Schizophrenia Spectrum and other Psychotic Disorders Flashcards
What are schizophrenia and other psychotic disorders 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)
- Negative symptoms
What are delusions?
5 examples of delusion types
Delusions are fixed beliefs that are not amenalbe to change in light of conflicting evidence
Examples:
- Persecutory delusions
——The most common! - Referential delusions = beliefs that unrelated or random things are directed at them (e.g., a newspaper containing coded messages for the individual)
- Grandiose delusions
- Erotomanic delusions (falsely believing another person is in love with them)
- Ni
7 examples of delusion types
Persecutory delusions
- The most common type!
Referential delusions
- = beliefs that unrelated or random things are directed at them
- Example: a newspaper containing coded messages for the individual
Grandiose delusions
Erotomanic delusions
- falsely believing another person is in love with them
Nihilistic delusions
- involve the conviction that a major catastrophe will occur
Somatic delusions
- Focus on preoccupations regarding physical health
Delusions of control
- one’s body or actions are being manipulated by some outside force
Difference between bizarre and nonbizarre delusions?
Bizarre delusions are
- clearly implausible
- not understandable to same-culture peers
- not derived from ordinary life experiences
- Example: One’s organs have been replaced by machines.
Nonbizarre delusions
Schizophrenia - menomic
Toddlers Dance Hilariously, Displaying Goofy, Nonsensical Steps
Schizophrenia - flow
- TWO OR MORE (each present for 1-month). At least one must be #1–3:
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms
- Persists SIX months.
Schizophrenia - criteria flow (A–C)
A. Two or more…each present for a significant portion of time during 1-month period (or less if treated)
B. Functioning deficit in one or more major areas
C. Continuous signs of disturbance for at least 6 months. At least 1 month of active symptoms.
- During prodromal or residual periods, schizophrenia symptoms may only be negative symptoms or at least two active symptoms in attenuated form. (E.g., odd beliefs)
- At least 1 month of active symptoms. Active symptoms must be present for a significant portion of the 1 month (or less if successfuly treated)
- May include periods of prodromal or residual periods (e.g., only negative symptoms, or at least 2 other attenuated symptoms)
Schizophrenia - criteria flow (D–F)
D. Schizoaffective/Mood disorders with psychotic features ruled out:
- No MDE or manic episodes concurrent with active-phase symptoms
- If mood symptoms present during active-phase, only for minority of duration
E. Not attributable to substance or medical condition
F. Hx of ASD or communication disorder? Schizophrenia dx only made if prominent delusions or hallucinations (among other requirements) are present
- IOW, for ASD + communication disorder people, disorganized speech is not enough
When should you use course specifiers for schizophrenia?
Only use course specifiers after a 1-year duration of the disorder
Schizophrenia specifiers – EE matrix for first six specifiers
First episode vs. Multiple episode
and
currently in partial remission vs. full remision vs. acute episode
Three remaining schizophrenia specifiers
and final specifier option
Continuous
- Symptoms fulfilling criteria are remaining for majority of illness course
- Subthreshold symptom periods are relatively brief
With catanoia
Unspecified
Also, severity specifier!
- Not mandatory
- DSM has related criteria for assessing psychosis symptom severity (p. 851)
chizo
Diagnostic Features
- Schizophrenia is a heterogeneous clinical syndrome—people’s presentations will vary
- Avolition (reduced goal-directed behavior) is linked to social dysfunction
Prodromal symptoms often precede active phase; residual symptoms often follow active phase
- Negative symptoms are common in prodromal and residual phases
- Withdrawing from previous routines, including social routines, are often the first sign of a disorder.
Mood symptoms and full mood episodes are common in schozophrenia
Beyond schizophrenia’s diagnostic criteria, what is crucial to assess for differentiating between schizophrenia spectrum and other psychotic disorders?
In addition tot eh five symptom domain areas identified in the diagnostic criteria, the assessment of cognition, depression, and mania symptoms domains is vital for making important distinctions between the various schizophrenia spectrum and other psychotic disorders
Associated Features
(affect, dysphoric, sleep, eating)
Individuals with schizophrenia may have:
- inappropriate affect (laughing for no reason)
- dysphoric mood (depression, anxiety, or anger)
- disturbed sleep pattern
- lack of interest in eating; food refusal
Associated Features
(affect, dysphoric, sleep, eating)
