Schizophrenia Spectrum and Other Psychotic Disorders Flashcards
Brief Psychotic Disorder
list the symptom criteria for Brief Psychotic Disorder
at least 1 of 4
* delusions
* hallucinations
* disorganized speech (e.g., derailment, tangentiality)
* abnormal behavior (e.g., disorganized or catatonic)
Brief Psychotic Disorder
the duration criterion for Brief Psychotic Disorder
1 day but less than 1 month
Psychotic Disorders
this term describes a fixed false belief that cannot change despite evidence to the contrary
delusion
ex. being followed; possessed; thoughts being controlled; parasitic infestation
Psychotic Disorders
this term describes sensory perceptions that occur without any external stimuli
hallucinations
ex. hearing voices, seeing things, feeling sensations on skin, smelling things, tasting strange or unpleasant things
Psychotic Disorders
this term describes a misinterpretation of an actual external stimulus
illusion
ex. hearing the wind blowing and thinking it is a bird chirping is an illusion
Schizophreniform Disorder
list the symptom criteria for Schizophreniform Disorder
- Two of 5 characteristic symptoms
* at least 1 symptom MUST be delusions, hallucinations, or disorganized speech
* grossly disorganized or catatonic behavior and negative symptoms (e.g., avolition, alogia, anhedonia)
Schizophreniform Disorder
the duration criterion for Schizoephreniform Disorder
at least one month but less than 6 months
Schizophrenia
lsit the symptom criteria for Schizophrenia
- active phase REQUIRED
- at least 2 of 5 characteristic symptoms
* 1 MUST be delusions, hallucinations, or disorganized speech
may consist of prodromal and/or residual phases with 2+ characteristic symptoms in weakened form OR negative symptoms only (e.g., avolition, alogia, anhedonia)
Schizophrenia
the duration criterion for Schizophrenia
- active phase: 1 month or more
- 6 months of continuous signs of disorder
Schizophrenia
list 3 etiologies for Schizophrenia
- genetics
- neurotransmitter abormalities
- brain abnormalities
Schizophrenia
the concordance rates of Schizophrenia for twins & research outcomes
monozygotic vs. dizygotic
- monozygotic: 48%
- dizygotic: 17%
- outcome research: inconsistent results with rates ranging from:
.40 to .50 (monozygotic)
.15 to .17 (dizygotic)
Schizophrenia
the concordance rates for child of parent(s) with Schizophrenia
one bio parent vs. two bio parents
- one bio parent: 13%
- two bio parents: 46%
Schizophrenia
genetic etiology has been confirmed by research investigating psychiatric outcomes for adult offspring of who?
discordant monozygotic and dizygotic twins (i.e., twin pairs with only 1 twin with Schizophrenia)
Schizophrenia
outcome research for adult offspring of discordant monozygotic and dizygotic twins found? What does this suggest about genetic liability?
- risk for offspring of monozygotic VS. discordant dizygotic twins was similar
- greater risk for offspring of non-affected twins
* discordant monozygotic twins have significant gentic liability that can be transmitted to offspring even if twin parent does not manifest symptoms of Schizophrenia
Schizophrenia
neurotransmitter abnormalities for Schizophrenia
- dopamine (dopamine hypothesis)
- glutamate
- serotonin
Schizophrenia
orignial vs. revised dopamine hypothesis
- (original) schizophrenia due to high levels of dopamine or hyperactivity of dopamine (esp. in basal ganglia)
- (revised) positive symptoms due to dopamine hyperactivity in subcortical regions of brain (esp. striatal areas); negative symptoms due to dopamine hypoactivity in cortical regions (esp. prefrontal cortex)
Schizophrenia
brain abnormalities associated with Schizophrenia
- enlarged ventricles and hypofrontality (low activity in PFC)
* linked to negative. & cognitive symptoms - dysfunction in temporal-limbic-frontal network
* negative symptoms - disinhibition in subcortical areas increases release of dopmaine in caudate nucleus, putamen, and nucleus accumbens
* positive symptoms
Schizophrenia
common comorbid conditions with Schizophrenia
- anxiety disorders
- OCD
- tobacco use disorder
Schizophrenia
% of people who have co-occuring Schizophrenia & tobacco use disorder
70% to 85%
over HALF meet criteria for tobacco use disorder
Schizophrenia
onset of psychotic symptoms; peak age of onset
gender differences
- initial: late teens to early 30’s
- onset - males: early- to mid-20’s
- onset - females: late-20’s
Schizophrenia
course over lifespan of psychotic symptoms vs. negative & cognitive symptoms?
