Schizophrenia Spectrum and Other Psychotic Disorders

Question 1

What are psychotic disorders?

Answer 1

psychotic disorders “are defined by abnormalities in one or more of the following five domains: delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia), and negative symptoms”

Question 2

List symptoms, Definitions and Examples pg 329 is a table in the book

Answer 2

See page 329

Question 3

True or False: The withdrawal from prescription or recreational drugs can cause psychotic symptoms?

Answer 3

True

Question 4

True of False- Psychotic behavior is not a symptom of Major depressive or manic episode?

Answer 4

False-yes they can be

Question 5

Table 10.2 has the overview of Psychotic Disorders Prevalence and Characteristics page 332

Answer 5

Page 332

Question 6

Counselor considerations in Schizophrenia and Psychotic Disorders

Answer 6

Important to have medication management : meeting client after stabilization helps with reality and communication
Be aware of stigmas
5 Recommendations on page 333
Accurate assessment and diagnosis is very important: Symptoms severity and duration are all important to monitor
Supportive living program knowledge is beneficial

Question 7

What is schizophrenia?

Answer 7

schizophrenia is characterized by several key features. First, an individual must experience at least a month during which two of the following psychotic symptoms are present: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, or negative symptoms (see Table 10.1 for definitions and examples). At least one of the symptoms must include delusions, hallucinations, or disorganized speech. In addition, these symptoms must be accompanied by a decrease in ability to function in major life areas such as relationships, work, and school. Together, the client must experience at least a 6-month disturbance in functioning, even if some of the symptoms are present in attenuated or reduced form. Although previous editions of the DSM system included five diagnostic subtypes of schizophrenia (i.e., paranoid, dis-organized, undifferentiated, residual, and catatonic), the DSM-5 discontinued using subtypes because men-tal health providers had difficulty using the subtypes in a reliable manner and because subtype identification did not necessarily inform treatment.

Question 8

What is the prevalence of schizophrenia

Answer 8

schizophrenia affects about 7 or 8 out of every 1000 people around the world
appear between ages 16 and 30, with males developing symptoms at somewhat earlier ages than females.

Question 9

Genetic Prevalence in Schizophrenia

Answer 9

Having a parent, brother, or sister with schizophrenia increases one’s risk of developing schizophrenia from 1% to 10%; having an identical twin with schizophrenia increases one’s risk to between 40% and 65%

Question 10

Counselor considerations in Schizophrenia?

Answer 10

Provide care in inpatient facilities or community mental health centers
Professional counselors bring strength-based, collaborative, and developmental perspectives to treatment
Understand the neurocognitive aspects of Schizophrenia

Question 11

What are is co-occurring disorders with schizophrenia?

Answer 11

Depression and substance use disorder specifically alcohol

Question 12

Interventions for Schizophrenia?

Answer 12

Psychopharmacotherapy
Psychosocial Interventions
Peer/Advocacy Groups
Rehabilitation Resources

Question 13

What are Rossler’s three main pillars in the treatment of schizophrenia?

Answer 13

Rössler (2011) identified three main pillars of treatment for schizophrenia: (1) medications to relieve symptoms and prevent relapse, (2) psychosocial interventions to help clients and families cope with the illness and prevent relapse, and (3) vocational rehabilitation to reintegrate into the com-munity and regain occupational functioning.

Question 14

What medications are used for Schizophrenia

Answer 14

-Generally speaking, psychiatrists will rely on two major types of medications in the treatment of schizophrenia: typical and atypical anti psychotics (NIMH, 2016d; Sadock, Sadock, and Ruiz, 2015). Depending on the client’s specific symptoms, psychiatrists may also supplement anti psychotic medications with antidepressants, anti anxiety drugs, lithium, anti epileptic drugs, and estrogen replacement for women (Sadock, Sadock, and Ruiz, 2015). Typical anti psychotics include longstanding drugs such as chlorpromazine (Thorazine) and haloperidol
(Haldol).

Question 15

What is the prognosis of schizophrenia?

Answer 15

more than one-half of those individuals diagnosed with schizophrenia, the disorder will
prove to be a lifelong disability

Question 16

What is schizophreniform disorder?

Answer 16

With the exception of duration and long-term impact, symptom criteria for schizophreniform disorder are identical to those for schizophrenia. These symptoms include two or more of the following over a 1-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and disoganized speech.

Question 17

What is the difference between schizophreniform and schizophrenia?

Answer 17

Unlike schizophrenia, the symptoms in schizophreniform disorder last at least 1 month but not more
than 6 months.

Question 18

What are counselor considerations for schizophreniform?

