Schizophrenia Spectrum

Question 1

Is psychosis a disorder?

Answer 1

NO

it is a defining feature in other disorders (i.e. schizophrenia, substance/med induced psychotic disorders, delusional disorder, etc.)

Question 2

What is psychosis?

Answer 2

delusions/hallucinations

generally also includes sxs such as disorganized speech, disorganized behavior and gross distortions of reality

Question 3

What are perceptual distortions?

Answer 3

being distressed by hallucinatory voices; hearing voices that accuse, blame or threaten punishment, seeing visions

Question 4

What are some positive sxs of of psychosis and schizophrenia?

Answer 4

delusions, hallucinations, distortions or exaggeration in language/communication, catatonic behavior, agitation

Question 5

What are some negative sxs of psychosis and schizophrenia?

Answer 5

blunted affect, emotional withdrawal, apathetic social withdrawal, alogia, avolition, anhedonia

Question 6

What is Alogia?

Answer 6

restricted fluency and production of thought and speech

Question 7

What is Avolition?

Answer 7

restriction in initiation of goal directed behavior

Question 8

What is Anhedonia?

Answer 8

lack of pleasure

Question 9

delusions

Answer 9

fixed beliefs that are not amenable to change in light of conflicting evidence

Question 10

Persecutory delusions

Answer 10

belief that one is going to be harmed/harassed by someone or something

(cheated on, spied on, followed, poisoned)

Question 11

referential delusions

Answer 11

belief that certain gestures, comments, environmental cues etc. are directed at them

Question 12

Grandiose delusions

Answer 12

when an individual believes that they have exceptional abilities, wealth or fame

Question 13

Erotomatic delusions

Answer 13

when an individual believes falsely that another person is in love with them

Question 14

Nihilistic delusions

Answer 14

involve the conviction that a major catastrophe will occur

Question 15

somatic delusions

Answer 15

preoccupatations regarding health and organ func.

Question 16

What are considered bizarre delusions

Answer 16

if they are clearly implausible and not understandable by others

(belief that organs were switched with someone else w/o leaving any scars)

Question 17

What is a non-bizarre delusion?

Answer 17

ex. belief that one is under surveillance by police without any proof

Question 18

What are hallucinations?

Answer 18

perception-like experiences that occur without an external stimulus

Question 19

What are hypnagogic hallucinations? hypnopompic?

Answer 19

occur while falling asleep

occur when waking up

considered to be WNL

Question 20

What is catatonic behavior?

Answer 20

a marked decrease in reactivity to the environment

ranges from resistance to lack of verbal and motor responses

Question 21

What are 2 prominent negative sxs in schizophrenia?

Answer 21

diminished emotional expression and avolition

Question 22

What is avolition?

Answer 22

decrease in motivated self-initiated purposeful activities

Question 23

Asociality

Answer 23

lack of interest in social interactions

Question 24

Describe delusional disorder

Answer 24

the presence of one or more delusions with a duration of one month or longer

Question 25

What are the delusional disorder subtypes?

Answer 25

erotomanic Grandiose Jealous Persecutory Somatic Mixed Unspecified

Question 26

Delusions disorder epidemiology

Answer 26

female > male Men: more often paranoid delusions women = more often erotomania

Question 27

Clinical features of delusional disorders

Answer 27

mental status: usually normal besides delusional beliefs usually have little insight and impaired judgement regarding their delusions

Question 28

What is the most common type of delusional disorder?

Answer 28

persecutory

Question 29

Capgras syndrome

Answer 29

a belief that a familiar person has been replaced with an identical "imposter"

Question 30

Fregoli syndrome

Answer 30

a belief that a familiar person is "disguised" as someone else

Question 31

Cotard syndrome

Answer 31

pts believe that they have lost all of their possessions, status and strength as well as their entire being including their organs

Question 32

Delusional disorder tx

Answer 32

challenging to tx establish alliance and negotiate sxs tx goals meds for sxs of depressed mood or irritability outpt (unless harm to self or others) +/- antipsychotics psychotherapy

Question 33

Describe brief psychotic disorder

Answer 33

presence of one or more of the following sxs (at least one must be in first 3) - Delusions - Hallucinations - Disorganized speech - Grossly disorganized or catatonic behavior

Question 34

Sxs of brief psychotic disorder

Answer 34

Abrupt onset of 1 or more: delusions, hallucinations, bizarre behavior/posture, disorganized speech +/- associated sxs: affective sxs, disorientation, impaired attention, catatonic behavior

Question 35

emotional volatility, outlandish dress/behavior, screaming or muteness, and impaired memory for recent events are commonly seen in which disorder?

Answer 35

brief psychotic disorder

Question 36

What must you always take into account when making a judgement about whether a pts beliefs are delusional?

Answer 36

religious beliefs

Question 37

What is schizophrenia?

Answer 37

disorder of the brain affecting how people think, feel and perceive hallmark sxs: hallucinations and delusions

Question 38

DSM 5 criteria for dx schizophrenia

Answer 38

2 or more: - Delusions - Hallucinations - Disorganized speech - Grossly disorganized or catatonic behavior - negative sxs (diminished emotional expression or avolition)

Question 39

What is thought broadcasting delusion?

Answer 39

the belief that one's thoughts are being broadcast or transmitted to others

Question 40

What is thought withdrawal delusion?

Answer 40

the belief that one's thoughts are being removed from their mind

Question 41

Delusions of reference

Answer 41

belief that all happenings revolve around oneself

Question 42

Positive sxs of schizophrenia

Answer 42

psychotic sxs (i.e. hallucinations-auditory, delusions and disorganized speech and behavior)

Question 43

Negative sxs of schizophrenia

Answer 43

decrease in emotional range, poverty of speech, loss of interests and drive...they have tremendous inertia

Question 44

cognitive sxs of schizophrenia

Answer 44

deficits in working memory, attention and in executive functions such as the ability to organize and abstract

Question 45

mood sxs of schizophrenia

Answer 45

pts often seem cheerful or sad in a way that is dif. to understand, often depressed

Question 46

What are some common auditory hallucinations in schizophrenia?

Answer 46

hearing own thoughts spoken by another voice, hearing voices arguing, hearing voices commenting on one's own behavior

Question 47

Tx of schizophrenia

Answer 47

antipsychotics (aka neuroleptics): non adherence, adverse effects psychosocial management

Question 48

Goals of tx for schizophrenia pts according to recovery model

Answer 48

- to have few or stable sxs - to avoid hospitalization - to manage his or her own funds/meds - to be working or in school at least half time

Question 49

Describe schizoaffective disorder

Answer 49

an uninterrupted period of illness during which there is a major mood episode (depressive or manic) concurrent with schizophrenia

Question 50

tx for schizoaffective disorder

Answer 50

pharmacotherapy and psychotherapy (if depressive type- SSRI +antipsychotic) neuro consult