schizophrenia and psychotic disorders

Question 1

schizophrenia spectrum and other psychotic disorders are a group of disorders involving what 3 things?

Answer 1

1. Severely impaired cognitive processes
   unusual or disordered thought processes
   perceptual disturbances
2. Personality disintegration/deterioration
3. Social withdrawal

Question 2

lifetime prevalence of schizophrenia? men or women more?

Answer 2

1-2%

men

Question 3

is schizophrenia the same as “split personality”?

Answer 3

NO!

Question 4

when is the onset of schizophrenia?

Answer 4

early adulthood

Question 5

hallucination

Answer 5

sensory perceptions not attributable to environmental stimuli

Question 6

delusion

Answer 6

firmly held false personal beliefs

Question 7

poverty of speech

Answer 7

lack of meaningful speech/limited output of speech (don’t give detail)

Question 8

avolition

Answer 8

inability to take goal oriented action (doing laundry, going to work, paying bills)

Question 9

loosening of associations vs disordered thinking

Answer 9

Loosening of associations – shifting from topic to topic

Disordered thinking – doesn’t make sense

Question 10

catatonia

Answer 10

extreme loss of motor ability or constant hyperactive motor activity
*waxy flexibilty- someone else can change their body position and they will stay there

Question 11

echolalia vs echopraxia

Answer 11

Echolalia – parrotlike repetition of word or phrase spoken by another person
Echopraxia – repetitive imitation of movements of another person

Question 12

pyschotic symptoms are divided into what two categories?

Answer 12

positive: added factors
negative: detracted factors

Question 13

positive symptoms: (5)

Answer 13

manifestations of psychosis: 
Hallucinations
Bizarre behavior
Delusions
Disorganization of speech
Thought disorder

Question 14

negative symptoms: (8)

Answer 14

lack of normal functions: 
Flat affect
Poverty of speech 
Avolition
Social withdrawal
Poor grooming
Anhedonia
Difficulty with abstract thinking
Barren thought content

Question 15

schizophrenia and other pyschotic disorders have abnormalities in the following 5 “domains”…

Answer 15

Delusions
Hallucinations
Disorganized thinking (speech)
Grossly disorganized or abnormal motor behavior
Negative symptoms

Question 16

6 types of schiz. / other psychotic disorders

Answer 16

Schizophrenia
Schizophreniform Disorder
Schizoaffective Disorder
Brief Psychotic Disorder
Delusional Disorder
Schizotypal Personality Disorder

Question 17

schizophrenia Dx: has abnormalities in how many of the “domains”? how long must they have this for, for the dx?

Answer 17

2 or more domains during a month (may change month to month)
with the entire thing for at least 6 months

Question 18

what are the 3 phases of schizophrenia?

Answer 18

Three Phases (typical)

1. Prodromal Phase – onset and buildup of Sz sxs. Negative symptoms present.
2. Active/Progressive Phase – psychotic symptoms, positive symptoms predominate (“Psychotic Break”)
3. Residual Phase – active symptoms decline; prodromal symptoms remain

Question 19

Review found ___ in ___ during first psychotic episode commits an act of serious violence

Answer 19

1 in 6

Question 20

what defines a BRIEF psychotic disorder ?

Answer 20

• No longer than 1 month
• Returns to premorbid level of functioning
• Commonly encountered after catastrophic event

Question 21

schizophreniform disorder: timeframe and symptoms

Answer 21

1-6 months

Same symptoms as Sz

Question 22

schizoaffective disorder: symptoms?

Answer 22

Meets criteria for Sz (criterion A) as well as MDE or Manic episode
- aka with major depression or bipolar 1

Question 23

delusional disorder: timeframe and symptoms

Answer 23

• Presence of 1 or more delusions
• 1 month or more in duration; functioning not markedly impaired
• Criterion A for Sz has never been met

Question 24

genetics and schizophrenia

Answer 24

twin- MOST risk (40-65% chance)
1st degree relative- 10x risk
2nd degree relative- greater risk

Question 25

what is the diathesis-stress model?

Answer 25

the BEST explanation for schizophrenia : a genetic- environment link: neurodevelopmental disease that emerges when environmental stress is imposed

Question 26

when might someone be hospitalized for schizophrenia?

Answer 26

Inability to care for self

Danger to self or others

Question 27

two medication options for schizophrenia

Answer 27

1. 1st gen “typical” anti-pyschotic drugs

2. 2nd gen “atypical” anti-pyschotic drugs

Question 28

what are the 1st gen anti-pyschotic drugs? what are there ADRs?

Answer 28

haloperidol, chlorpromazine, thioridazine, fluphenazine

ADRs: more extrapyramidal side effects (EPS) (rigidity, bradykinesia, and tremor resembling Parkinson’s disease; severe restlessness known as akathisia; and abnormal involuntary movements known as tardive dyskinesia

Question 29

what are the 2nd gen anti-pyschotic drugs? ADRs?

Answer 29

risperidone, clozapine, quetiapine

ADRs: fewer side effects, less risk of EPS

Question 30

4 types of pychotherapy for schizophrenia

Answer 30

1. Cognitive Behavioral Therapy: Develop coping methods
   Develop rational cognitive perspectives about symptoms
2. Family Psychoeducation
3. Personal Therapy
4. Compliance Therapy

Question 31

personal therapy vs compliance therapy

Answer 31

Personal Therapy: Long term, focuses on affect regulation and adaptive responses to stress

Compliance Therapy: Short intervention during acute illness phase. Motivational interviewing for medication adherence

Question 32

The most accepted etiological theory for schizophrenia is…

Answer 32

diathesis- stress model (gene + environment stressor)