Schizophrenia Spectrum and Other Psychotic Disorders (Pearls)

Question 1

Otherwise normally functioning person with a belief in something that does not exist

This describes what kind of disorder?

Answer 1

Delusional disorder

Question 2

Describe delusional disorder

Answer 2

One or more non-bizarre delusions of thinking—such as expressing beliefs that occur in real life such as being poisoned, being stalked, being loved or deceived, or having an illness, provided no other symptoms of schizophrenia are exhibited.

Question 3

What is needed to Dx delusional disorder?

Answer 3

No accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect.
Beliefs lasting > 1-month
Functioning is otherwise unimpaired

Question 4

What is the Tx for delusional disorder?

Answer 4

1. psychotherapy

2. Atypical antipsychotic agents

Question 5

What condition is described as A mental health condition including schizophrenia and mood disorder symptoms?

Answer 5

schizoaffective disorder

Question 6

What criteria is needed to Dx schizoaffective disorder?

Answer 6

Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.
Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.

Question 7

Tx for schizoaffective disorder?

Answer 7

atypical antipsychotic agents first line

anticonvulsants, SSRIs

Question 8

What criteria needs to be met for Schizophrenia dx?

Answer 8

Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3):
Delusions
Hallucinations - auditory (most common), tactile olfactory visual
Disorganized speech/thought processes unable to stay on topic (loose associations) unable to provide answer related to questions (tangential response)

Continuous signs of the disturbance persist for at least 6 months.

Question 9

Tx for schizophrenia

Answer 9

Atypical Antipsychotics: (risperidone, olanzapine, aripiprazole, ziprasidone, quetiapine, asenapine, paliperidone) for negative symptoms & fewer side effects

Clozapine is an atypical antipsychotic that is not considered first line because of the propensity to cause agranulocytosis.

Typical neuroleptics - dopamine antagonists (haloperidol, chlorpromazine, thioridazine, loxapine, fluphenazine) best for positive symptoms

Question 10

Tx option for resistant cases of schizophrenia?

Answer 10

clozapine or antipsychotic + another med (benzo, carbamazepine, valproate, lithium)

Question 11

Schizophreniform disorder is major psychosis for _______ month but _____________ months and no social or occupational impairment?

Answer 11

greater than 1 but less than 6 months

Question 12

What is the big difference between Schizophrenia and schizophreniform

Answer 12

duration of symptoms found in schizophreniform disorder is longer than 1 month and less than 6 months and there is no social or occupational impairment.

Question 13

Tx for schizophreniform?

Answer 13

1. Psychotherapy

2. atypical antipsychotics as the usual drug of choice.

Question 14

If someone who is experiencing schizophreniform is not responding to initial atypical antipsychotic may benefit from?

Answer 14

being switched to another atypical antipsychotic, the addition of a mood stabilizer such as lithium or an anticonvulsant, or being switched to a typical antipsychotic.