Schizophrenia & Psychotic Disorders (Morrison Ch. 2) Flashcards
Morrison describes “psychotic” as:
“out of touch with reality”
What is the term for a mental disorder if it resulted in ‘impairment that grossly interferes with the capacity to meet ordinary demands of life’ … or a ‘gross impairment in reality testing”?
Psychotic
What are the specific symptoms the DSM-5 uses for the term “psychotic”?
Delusions
Catatonic/Disorganized Behavior
Negative Symptoms
Disorganized Speech
Hallucinations
What are the decreasing abilities or loss of normal functions (affect, speech, avolition)?
Negative symptoms
What is an excess or distortion of normal functions (e.g. delusions, hallucinations, etc.)?
Positive symptoms
What refers to the ability to distinguish between reality and fantasy?
Reality testing
What are false beliefs about reality?
Delusions
(These are maintained despite enormous, obvious, incontrovertible proof to the contrary, and they are not widely believed in the person’s culture or subculture)
What kind of delusions are involved and exaggerated sense of one’s importance, power, ability or identify?
Grandiose delusions
What kind of delusions involve suspicions about a rival or about one’s partner being unfaithful?
Jealousy delusions
What kind of delusions involve themes of nonexistence, either of the patient, others or the world. “ My insides are gone”?
Nihilistic delusions
What kind of delusions happen when a person is convinced others are trying to harm, cheat, attack, or conspire against him or her?
Persecutory delusions
What kind of delusions is pertaining to the patient’s body, not consistent with cultural beliefs or with physiology or medicine?
Somatic delusions
What kind of delusions are beliefs that external events or people are sending messages or commands of great personal importance to the patient? (Songs, newscasters, and articles are directed toward me)
Ideas of reference
What kind of delusion contains:
- Thought withdrawal
- Thought insertion
- Delusions of control (one’s body or actions are being acted on or manipulated by some outside force)
Bizarre delusions
What are the perceptual experiences without external stimuli?
Hallucinations
What are six kinds of hallucinations?
- Auditory
- Visual
- Olfactory – smell
- Gustatory – taste (Bad)
- Somatic – physical sensation within body
- Tactile – being touched or something under skin
In order for a hallucination to count as psychotic, the experiences must occur while…
fully awake
What psychotic disorder contains these key features:
- Loose associations
- Illogical Thinking
- Perseveration
- Clanging
- Neologisms
- Echolalia
- Blocking
- Loss of abstract thinking
Disorganized Thinking (speech)
In Disorganized Thinking (speech), what is it called when someone leaps from subject to subject without the connections being clear? For example, “School is nice. I adore earlobes.”
Loose Associations
In Disorganized Thinking (speech), what is it called when someone states conclusions that contain clear, internal contradictions or are blatantly erroneous? For example, a patient refuses to go to the movies because the tickets are green.
Illogical Thinking
In Disorganized Thinking (speech), what is it called when someone uses persistent repetition of speech or movement?
Perseveration
In Disorganized Thinking (speech), what is it called when someone uses the sound of a word, instead of its meaning, dictates the course of subsequent associations? “Ding, dong, dell. .”
Clanging
In Disorganized Thinking (speech), what is it called when someone uses distortions of words or new words that a patient invents?
Neologisms
In Disorganized Thinking (speech), what is it called when someone uses meaningless, persistent, verbal repetition of words or sounds heard, often with a mocking, mumbling, staccato or parrot-like tone.
Echolalia
In Disorganized Thinking (speech), what is it called when a person’s train of thought abruptly and unexpectedly stops?
Blocking
What kind of psychotic disorder manifests itself in a variety of ways, ranging from childlike silliness to unpredictable agitation?
- Dressing unusually (e.g. wearing multiple overcoats, scarves, and gloves on a hot day).
- Inappropriate sexual behavior (e.g. disrobing in public)
- Unpredictable and untriggered agitation (e.g. showing or swearing all of a sudden for no apparent reason)
Grossly Disorganized/Abnormal Motor Behavior
In Grossly Disorganized/Abnormal Motor Behavior, what is it called when the patient may be immobile, mute, and unresponsive, yet fully conscious?
Catatonic stupor
In Grossly Disorganized/Abnormal Motor Behavior, what is it called when the patient may show uncontrolled and aimless motor activity?
Catatonic excitement
In Grossly Disorganized/Abnormal Motor Behavior, what is it called when the patient may show a repeated movement that is not goal-directed (e.g. rocking back and forth)?
Stereotypy
In Grossly Disorganized/Abnormal Motor Behavior, what is it called when the patient imitates the movements and gestures of another person?
Echopraxia
What kind of psychotic disorder has the following features?
- Alogia
- Affective flattening or blunting
- Avolition
- Anhedonia
- Asociality
Negative Symptoms
With Negative Symptoms, what is it called when the patient has a diminution in the amount of spontaneous speech or a tendency to produce speech that is empty or impoverished in content when the amount is adequate?
Alogia
With Negative Symptoms, what is it called when the patient has a reduced intensity of emotional expression and response?
