Schizophrenia Spectrum

Question 1

Erotomanic delusion

Answer 1

are delusions that involve romance. Patients with this type of delusion will often falsely believe that someone else is in love with them
delusion may be someone known to the patient (e.g., friend, acquaintance) or unknown to the patient (e.g., celebrity)

Question 2

Grandiose delusions

Answer 2

delusions that center around the patient believing they have abilities that are beyond what is expected of the individual. These delusions may also involve claims of wealth or fame

Question 3

Persecutory delusions

Answer 3

delusions involve the patient being focused on being harmed or harassed by another individual, organization, or group
MC type of delusion in psychotic d/o

Question 4

Nihilistic delusions

Answer 4

the belief that the world, body, or a body part have ceased to exist or that there is an impending catastrophic event

Question 5

What does anosognosia mean?

Answer 5

Poor insight

Question 6

Schizoaffective
Pt:
Dx:
Tx:

Answer 6

Pt: Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative sx

Dx: Must have: delusions or hallucinations x2+ weeks in the absence of major mood episode
Meets dx for schizophrenia + meets dx for mood d/o (manic or depressive)

Tx:
Antipsychotics as with schizophrenia
Adjunct meds prn for acute depressive or manic symptoms

Question 7

Delusional d/o
Pt:
Dx:
Tx:

Answer 7

Pt: Fixed false belief
Non bizarre delusion without impairment

Dx:
1+ delusion for at least 1 month without appearing otherwise odd or impaired
Criteria for schizophrenia has never been met

Tx:
Gentle confrontation, establish a therapeutic alliance  
2nd gen antipsychotics
-Aripiprazole
-ziprasidone

Question 8

Schizophrenia
Path:
Dx:
Tx:

Answer 8

Path:
+sx-> excess dopamine
-sx -> excess serotonin
teens-20s after first stressor

dx: (rule out drugs)
Sx >6m
>/=2sx, 1 sx must be 1-3
1. delusions 
2. hallucinations 
3. disorganized speech
4. disorganized behavior 
-sx: flat affect, poverty of speech or movement, anhedonia, cognitive delay 

Tx: lifetime
antipsychotics 
-combative: haldol
-noncompliant: depo
Acute mania:
-zyprexa, risperdal, seroquel, geodon, abilify, saphris, vraylar 
Depression:
-seroquel, symbyax, latuda
Maintenance:
-zyprexa, abilify, seroquel (adjunct to lithium or depakote), risperdal

Question 9

Schizophreniform
Dx:
Tx:

Answer 9

Dx:
Sx >1m but <6m

Tx:
Tx for 3-6m