Schizophrenia Spectrum and other Disorders Lecture Powerpoint Flashcards
Psychosis definition
Severe disruption of thought, perception, and behavior resulting in loss of reality caused by conditions, sleep deprivation, abuse of alcohol or other drugs
Key features of psychotic disorders (5)
- delusions
- hallucinations
- disordered thinking/speech
- grossly disorganized or abnormal motor behavior
- negative symptoms
Bizarre and non bizarre delusions
Bizarre are completely not based in reality, nonbizarre could be conceivable but are likely not true (could be validated or disproven by family member)
Most common delusion type in psychosis
Persecutory - that one is going to be harmed/harassed by an individual, organization, or other group
Most common hallucination type in schizophrenia
Auditory
Referential delusions
A common delusion type in psychosis characterized by certain gestures, comments, environmental cues directed at oneself
Hallucinations
Perception like experiences that occur without external stimulus, are vivid and clear but not under voluntary control
Disorganized thinking
Inferred from individuals speech where they switch from one topic to another through derailment or loose associations
Grossly disorganized or abnormal motor beavior (including catatonia)
Manifestation ranging from sdf
Negative symptoms
Account for substantial portion of morbidity associated with schizophrenia but are less common with other psychotic disorders, include diminished emotional expression and avolution (decrease in motivated self initiated purposeful activities)
Schizophrenia definition
Chronic recurrent psychosis associated with impairments in social and occupational functioning for at least 6 months**, strongly associated with both genetic factors and environmental ones, much higher suicide rate than general population
Schizophrenia pathophysiology
Overactive dopaminergic and serotonin pathways that lead to psychosis
Schizophrenia positive symptoms (4)
- Fixed false delusions either bizarre or nonbizarre
- hallucinations (auditory hallucinations most common)
- disorganization of behaviors and thoughts interpreted from speech
- cognitive impairment early on
Cotard’s delusion
Delusional belief that one is already dead, does not exist, or have lost their blood and internal organs
Schizophrenia associated physical manifestations
- neurological
- catatonia
- metabolic disturbances
Catatonic
A state of immobility and stupor from abnormality of movement and behavior arising from disturbed mental state
Schizophrenia first rank symptoms (4)
- audible thoughts
- somatic passivity (feeling of being touched or unusual sensation)
- thought insertion (feeling external force putting thoughts in mind)
- voices arguing about the patient
Schizophrenia labs (5)
- Chemistry panel for electrolytes
- hormone levels
- urinalysis
- tox screen
- lumbar puncture
Treatment principle for psychosis
Earlier they get treatment the better the outcome, start slow, go slow, be patient, adjust dose
Tardive dyskinesias
Side effect of antipsychotic medications or some psychotic states characterized by involuntary movements of tongue, face, lips, etc with repeated jerking movements that can become irreversible if not carefully treated
Schizophrenia treatment (1)
-antipsychotic drugs
Schizophrenia recovery
Only 20% achieve complete recovery, many reach no more than mild psychotic symptoms
Remission
State of which individual has no symptoms, or minimal symptoms that do not interfere with behavior for a period of at least 6 months
Schizophreniform vs schizophrenia
Schizophreniform is the same criteria met but has not lasted for more than 6 months
Schizoaffective disorder vs schizophrenia
Schizoaffective disorder is the same criteria met but has a prominent mood component that occurs in the absence of a mood episode
Delusional disorder
Presence of 1 or more delusions for a month or longer, but absent hallucinations or other marked mood symptoms
Brief psychotic disorder
Presence of one or more psychotic symptoms with sudden onset and full remission within one month
Example of brief psychotic disorder
Post partum psychoses