Schizophrenia Spectrum Flashcards
5 domains of abnormalities
- delusions
- hallucinations
- disorganized thinking (speech)
- grossly disorganized or abnormal motor behavior (including catatonia)
- negative symptoms
delusions
fixed beliefs that are not amenable to change in light of conflicting evidence.
bizarre delusions
clearly implausible and not understandable to same-culture peers and do not derive from ordinary life experiences.
hallucinations
perception-like experiences that occur without an external stimulus
- auditory are the most common
2 common negative symptoms
diminished emotional expression and avolition
avolition
decrease in motivated self-initiated purposeful activities
schizotypal personality disorder
a pervasive pattern of social/interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships, and by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in various contexts.
schizotypal criteria
A: 5 or more of the following:
1. ideas of reference
2. odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms
3. unusual perceptual experiences, including bodily illusions
4. odd thinking and speech
5. suspiciousness or paranoid ideation
6. inappropriate or constricted affect
7. behavior or appearance that is odd, eccentric, or peculiar
8. lack of close friends or confidants other than 1st degree relatives
9. excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgements about self
B: doesn’t occur exclusively during the course of schizophrenia, bipolar disorder or MDD with psychotic features, another psychotic disorder, or autism spectrum disorder
delusional disorder criteria
A. the presence of 1+ delusions within a month or longer
B. criterion A for schizophrenia has never been met
C. apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd
D. if manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods
E. the disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder
delusional disorder specifiers
SPECIFY WHETHER
EROTOMANIC TYPE: another person is in love with them
GRANDIOSE TYPE: having some great (but unrecognized) talent or having made some important discovery
JEALOUS TYPE: their spouse or lover is unfaithful
PERSECTORY TYPE: being conspired against, cheated, followed, poisoned or drugged, harassed, or obstructed in the pursuit of long-term goals
SOMATIC TYPE: bodily functions or sensations
MIXED TYPE: no one delusional theme predominates
UNSPECIFIED TYPE: the dominant delusional belief cannot be clearly determined in the specific types (listed above)
SPECIFY IF
WITH BIZARRE CONTENT
SPECIFY IF:
1ST EPISODE, CURRENTLY IN ACUTE EPISODE
1ST EPISODE, CURRENTLY IN PARTIAL REMISSION
1ST 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
brief psychotic disorder criteria
A. presence of one or more of the following symptoms At least 1 of these must be 1,2, or 3
1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganized or catatonic behavior
B. duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning
C. the disturbance is not better explained by major depressive or bipolar disorder with psychotic features or another psychotic disorder and is not attributable to the effects of a substance or another medical condition
brief psychotic disorder specifiers
SPECIFY IF:
WITH MARKED STRESSOR(S): (brief reactive psychosis) if symptoms occur in response to events that, singly or together, would be markedly stressful to almost anyone in similar circumstances in that person’s culture
WITHOUT MARKED STRESSORS: if symptoms do not occur in response to an event like above
WITH PERIPARTUM ONSET: if onset is during pregnancy, or within 4 weeks postpartum
SPECIFY IF:
WITH CATATONIA
SPECIFY CURRENT SEVERITY
schizophreniform disorder criteria
A. 2+ of the following, each present for a sig. portion of time during a 1-month period (or less if successfully treated). At least one must be 1,2, or 3:
1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganized or catatonic behavior
5. negative symptoms
B. an episode lasts at least 1 month but less than 6 months. if the diagnosis is made without waiting for recovery, it’s “provisional”
C. schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1- no major depressive or manic episodes have occurred concurrently with active-phase symptoms, or 2- if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of illness
D. the disturbance is not attributable to the physiological effects of a substance or another medical condition
schizophreniform disorder specifiers
SPECIFY IF:
WITH GOOD PROGNOSTIC FEATURES: requires the presence of at least 2 of the following: onset of prominent psychotic symptoms within 4 weeks of the first noticeable change in usual behavior/ functioning; confusion or perplexity; good premorbid social and occupational functioning; and absence of blunted or flat affect
WITHOUT GOOD PROGNOSTIC FEATURES: if 2 or more of the above features have not been present
SPECIFY IF:
WITH CATATONIA
SPECIFY CURRENT SEVERITY
Schizophrenia criteria
A. two or more of the following, each present for a sig. portion of time during a 1-month period (or less if successfully treated). At least one must be 1,2, or 3
1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganized or catatonic behavior
5. negative symptoms
B. for a sig. portion of time since onset, the level of functioning in 1 or more major areas is markedly below the level prior to onset
C. continuous signs of the disturbance persist for at least 6 months. Must include at least 1 month of symptoms that meet criteria A and may include periods of prodromal or residual symptoms. During those periods, the signs may be only negative symptoms or by 2 or more criterion A symptoms in an attenuated form.
D. schizoaffective disorder and depressive or bipolar disorder with psychotic symptoms have been ruled out because either 1- no major depressive or manic episodes have occurred with the active-phase symptoms, or 2- if mood episodes have occurred during active-phase symptoms they have been present for a minority of the total duration of active/residual periods
E. the disturbance is not attributable to the physiological effects of a substance or another medical condition
F. with a history of autism spectrum or a communication disorder of childhood onset, schizophrenia is only diagnosed with prominent hallucinations or delusions