Schizophrenia and Psychotic Disorders -Murad Flashcards
What is the DSM IV criteria for Schizophrenia?
2 or more of the following:
- positive symptoms:
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized/catatonic behavior
- Negative symptoms: (flat affect, anergia, withdrawal, anhedonia (no pleasure))
- Social/occupational dysfunction
- duration > 6 months
- other mental d/o excluded
What is the difference between a hallucination and an illusion?
- hallucination: sensory perception without an external stimuli
- illusion: actual external stimulus that is misperceived
What are examples of psychosis?
- delusions
- hallucinations
- disorganized speech
- disorganized behavior or catatonic behavior
psychosis is NOT a dx but a symptom
What negative symptoms can be identified solely on observation?
reduced speech or reduced content of speech (words with little meaning)
poor grooming
limited eye contact
The DSM IV-TR criteria for Schizophrenia include all of the following Except? A. prominent delusions B. hallucinations C. disorganized behavior or speech D. continues signs of the disturbance
D. Continued signs of disturbance
What is schizophreniform disorder?
all criteria for schizophrenia met except ONLY from > 1 month to < 6 months
functioning preserved
absence of blunted/flat affect
good premorbid social and occupational functioning
Schizophrenic hallucinations are most commonly:
A tactile B auditory C visual D olfactory E gustatory
B auditory
can occur in any of the senses though
Negative symptoms of schizophrenia include all of the following except:
A flattened affect B loose associations C avolition D anhedonia E loss of spontaneity
B loose associations
this is a positive symptom
What are the different subtypes of schizophrenia?
- paranoid (does NOT require paranoia)
- undifferentiated
- disorganized
- residual
- catatonic
What is the dopamine hypothesis of schizophrenia?
What effects will increased dopamine have on the mesolimbic pathway and what effect will this have on schizophrenic pts?
What effect will an decrease in dopamine have on the mesocortical pathway and what effect will this have in schizophrenic pts?
dopamine levels related to schizophrenia–> increased dopamine found in the amygdala of postmortem schizophrenic pts
increase in dopamine in the mesolimbic pathway can cause the positive symptoms of schizophrenia
decrease in dopamine can lead to the under activity of the mesocortical pathway–> negative, cognitive and affective symptoms of schizophrenia
What is the effect of medication in a schizophrenic pt?
What happens with the treatment of the positive symptoms of schizophrenia?
medications generally establish anti-psychotic effects by blocking dopamine
the negative symptoms often become worse due to a decrease in the DA levels in the mesocortical pathway
Regarding the Dopamine hypothesis of Schizophrenia all of the following are correct except:
A. is the most most widely accepted hypothesis
B decreased DA activity is the core deficit in Schizophrenia
C is based upon evidence from studies of D-amphetamine
D is substantiated by evidence from anti-psychotic drug studies
E D1 and D5 receptors are present in high concentrations in the cortex and striatum
B. decreased DA activity is the core deficit in schizophrenia
the core deficit in schizophrenia is an increase in DA
What is delusional disorder?
Non-bizarre delusions (things that could potentially be real)
Criteria A schizophrenia met (+ and - s/s)
Functioning NOT impaired
Types: Erotomanic Grandiose Jealous Persecutory Somatic mixed
What is brief psychotic d/o?
Same as Schizophrenia but < 1 month in duration
What is the treatment for schizophrenia?
treat the underlying s/s
- correct dx is imperative for correct tx
- tx: symptom management!!
-normally need medication
can also use CBT for increasing Rx compliance and improving functioning
What are some side effects of antipsychotics?
- acute dystonia
- akathisia
- neuroleptic malignany syndrome
- perioral tremor
- tardive dyskinesia
atypical SEs:
- metabolic syndrome (HTN, DM, hyperlipidemia)
- cardio toxicity
- elevated prolactin
Clozapine (Clozaril) is an excellent antipsychotic because it: A has a low risk of agranulocytosis B produces almost no EPS side effects C starts working immediately D is relatively inexpensive E can be used as a first line drug
B produces almost no EPS side effects
Schizophrenic patients are at higher risk of mortality due to all of the following except:
A increased cigarette smoking
B increased sensitivity to Rx side effects
C obesity
D diabetes
E hypertriglyceridemia
B increased sensitivity to the Rx side effects
Which of the following are effective first line treatments for Schizophrenia? A anti-depressant medication B Zydis (Zyprexa, Olanzapine) C Clozapine (Clozaril) D ECT E CBT alone
B Zyprexa, olanzapine
anti-psychotics are the first line meds
The difference between Schizophrenia and Schizophreniform d/o is?
A delusions do not have to be present in Schizophreniform d/o
B the total duration for schizophreniform can be no longer than 6 months
C social or occupational dysfunction is only present in Schizophrenia
D major depression must be present in Schizophreniform d/o
B the total duration for schizophreniform can no longer be longer than 6 months
