Schizophrenia Spectrum and Other Psychotic Disorders Flashcards
Peak ages of psychotic disorders and gender
15-25 for men
25-35 women
Onset before 10 or after 50 rare
Men - more likely to be impaired and have worse social functioning
Schizo and suicide
Half attemtp
10-15 die
Equal in gender
Schizo and drugs…other things
30-50 alcohol
Others are marijuana and cocaine
more liley born in winter/early spring (virl?_
imaging of schizo
Ventricular enlargement
Key features of schizo
Delusions - bizarre if clearly implausible
Hallucinations - auditory most common…those when falling asleep/waking up are within normal range
Disorganizing thinking - thought process
disorders
Disorganized or abnomral motor behaior
Negative symptoms of schizo
Diminished emotions
Avolition - lack of goal directed
Alogia - can’t speak
Anhedonia - can’t experience pleasure
Diagosis of schizo
at least 1 month2 or more of delusions, hallucinations, disorg speech, motor, neg symptoms (need 1 to be 1-3)
Level of functing decrease
Signs of distubrnace persist for 6 months
Others ruled out and no drugs
If autism, then only if prominent or hallucinations
Prognosis of schizo
Good is later onset, acute onset, mood symptoms, married
Poor is insidious onset, no remission in 3 years
Prodromal schizo
Somaplaints about somatic
Abstract ideas, philosophy, occult, or religion
Violence and schizo
Violent is mor common
Impulsive behavior
More likely to commit murder
Schizo course
No retunr to baseline (like mood disorders)
ositive symps become less severe
Bheavior therapy
Address abilities through use of token economies and social skills
Family oriented therapy
Educating the family
Case management
House visits
Group therapu
Helps reduce social isolation and improves reality testing
Indiidual therapy
Form alliance with the therapist…need ot be more flexible in length
Anti-psychotic meds
Non-compliance is an issue
Issues related to positive symptoms
Long-acting IM may be needed
Brief psychotic disorder
One of more:
Delusion, hallucinations, disorg speech, motor symps (1 must be 1-3)
Duration at least 1 day but lesss than a month with return to premorbind level
Specify with stressors, without, or postpartum
Schizophreniform dz
2 or more present during a 1 month (same as schizo)
Episode at least 1 month but less than 6
Good be good prognostic - onset within 4 weeks, no flat affec
Without good prognostic
Could have Catatonia
Schizoaffective disorder
Uninterrupted period of illness during which there is a maojr mood episode with criteria A of schizo
Delusion or hallu for 2 or more weeks in absnece of major mood episdoe during lifetime udration of the illness
Need symptoms that meet criteria for a major mood episode
Could be bipolar, depressive, with catatonia
Catatonia
3 or more of a bunch of symptoms
Stupor Catalepsy Waxy felxibility Mutism Negativisim Posturing Mannerism
No psychomotor activing
Passive induction of a posture against gravity
Slight, even resistance ot positioning by examiner
Very little to no verbal response
Opposition to or no response ot instruction
Active maintennace against gravity
Odd caricature of normal actions
Stereotypy Agitation Grimacing Echolalia Echopraxia
Repetitive, abnormal, frequent non-goal directed movements
Repeating words
Repeating movements
Delusional disorder
One of more delusions with a duration of 1 month or longer
No crtieria A for schizo
Functioning not markedly impaired
If modd episodes, brief
Specify type