Schizophrenia Spectrum and Other Psychotic Disorders Flashcards
What are psychotic disorders?
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”
List symptoms, Definitions and Examples pg 329 is a table in the book
See page 329
True or False: The withdrawal from prescription or recreational drugs can cause psychotic symptoms?
True
True of False- Psychotic behavior is not a symptom of Major depressive or manic episode?
False-yes they can be
Table 10.2 has the overview of Psychotic Disorders Prevalence and Characteristics page 332
Page 332
Counselor considerations in Schizophrenia and Psychotic Disorders
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
What is schizophrenia?
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.
What is the prevalence of schizophrenia
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.
Genetic Prevalence in Schizophrenia
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%
Counselor considerations in Schizophrenia?
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
What are is co-occurring disorders with schizophrenia?
Depression and substance use disorder specifically alcohol
Interventions for Schizophrenia?
Psychopharmacotherapy
Psychosocial Interventions
Peer/Advocacy Groups
Rehabilitation Resources
What are Rossler’s three main pillars in the treatment of schizophrenia?
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.
What medications are used for Schizophrenia
-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).
What is the prognosis of schizophrenia?
more than one-half of those individuals diagnosed with schizophrenia, the disorder will
prove to be a lifelong disability
What is schizophreniform disorder?
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.
What is the difference between schizophreniform and schizophrenia?
Unlike schizophrenia, the symptoms in schizophreniform disorder last at least 1 month but not more
than 6 months.
What are counselor considerations for schizophreniform?
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
Treatment Interventions for Schizophreniform
Medication
Family Psychoeducation
Supported employment
Psychosocial approaches
What is the prognosis of Schizopherniform?
two-thirds of individuals go on to meet criteria for schizophrenia or schizoaffective disorder
Brief Psychotic Disorder
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
Counselor considerations for Brief Psychotic Disorder
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
Treatment Interventions for Brief Psychotic Disorder
Client Saftey is number one
Severe psychotic symptoms should be inpatient
What medications are used for brief psychotic disorder
Common atypical antipsychotics used in the treatment of clients experiencing brief psychotic disorder include olanzapine (Zyprexa) and intramuscular ziprasidone (Geodon).
Prognosis for brief psychotic disorder
The prognosis for those diagnosed with a brief psychotic disorder that resolves within 30 days is very good
Delusional Disorder
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
What are the sub types of Delusional Disorder?
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.
Counselor considerations with Delusional disorder?
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
Treatment and interventions with Delusional Disorder
ACT
Mindful Relaxation
Antipsychotic Medications
What is the prognosis for delusion disorders
clients diagnosed with delusional disorder demonstrate higher levels of functioning when com-pared to those with perceptual psychotic symptoms
Schizoaffective Disorder
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
What is the difference between schizoaffective disorder and schizophrenia?
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
What are counselor considerations for Schizoaffective disorder
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
Treatment Intervention for schizoaffective disorder
Pyschoeducation
Problem solving
Family involvement
Prognosis
Compared to schizophrenia, schizoaffective disorder has a better long-term prognosis. Adherence to a holis-tic treatment plan will support better outcomes
