Schizophrenia Spectrum and Other Psychotic Disorders Flashcards
what are the psychotic disorders (4)
delusional disorder
schizoaffective disorder
schizophrenia
schizophreniform disorder
otherwise normal functioning person with a belief in something that does not exist
delusional disorder
what type of delusions are included in delusional disorder
non-bizarre delusions of thinking that occur in real life:
-being poisoned
-being stalked
-being loved or deceived
-having an illness
dsm 5 for delusional d.o
-one or more non bizarre delusions of thinking with NO
accompanying hallucinations, thought disorder, or flattening of affect
-beliefs lasting > 1 mo
-functioning is otherwise unimpaired
tx for delusional d.o
psychotherapy
atypical antipsychotics
a brief psychotic disorder has sx that last for _
1 day to 1 month
(after 1 month it is delusional d.o)
mental health condition including schizophrenia AND mood disorder sx
schizoaffective disorder
2 mood disorders that commonly occur w. schizoaffective d.o
dpn
bipolar
dsm 5 for schizoaffective d.o
-delusions or hallucinations for 2 or more weeks in the absene of a major mood episode (depressive or manic) during the lifetime duration of the illness
-sx that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of illness
tx for schizoaffective disorder
psychotherapy
atypical antipsychotics - 1st line pharm
anticonvulsants
SSRIs
major psychosis for > 6 mo PLUS difficulty functioning
schizophrenia
dsm 5 for schizophrenia (this one’s a doozie)
-2 or more of the following (each present for a significant portion of time during a 1 month period) - at least one must be 1, 2, or 3:
1. delusions
2. hallucinations
3. disorganized speech/thought process/tangential response
4. sx impair ADLs
5. disorganized/inappropriate behavior
6. negative symptoms
7. inability to hold job or maintain relationships
-continuous signs of the disturbance must persist for at least 6 mo
examples of negative symptoms (4)
blunted affect
poor posture
lack of goal-directed activities
lack of initiative
negative symptoms are same-same
deficit symptoms
examples of positive symptoms (4)
psychotic symptoms:
-hallucinations
-delusions
-disorganized speech
-disorganized or catatonic behavior
what feature is most suggestive of schizophrenia
the presence of both positive and negative symptoms
tx for schizophrenia
atypical antipsychotics - 1st line
typical antiosychotics
benzos
carbamazepine
valproate
lithium
examples of atypical antipsychotics
risperidone
olanzapine
aripiprazole
ziprasidone
quetiapine
asenapine
paliperidone
moa for atypical antipsychotics
DA AND 5HT 2 receptor blockers
atypical antipsychotics are used to treat what sx of schizophrenia
negative symptoms
what atypical antipsychotic is not considered first line for schizophrenia?
why?
clozapine
causes agranulocytosis and sz
what are examples of typical antipsychotics (neuroleptics)
haloperidol
chlorpromazine
thiordazine
loxapine
fluphenazine
what symptoms are typical antipsychotics best for in schizophrenia
positive symptoms
tx for resistant schizophrenia
-clozapine
-antipsychotic PLUS benzo, carbamazepine, valproate, or lithium
tx for acute psychosis in pt w. schizophrenia
benzos
antipsychotics: fluphenazine, haldol, olanzapine
2 meds that have no benefit for acute psychosis in schizophrenia pt
antidepressants
lithium
non pharm tx for schizophrenia
behavior-oriented/group/family therapy
s.e of antipsychotics
EPS
parkinsononian sx
neuroleptic malignant syndrome
TD
agranulocytosis - clozapine
s.e are more likely to occur w. _ antipsychotics (neuroleptics)
typical
what side effect is minimal to absent with atypical antipsychotics
EPS movement s.e
in order for dx of schizophrenia, sx must last longer than
6 mo
what is schizophreniform disorder
major psychosis for > 1 mo BUT < 6 mo and NO social or occupational impairment
what separates schizophreniform disorder from schizophrenia and schizophreniform disorder (2)
schizophreniform lasts longer than 1 mo and less than 6 mo
schizophreniform has no affect on social/occupation
tx for schizophreniform disorder
psychotherapy
atypical antipsychotics
tx for resistant shizophreniform disorder
-switch to another atypical antipsychotic
-combine atypical antipsychotic w. lithium or anticonvulsant
-switch to typical antipsychotic
work up for new osnet psychosis should include
CBC
CMP
TSH
UA
urine tox
STI
blood levels of therapeutic meds
+/- EKG, CT/MRI, EEG, LP
otherwise normally functioning person with a belief in something that does not exist, but no other symptoms of schizophrenia
delusional d.o
psychotic d.o featuring sx of both schizophrenia AND mdd, such as dpn, or bp d.o
schizoaffective d.o
t/f: sx of schizoaffective d.o may occur at the same time or different times
t!
psychotic d.o characterized by delusions, hallucinations, disorganized speech, and/or diminished inappropriate emotional expression for > 6 mo PLUS difficulty functioning
schizophrenia
major psychosis for > 1 week but < 6 mo and no social or occupational impairment
schizophreniform d.o
psychotic d.o involving the sx of schizophrenia but lasting < 6 mo
schizophreniform d.o
75 yo pt began thinking her daughter was telling her caretakers to steal her money, although both daughter and caretaker deny this
delusional d.o
45 yo truck driver who c/o hearing things that are not there x 2 weeks - he was severely depressed five months ago and was placed on prozac by his pcp - he recently started hearing voices
schizoaffective d.o
25 yo c/o visual and auditory hallucinations x 2 months - he is a graduate student and states his hallucinations have been getting worse - he is able to attend class but it is becoming difficult to concentrate
schizophreniform d.o