Answer 18

attention to medication
it is identical to schizophrenia but watch the duration of the symptoms
usually this is the first episode of psychosis for those clients
Be realistic but optimistic

Question 19

Treatment Interventions for Schizophreniform

Answer 19

Medication
Family Psychoeducation
Supported employment
Psychosocial approaches

Question 20

What is the prognosis of Schizopherniform?

Answer 20

two-thirds of individuals go on to meet criteria for schizophrenia or schizoaffective disorder

Question 21

Brief Psychotic Disorder

Answer 21

symptoms similar to those seen in schizophrenia. However, as the name implies, the client experiences the symptoms for a short amount of time, not less than 1 day, and not more than 1 month.
Triggered by a traumatic or stressful event

Question 22

Counselor considerations for Brief Psychotic Disorder

Answer 22

The diagnosis of brief psychotic disorder mandates that the symptoms not be due to other psychotic disorders such as schizophrenia, schizoaffective disorder, or delusional disorder.

mindful of the timeline of symptoms, especially when establishing a marked stressor or series of traumatic events. I

Question 23

Treatment Interventions for Brief Psychotic Disorder

Answer 23

Client Saftey is number one

Severe psychotic symptoms should be inpatient

Question 24

What medications are used for brief psychotic disorder

Answer 24

Common atypical antipsychotics used in the treatment of clients experiencing brief psychotic disorder include olanzapine (Zyprexa) and intramuscular ziprasidone (Geodon).

Question 25

Prognosis for brief psychotic disorder

Answer 25

The prognosis for those diagnosed with a brief psychotic disorder that resolves within 30 days is very good

Question 26

Delusional Disorder

Answer 26

Delusional disorder involves the presence of non bizarre cognitive distortion
Clients with delusional disorder do not usually present with the traditional psychotic symptoms or bizarre behavior categorized by the underlying theme of the delusion and diagnosed by a corresponding sub type

Question 27

What are the sub types of Delusional Disorder?

Answer 27

erotomanic type: encompasses beliefs related to romantic relationships
grandiose type: beliefs related to exceptional talent or groundbreaking innovation
jealous type: involves the belief that one’s partner is being unfaithful
persecutory type: involves the belief that others want to do the client harm, even though there is no evidence to support that the client is being persecuted. The client’s perception that others want to harm him or her may lead to legal system involvement should a client decide to retaliate
Somatic type: describes beliefs associated with bodily functions or sensations
Mixed type: when clients do not meet the full criteria for any one subtype but instead demonstrate symptoms from more than one delusional category
Unspecified type: is assigned if the belief cannot be categorized into any of the defined subtypes.

Question 28

Counselor considerations with Delusional disorder?

Answer 28

be attuned to subtle clues that suggest a potential for these nonbizarre delusions within the client’s story
They maybe time consuming clients
overall intellectual or occupational functioning may not be negatively affected by the delu-sion, a client may experience distress in social or personal relationships

Question 29

Treatment and interventions with Delusional Disorder

Answer 29

ACT
Mindful Relaxation
Antipsychotic Medications

Question 30

What is the prognosis for delusion disorders

Answer 30

clients diagnosed with delusional disorder demonstrate higher levels of functioning when com-pared to those with perceptual psychotic symptoms

Question 31

Schizoaffective Disorder

Answer 31

Schizoaffective disorder involves the presence of both psychosis and mood disturbances
present with the domains of psychosis described in this chapter (i.e., delusions, hallucinations, and/or disorganized behavior), yet they experience psychosis concurrently with a predominant major depressive episode and/or a manic episode

Question 32

What is the difference between schizoaffective disorder and schizophrenia?

Answer 32

the key to distinguishing schizoaffective disorder from schizophrenia is the prominent presence of mood symptoms. It is suggested in the DSM-5 (APA, 2013) that counselors consider a diagnosis of schizophrenia if psychotic symptoms become prominent in proportion to mood symptom

Question 33

What are counselor considerations for Schizoaffective disorder

Answer 33

There are some experts who insist schizoaffective is not a valid disorder but, rather, two distinct diagnoses: schizophrenia and a depressive or bipolar disorder
Diagnosis of schizoaffective disorder is difficult
Counselors must consider the timing of symptoms carefully when assessing for schizoaffective disorder so they can differentiate between schizoaffective disorder
Clients diagnosed with schizoaffective disorder generally demonstrate better cognitive functioning
than clients diagnosed with schizophrenia

Question 34

Treatment Intervention for schizoaffective disorder

Answer 34

Pyschoeducation
Problem solving
Family involvement

Question 35

Prognosis

Answer 35

Compared to schizophrenia, schizoaffective disorder has a better long-term prognosis. Adherence to a holis-tic treatment plan will support better outcomes