benzos for catatonic disorder
What do we have to do pharamcologically for schizo?
- block the DA receptors!!!
- first gen antipsychotics: haloperidol, fluphenazine
- lorazepam calms them down
What are some first generation antipsychotics adverse effects?
- EPS syndromes
- NEuropleptic malignant syndrome
What do the second generation antipsychotics do?
- block DA receptors AND affect serotonin activity
- Clozapine (agranulocytosis… watch out)
- Risperidone
- Olanzapine
- Quetiapine
- Ziprasidone: QTc prolongation
- Iloperidone
- Aripiprazole: partial DA agonist
If it ends with “pine”, what side effect must we worry about?
- weight gain
- p….. pig
What is Schizoaffective disorder?
- Uninterrupted period of illness with either a major depressive episode or manic episode concurrent with sx 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 sx
What is brief psychotic disorder?
- Presence of at least … of the following:
- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
- 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
What is Schizophreniform?
- Meets criteria A, D, and E for schizophrenia
- an episode of the disorder lasts at least 1 month but less than 6 months
What is delusional disorder?
- delusions of at least 1 month’s duration,
- has never met criterion A for schizophrenia
- apart from the impact of the delusion, functioning is not impaired and behavior is not odd or bizarre
If schizo, what time line are we looking for?
-> 6 months
Schizophreniform time
-1-6 months
Brief psychoti disorder
-<1 month
What is schizoid
-very inroverted and voluntarily withdrwas from social interactions
What is schizotypal?
-schizoid sx + magical thinking and odd behavior
What is schizophrenia?
schizotypal+ psychosis
What is schizoaffective?
-Schizophrenia+ mood disorder