- psychotic: decrease with increasing age
- negative & cognitive: persist despite aging
Schizophrenia
characteristics of a better prognosis
gender differences
- female gender
- an acute and late onset of symptoms
- comorbid mood symptoms (esp. depression)
- predominantly positive symptoms
- precipitating factors
- family history of mood disorder
- good **premorbid adjustment **
Schizophrenia
characteristics of a worse prognosis
- anosognosia (lack of insight or awareness of disorder)
- family members with high expressed emotion (emotional response of family members to patient), esp. high levels of criticism and hostility & emotional overinvolvement
Schizophrenia
onset, course, and prognosis for non-Western developing countries VS. Western industrialized countries
geographic location; acculturation
- non-Western developing countries: acute onset, shorter course, & higher rates of remission (than western industrialized countries)
Schizophrenia
first-line treatment
multimodal
* psychosocial interventions
* antipsychotic drugs
* adjunctive medications to treat comorbid disorders
Schizophrenia
list 8 evidence-based psychosocial interventions
psychotherapy; skills-based; community support
- CBT for psychosis
- cognitive remediation for Schizophrenia
- ACT
- assertive community treatment
- family psychoeducation
- illness self-management training
- social skills training
- supported employment services
Schizophrenia
factors to consider when prescribing antipsychotics drugs
- drug’s likely benefits & side effects
- potential **interactions **with other drugs
- patient’s preferences
- past response to antipsychotics
- health conditions impacted by side effects
Schizophrenia
clozapine (2nd gen) found to be most effective drug for what type of Schizophrenia?
treatment-resistant Schizophrenia
(e.g., symptoms show no, partial, or suboptimal response to 2 antipsychotics meds trialed for 6 wks each at an adequate dosage)
Schizophrenia
factors increasing medication adherence & decreasing risk for relapse
involvement of family & other support system(s)
Schizophrenia
multicompetent early interventions for individuals in early stages of disorder and/or are high risk
- NAVIGATE:
* team-based program that targets ppl in first episode psychosis
* includes: family education, individual resiliency training, supported employment & education, and individualized medication treatment
Schizophrenia
describe individualized resiliency training
- based on CBTp
- teaches skills to manage illness
- helps patients process precursors, triggers, and effects of psychotic episodes
- uses cognitive restructuring
- teaches strategies to improve well-being by strengthening positive feelings, thoughts, and behaviors
Schizoaffective Disorder
symptom criteria
- symptoms of Schizophrenia
- a major depressive OR manic episode
- presence of delusions or hallucinations
Schizoaffective Disorder
duration criteria
- depression/mania present for most of the duration of illness
- delusions or hallucinations present for 2 or more weeks without mood symptoms
Delusional Disorder
symptom criteria
- one or more delusions
- overall functioning has not been markedly impaired except for direct effects of delusion
Delusional Disorder
duration criteria
at least 1 month
Delusional Disorder
subtypes and descriptions
5
- erotomanic - believe another person is in love with them
- grandoise - believes they have great but unrecognized talent or insight
- jealous - believes partner is unfaithful
- persecutory - believes they are being conspired against, spied on, poisoned, maliciously maligned
- somatic - involves bodily functions or sensations