Affective flattening or blunting
With Negative Symptoms, what is it called when the patient has a loss of the ability to initiate goal-directed behavior and carry it through to completion?
Avolition
With Negative Symptoms, what is it called when the patient has the inability to experience pleasure, and no longer able to enjoy activities that previously gave them pleasure?
Anhedonia
With Negative Symptoms, what is it called when the patient has a lack of interest in social interaction?
Asociality
What are the psychotic disorders in the DSM-5?
- Schizotypal (personality) disorder
- Delusional Disorder
- Brief Psychotic Disorder
- Schizophreniform Disorder
- Schizophrenia
- Schizoaffective Disorder
- Substance/ Medication-Induced Psychotic Disorder
- Psychotic Disorder, other medical condition
- Catatonia
What psychotic disorder is “the most debilitating and costly of all adult psychiatric illnesses”?
Schizophrenia
What psychotic disorder is characterized by impairments in social functioning, including difficulty establishing and maintaining interpersonal relationships, problems working or fulfilling other instrumental roles (e.g., student, homemaker, employee) and difficulties caring for oneself (e.g., poor grooming and hygiene.)
Schizophrenia
What psychotic disorder is NOT a “split personality” but rather a “shattered or fragmented personality”?
Schizophrenia
What are three important notes about people living with Schizophrenia?
- Many rely on others to meet their daily living needs and live with relatives
- It is estimated between 10-20% of homeless persons have schizophrenia
- Some individuals can be high functioning members of society
What Psychotic Disorder has:
1) 2 or more of the following, each present for a significant portion of time during a 1 month period.
- 1) Delusions
- 2) Hallucinations
- 3) Disorganized speech (e.g., frequent derailment or incoherence)
- 4) Grossly disorganized or catatonic behavior
- 5) Negative symptoms, i.e., affective flattening, alogia, or avolition
2) Social/occupational dysfunction
Schizophrenia
What is the duration of signs of disturbance for someone with Schizophrenia?
- Continuous signs of disturbance persist for 6 months.
- This 6 month period must include 1 month of symptoms
What are the 3 phases of Schizophrenia?
- Prodromal Phase
- Active Phase
- Residual Phase
Which phase of Schizophrenia typically occurs in the mid to late teens or early 20s, characterized by changes in emotional cognitive, and social functioning?
- Deteriorated function, such as hygiene maintenance
- Negative symptoms predominant
Prodromal Phase
Which phase of Schizophrenia is when positive psychotic symptoms develop?
Active Phase
Which phase of Schizophrenia is when active phase symptoms are absent or no longer prominent? (They are still impaired –may have trouble functioning and continue to experience negative symptoms)
Residual Phase
What is the prevalence of Schizophrenia?
- 0.08 -1.0% of the
population - Afflicts men slightly more frequently than women
- Approximately the same occurrence in European and African Americans
- Greater prevalence among low SES
What is the etiology of Schizophrenia?
- No clear mechanism has been established
- Strong evidence for genetic as well as environmental influences
- Involve abnormalities of the brain’s anatomical structure and function which in turn are associated with perceptual, cognitive, physiological and behavioral abnormalities
What is a fun fact about some people with Schizophrenia?
They are able to tickle themselves because of a different brain structure, and may not make a distinction between themselves and others.
Which disorder is characterized by the presence of well-systematized, non-bizarre delusions accompanied by affect appropriate to the delusion?
Delusional Disorder
How long must delusions have lasted to be diagnosed with Delusional Disorder?
At least 1 month.
What are the subtypes of Delusional Disorder?
- Persecutory type
- Erotomanic type
- Grandiose type
- Jealous type
- Somatic type
Which Psychotic Disorder’s behavior is generally not odd or bizarre apart from the delusions, and not better explained by a mood disorder, substance use, or a medical condition?
Delusional Disorder
Which Psychotic Disorder has a presence of either a depressive or a manic episode concurrently with symptoms characteristic of Schizophrenia?
Schizoaffective Disorder
For Schizoaffective Disorder, Hallucinations or delusions must be present for ______ in absence of prominent mood symptoms, but mood symptoms must be present for a substantial portion of the total duration of the illness.
2 weeks or more
Which Psychotic Disorder has the same symptoms of Schizophrenia, with a briefer duration of 1-6 months?
Schizophreniform Disorder
What is a key differentiator in diagnoses of Schizophreniform Disorder and Schizophrenia?
Schizophreniform must recover fully within 6 months
About ____ of those with this Schizophreniform Disorder are later diagnosed with Schizophrenia?
Half
What Psychotic Disorder does Morrison describe as, “A place to park your patient while you gather more information”?
Schizophreniform Disorder
What is the main distinguishing point of a Brief Psychotic Disorder?
Duration
Which Psychotic Disorder must have psychotic symptoms for at least 1 day, but complete recovery within 1 month?
Brief Psychotic Disorder
Which Psychotic Disorder is sometimes given to women showing psychosis around the time of birth (postpartum psychosis)?
Brief Psychotic Disorder
