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Clinical Disciplines (Melicia) > Schizophrenia Spectrum > Flashcards

Schizophrenia Spectrum Flashcards

1
Q

Is psychosis a disorder?

A

NO

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

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2
Q

What is psychosis?

A

delusions/hallucinations

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

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3
Q

What are perceptual distortions?

A

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

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4
Q

What are some positive sxs of of psychosis and schizophrenia?

A

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

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5
Q

What are some negative sxs of psychosis and schizophrenia?

A

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

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6
Q

What is Alogia?

A

restricted fluency and production of thought and speech

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7
Q

What is Avolition?

A

restriction in initiation of goal directed behavior

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8
Q

What is Anhedonia?

A

lack of pleasure

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9
Q

delusions

A

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

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10
Q

Persecutory delusions

A

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

(cheated on, spied on, followed, poisoned)

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11
Q

referential delusions

A

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

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12
Q

Grandiose delusions

A

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

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13
Q

Erotomatic delusions

A

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

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14
Q

Nihilistic delusions

A

involve the conviction that a major catastrophe will occur

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15
Q

somatic delusions

A

preoccupatations regarding health and organ func.

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16
Q

What are considered bizarre delusions

A

if they are clearly implausible and not understandable by others

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

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17
Q

What is a non-bizarre delusion?

A

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

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18
Q

What are hallucinations?

A

perception-like experiences that occur without an external stimulus

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19
Q

What are hypnagogic hallucinations? hypnopompic?

A

occur while falling asleep

occur when waking up

considered to be WNL

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20
Q

What is catatonic behavior?

A

a marked decrease in reactivity to the environment

ranges from resistance to lack of verbal and motor responses

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21
Q

What are 2 prominent negative sxs in schizophrenia?

A

diminished emotional expression and avolition

22
Q

What is avolition?

A

decrease in motivated self-initiated purposeful activities

23
Q

Asociality

A

lack of interest in social interactions

24
Q

Describe delusional disorder

A

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

25
Q

What are the delusional disorder subtypes?

A

erotomanic

Grandiose

Jealous

Persecutory

Somatic

Mixed

Unspecified

26
Q

Delusions disorder epidemiology

A

female > male

Men: more often paranoid delusions

women = more often erotomania

27
Q

Clinical features of delusional disorders

A

mental status: usually normal besides delusional beliefs

usually have little insight and impaired judgement regarding their delusions

28
Q

What is the most common type of delusional disorder?

A

persecutory

29
Q

Capgras syndrome

A

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

30
Q

Fregoli syndrome

A

a belief that a familiar person is “disguised” as someone else

31
Q

Cotard syndrome

A

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

32
Q

Delusional disorder tx

A

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

33
Q

Describe brief psychotic disorder

A

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
34
Q

Sxs of brief psychotic disorder

A

Abrupt onset of 1 or more: delusions, hallucinations, bizarre behavior/posture, disorganized speech

+/- associated sxs: affective sxs, disorientation, impaired attention, catatonic behavior

35
Q

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

A

brief psychotic disorder

36
Q

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

A

religious beliefs

37
Q

What is schizophrenia?

A

disorder of the brain affecting how people think, feel and perceive

hallmark sxs: hallucinations and delusions

38
Q

DSM 5 criteria for dx schizophrenia

A

2 or more:

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • negative sxs (diminished emotional expression or avolition)
39
Q

What is thought broadcasting delusion?

A

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

40
Q

What is thought withdrawal delusion?

A

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

41
Q

Delusions of reference

A

belief that all happenings revolve around oneself

42
Q

Positive sxs of schizophrenia

A

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

43
Q

Negative sxs of schizophrenia

A

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

44
Q

cognitive sxs of schizophrenia

A

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

45
Q

mood sxs of schizophrenia

A

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

46
Q

What are some common auditory hallucinations in schizophrenia?

A

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

47
Q

Tx of schizophrenia

A

antipsychotics (aka neuroleptics): non adherence, adverse effects

psychosocial management

48
Q

Goals of tx for schizophrenia pts according to recovery model

A
  • 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
49
Q

Describe schizoaffective disorder

A

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

50
Q

tx for schizoaffective disorder

A

pharmacotherapy and psychotherapy

(if depressive type- SSRI +antipsychotic)

neuro consult

Clinical Disciplines (Melicia) (9 decks)

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