Schizophrenia And Spectrum Disorders Flashcards
What is the duration of brief psychotic disorder?
1 day to 1 month
What is the duration of schizophreniform disorder?
> 1 month but <6 months
What type of hallucinations usually occur in schizophrenia
Auditory
Others (visual, olfactory, gustatory, tactile) = substance (esp cocaine with tactile) or medical cause (esp epilepsy aura) until proven otherwise
Name 8 content specifiers for delusional disorder
- Erotomatic type (important person loves/cares)
- Grandiose type
- Jealous type
- Persecutory type(believe others want to harm him)
- Somatic type
- Mixed type
- Unspecified type eg Capgra’s (familiar belief/person replaced by imposter), Fregoli’s (familiar person can change form)
- With bizarre content
Schizophrenia age of onset for genders?
Male: 10-25 years
Female: 25-35 years, 2nd peak in middle age
After 45= late onset schizophrenia
Name 10 risk factors of a schizophrenic patient at risk of suicide.
- Young
- White
- Male
- Unmarried
- Excessive treatment dependant
- Good pre-morbid function
- Substance abuse
8-awareness of illness - Loss in faith of treatment
- Fear of further mental deterioration
Etc
Which hormone and anatomical regions are. suspected to be involved positive and negative symptoms of in schizophrenia? ( 4)
Dopamine.
Positive symptoms by hyperactivity da pathways in limbic and mesolimbic areas
Negative by hypoactivity in prefrontal and neocortical pathways
Also involvement, glutamate, na, 5ht
Name and describe the 4 neurodevelopmental stages of schizophrenia
1 risk: genetic, environmental, subtle behavioural changes
- prodrome: changes in thoughts, social isolation, impaired functioning
- Onset of psychosis: positive, negative, cognitive symptoms
- Chronic disability stage: psych deficits, unemployed, homeless, incarceration, 7% suicide rate, obesity and smoking
Dsm-5 criteria for schizophrenia? (8)
1. 2 or more of the following symptoms of which at least 1 is the first 3. Must be present for at least 1 month • delusions • hallucinations • Disorganised speech • disorganised or catatonic behaviour • Negative symptoms 2. Continuous disturbance for 6 months (attenuated, residual symptoms ) 3. Social or occupational dysfunction
Name 10 good prognostic factors for schizophrenia
- Late age onset
- Obvious precip factors
- Acute onset
- Good premorbid, social, sexual and work study
- Mood disorder symptoms
- Married
- Family history mood disorder
8- good support system - Positive symptoms
- No neurological signs and symptoms, no perinatal trauma, remission in 3 years
Clinical features of schizotypal personality disorder? (5)
• Pervasive pattern since childhood • eccentric, magical thinking • odd beliefs • excessive social anxiety • odd eccentric behaviour/appearance Malignant! Most likely personality disorder to move to psychiatric disorder or syndrome Frank psychosis absent
Clinical features schizoid personality disorder?
Think of Mr robot
• No interest in having relationships
• reclusive to self, “loner”
• usually work night jobs
How is delusional disorder diagnosed? (5) (time, criteria, functioning, onset, mood symptoms)
- Non-bizarre delusions for more than 1 month
- criteria A for schizophrenia never met
- functioning not markedly impaired, behaviour not odd or bizarre
- insidious (gradual) onset
- if mood episodes have occurred with delusions, they’ve been brief.
How is schizo affective disorder diagnosed? (3)
- Uninterrupted period of illness with mde/ manic episode/ mixed episode (aka mood episode), and concurrent with criteria A for schizophrenia
- Period of delusions and hallucinations for 2 weeks in absence of prominent mood symptoms
- mood episode present for substantial portion of total duration illness, > 50%
Brief psychotic disorder criteria A
Presence of one or more, at least 1 must be 1,2 or 3
- Delusions
- Hallucinations
- Disorganised speech eg frequent derailment, incoherence
- Grossly disorganised or catatonic behaviour
Criteria a of schizoaffective disorder
Uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with critenia a of schizophrenia
Criteria B of schizoaffective disorder (delusions and hallucinations)
Delusions or hallucinations for 2 or more weeks in absence of major mood episode, depressive or manic , during lifetime duration of iness
Criteria C of schizoaffective disorder (mood episodes )
Symptoms that meet criteria for major mood episode are present for majority of total duration of active and residual portions of illness
Which disorder describes transfer of delusions from one person to another?
Shared psychotic disorder
Name 5 negative symptoms of schizophrenia
5 As
- asocial
- anhedonia
- affective blunting
- alogia
- avolition ( lack motivation to interact with environment)
Name 4 presentations that fall under other specified schizophrenia spectrum and other psychotic disorder
- Persistent auditory hallucinations in absence of any other features
- delusions with significant overlapping mood episodes
- attenuated psychosis syndrome
- delusional symptoms in partner of individual with delusional disorder
Name 8 course specifiers for delusional disorder that can only be used after 1 year duration
- 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
- continuous
- unspecified
Name 4 specifiers brief psychotic disorder
- With marked stressor(s )
- without marked stressor(s )
- with postpartum onset (during pregnancy / within 4 weeks pp)
- with Catatonia
Name 3 specifiers schizophreniform disorder
- With good prognostic features: at least 2 - onset psychosis within 4 weeks of first noticeable change in behaviour/functioning, good premorbid social + occupational functioning, confusion/perplexity, absence of blunted / flat affect
- without good prognostic features
- with Catatonia
