Schizophrenia: Prodrome Flashcards

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1
Q

Why is pre-treatment for Schizophrenia controversial?

A

A) because one is treating a disease with medication that causes severe side effects, that is only a probability and false-positives may occur
B) Even predictions through genetic probability is ineffectual.
C) There is no indication how long one should be on medication and there is always the problem of adherence to medications.

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2
Q

Define Indicated Prevention

A

early intervention in patients presenting with prodromal symptoms to prevent psychosis

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3
Q

Benefits of reducing the Duration of Untreated Psychosis (DUP)

A
  1. Prevents or limits future severity
  2. Disorder is less chronic
  3. Prevents/limits collateral damage
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4
Q

Rapid intervention for 1st episode psychosis may result in ___

A

remission

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5
Q

What may still be present despite remission of symptoms?

A

Difficulties in everyday functioning

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6
Q

Defining symptom that may be present years before onset of psychosis

A

Social Withdrawal (as well as negative symptoms)

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7
Q

80-90% of people with schizophrenia reported these cognitive changes prior to psychosis

A

Perception,
Thinking,
Mood

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8
Q

Typical pattern (From prodromal to psychosis)

A

A) Non-specific symptoms and negative symptoms develop

Followed by B & C concurrently
B) Attenuated, mild, positive symptoms
C) Distress & decreased functioning

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9
Q

Assessments score for these Positive Symptoms

A
Unusual Thought content
Suspiciousness
Grandiosity
Perceptual Abnormalities
Conceptual Disorganization

Under The Counter, Suspicious Giant Purple Angels Chatter Dramatically

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10
Q

Assessments score for these Negative Symptoms

A
Social Isolation
Avolition
Decreased expression of emotion
Decreased experience of emotion
Decreased ideational richness
Deterioration in role functioning
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11
Q

What is Avolition?

A

Lack of motivation

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12
Q

What is ideational richness?

A

Difficulty in following conversations, making sense of familiar phrases, etc.

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13
Q

Assessments score for Disorganization

A

Odd Behavior/Appearance
Bizarre Thinking
Trouble focusing
Poor hygiene

Think Bizarro superman

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14
Q

Assessments score for general symptoms

A

Sleep disturbance
Dysphoric mood
Motor disturbance
Impaired stress tolerance

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15
Q

Notable cognitive declines in the prodrome include:

A

spatial working memory
verbal declarative memory
attention

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16
Q

This important aspect of social cognition is impaired in every stage of schizophrenia

A

Facial Affect Recognition

17
Q

PACE Study author

A

McGorrey (Australia)

18
Q

PACE Study experimental group and control group

A

Experimental Group: Risperidone 1-3 mg / day + modified CBT

Control: needs based intervention

19
Q

PACE study findings

A

9.7% treatment group progressed to psychosis vs. 36% in control

However, 6 months after the study concluded significance between groups disappeared as the treatment group progressing to psychosis increased to 19%

20
Q

PRIME study author

A

McGlashan (Yale)

21
Q

PRIME study experimental group and control group

A

Experimental Group: Olanzapine

Control Group: Placebo

22
Q

PRIME study findigs

A

At 8 weeks Experimental group was significantly better than placebo

At 1 year the split was 16% Olanzapine group vs 35% placebo group

In Year 2 the difference between groups disappeared as 33% in the experimental group converted to psychosis.

23
Q

EDIE study experimental group and control group

A

Experimental group: Cognitive Therapy

Control Group: monitoring

24
Q

EDIE study findings

A

Cognitive therapy was found to significantly reduce progression to psychosis after 12 months (6% experimental group vs 22% control).

After 3 years differences between groups disappeared.

25
Q

What is conceptual disorganization?

A

irrelevant, rambling, or incoherent verbalizations