Schizophrenia and Psychotic Disorders Flashcards
Schizophrenia vs schizoaffective vs schizophreniform
Schizophrenia
Schizoaffective: major mood episode with schizophrenia
Schizophreniform: Pre-schizophrenia
Schizophrenia overall
2/5 symptoms for at least one month, with at least symptom 1, 2, or 3 (delusions, hallucinations, disorganized speech)
Level of functioning (work, relationships, self-care) is below baseline prior to onset (clinically significant portion)
Disturbance for 6 months, with at least one month of symptoms in A (Active phase)
Rule out schizoaffective and depressive/bipolar with psychotic features
Not substance of medical condition
If history of ASD or communication disorder, only schizo if prominent delusions or hallucinations
Schizophrenia Symptoms
Criteria A
2/5 for at least one month, with at least 1, 2, or 3
Delusions
Hallucinations
Disorganized Speech
Grossly disorganized or catatonic behavior
Negative symptoms
Delusions
A cognitive error, though, erroneous belief
Hallucinations
Erroneous sensory experience, can happen in all sensory modalities (auditory, physical, etc.)
Catatonia
Decrease responsivity to enviornment
there is a diagnosis about this, lots of types, don’t want to learn
Phases of Schizophrenia
Prodromal phase: gearing up to active phase, can include only negative symptoms, symptoms attenuated form (not full delusion, but odd beliefs)
Active Phase: Full symptoms
Residual periods: some symptoms, but in attenuated form, often after they have treatment. Mostly negative symptoms
6 months can include all of these, the one month period refers to active phase
Schizophrenia Specifiers
General psychotic specifiers (See later)
Negative vs Positive Symptoms
Negative: things we expect to be there but aren’t there (diminished expression, avolition) –> harder to treat
Positive symptoms: hallucinations, delusions –> more amenable to treatment
Avolition
Lack of goal directed activity
Schizoaffective
Major mood episode (depressive or manic) with criterion A of schizophrenia (if depressive episode need depressed mood)
Delusions or hallucinations for 2 weeks without major mood episode
Major mood episode symptoms present for majority of illness (residual, active)
Not from substance or medical condition
Schizoaffective Specifiers
Specify if bipolar or depressive type
Bipolar type: Manic episode part of presentation, depressive might also occur
Depressive: only if major depressive episode part of presentation
Schizophreniform
2/5 symptoms for at least one month, with at least symptom 1, 2, or 3 (delusions, hallucinations, disorganized speech)
Lasts at least 1 month, but less than 6 months
Rule out schizoaffective and depressive/bipolar with psychotic features
Not substance of another medical condition
Schizophreniform, how qualify if still less than 6 months, waiting to see if recover
Provisional
Schizophreniform Symptoms
2/5 for at least one month, with at least 1, 2, or 3
Delusions
Hallucinations
Disorganized Speech
Grossly disorganized or catatonic behavior
Negative symptoms
Schizophreniform Specifiers
With or without good prognostic features:
**Look at negative symptoms and rate of decline. More hopeful prognosis:
- Fewer negative symptoms
- Quick onset (slower onset is worse)
Catatonia
Severity (optional but useful)
Brief Psychotic Disorder
1/4 symptoms with at least 1, 2, or 3
At least 1 day but less than one month, with return to premorbid level of functioning
Not MDD/bipolar disorders with psychotic features, or other psychotic disorder like schizophrenia
Brief Psychotic Disorder symptoms
1/4 symptoms with at least 1, 2, or 3
Delusions
Hallucinations
Disorganized Speech
Grossly disorganized or catatonic behavior
**not looking at negative symptoms
Brief Psychotic Disorder Specifiers
Stressor (with or without marked stressor)
Peripartum onset
Cataonia
Current severity
Peripartum
The period shortly before, during, and immediately after giving birth
Delusional Disorder
At least one delusion with duration of 1 month
Never met criteria for schizophrenia (if hallucinations present they are small and related to delusion)
Apart from delusion, function well
If manic or depressive episodes, shorter in duration than delusional periods
not from substance or medical condition
Delusional Disorders Specifiers
Type
If with Bizarre Content
Episode number (first episode, multiple episodes, continuous, unspecified) and episode status (acute, or partial/full)
Severity
Delusional Disorders Specifiers: Episode and remission
First episode, currently in acute episode
First episode, currently in partial remission
First episode, currently in full remission
Multiple episodes, currently in acute episode
Multiple episodes, currently in partial remission
Multiple episodes, currently in full remission
Bizarre vs non-bizarre delusional content
Non-bizarre: something that could happen to somebody, but probably not happening to this person. Ex. The FBI is tapping my phone. We know the FBI does this, but probably not happening for this one person
Bizarre: something that isn’t happening to anyone. Ex. Aliens abducted me, implanted a baby in me, and returned me with no scars
