Schizophrenia & Other Psychotic Disorders Flashcards
Delusions
false beliefs that are firmly held despite what almost everyone else believes or the existence of contradictory evidence
Types:
Persecutory- person thinks he or she is being followed, tricked, or spied on
Referential- person believes that passages from books and newspapers or other messages are specifically directed at him or her
Bizarre- the person’s delusions are outside the range of ordinary life experience
Hallucinations
perception-like experiences that occur without an external stimulus;
this may affect any sensory modality, but auditory hallucations are most frequent and often take the form of pejorative or threatening voices or a running commentary on the person’s thoughts or actions
Disorganized thinking
usually inferred from the individual’s speech; often invovles a loosening of associations that is manifested as incoherence, answers or comments that are unresponsive to questions, and “slipping off the track” from one topic to another
Grossly disorganized or abnormal motor behavior
can take several forms including unpredictable agitation, a markedly disheveled appearance, clearly in appropriate sexual behavior, or catatonia (decreased motor activity and reduced reactivity to environmental stimuli
Negative symptoms
involve a restriction in the range and intensity of emotions and other functions and include blunted emotional expression, anhedonia (decreased ability to experience pleasure), asociality (lack of interest in social interactions), alogia (diminished speech output), and avolition (restricted initiation of goal-directed behavior
Delusional Disorder
the presence of one or more delusions that last at least one month; Overall, psychosocial functioning is not markedly impaired, and any impairment is directly related to the delusions
Subtypes:
- Erotomanic- person believes that someone is romantically in love with him/her
- Grandiose- person believes that he/she has great but unrecognized talent or insight or has made an important discovery
- Jealous- person believes that his/her spouse or lover is unfaithful
- Persecutory- person believes that he/she is being conspired against, cheated, spied on, poisoned, etc.
- Somatic- person believes that he/she has an abnormal bodily function or sensation
- Mixed
- Unspecified
Schizophrenia
requires the presence of at least two active phase symptoms (delusions, hallucinations, disorganized speech, grossly disorganized behavior, negative symptoms) for at least one month with at least one symptom being delusions, hallucinations or disorganized speech; must be continuous signs of the disorder for at least 6 months; must cause significant impairment in functioning
Associated Features of Schizophrenia
inappropriate affect, dysphoric mood, disturbed sleep pattern, and lack of interest in eating
Anosognosia- poor insight into their illness
Risk for violent behavior is no greater for people with Schizophrenia
.3-.7% prevalence; slightly lower for females than males
Often misdiagnosed in African Americans
Course/Prognosis of Schizophrenia
onset is usually between the late teens and early 30s with the peak age of onset being in the early to mid20s for males and the late 20s for females; complete remission is rare
Better prognosis is associated with good permorbid adjustment, an acute or late onset, female gender, the presence of a precipitating event, a brief duration of active-phase symptoms, insight into the illness, family history of a mood disorder, and no family history of Schizophrenia
Etiology of Schizophrenia
substantially higher among first-degree biological relatives than the general population
Concordance Rates: Biological sibling: 10% Fraternal (diszygotic twin)= 17% Identical (monozygotic) twin= 48% Child of two parents with Schizophrenia= 46%
Also higher for people born in late winter or early spring; possible link between schizophrenia and prenatal exposure to an influenza virus
Brain abnormalities linked to schizophrenia
Enlarged ventricles is the most common structural brain abnormality
Smaller than normal hippocampus, amygdala, and globus pallidus
Hypofrontality has been linked to the negative symptoms of schizophrenia and refers to lower-than-normal activity in the prefrontal cortex as measured by cerebral blood flow and glucose metabolism
Dopamine Hypothesis
first biochemical explanation for Schizophrenia and attributes it to elevated dopamine levels or oversensitive dopamine receptors
New research says may differ for positive and negative symptoms of disorder and include serotonin, glutamate, and GABA
Treatment of Schizophrenia
antipsychotic (neuroleptic) drugs
Traditional (first generation) antipsychotics- include haloperidol and fluphenazine; most useful in eliminating positive symptoms, but severe side effects such as tardive dyskinesia
Atypical (second-generation) antipsychotics- include clozapine and risperidone; less likely to cause tardive dyskinesia and may be effective for reducing both positive and negative symptoms
Schizophreniform Disorder
criteria is identical to schizophrenia except that the disturbance is present for at least one month but less than six months; impaired social or occupational functioning may occur but is not required; about 2/3 of people will eventually meet criteria for Schizophrenia or Schizoaffective Disorder
Brief Psychotic Disorder
characterized by the presence of one or more of four characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior) with at least one symptom being delusions, hallucinations, or disorganized speech; symptoms are present for at least one day but less than one month with an eventual return to premorbid functioning; onset of this disorder often follows exposure to an overwhelming stressor
