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Schizophrenia Spectrum and Other Psychotic Disorders Flashcards

1
Q

What age are males and females when psychotic disorders start?

A

males 15-25yr

females 25-35yr

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2
Q

What is the most common psychotic disorder affecting 1% of the population?

A

Schizophrenic

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3
Q

What is schizophrenic disorder?

A

a massive disruption of thinking, mood, and overall behavior coupled with poor filtering of stimuli

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4
Q

What percent of pts with schizophrenia require long term hospitalization?

A

50%

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5
Q

What 3 things causes schizophrenia?

A

genetic, environmental, neurochemical

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6
Q

Who responds more successfully to medications?

A

Women than man

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7
Q

What percent of schizophrenics have no affected parent?

A

80%

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8
Q

What are two environmental influences of schizophrenia?

A
  • born in the winter, with maternal virus infection during the 3rd trimester
  • exposure to diuretics for severe maternal HTN
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9
Q

What 3 neuro changes take place in a schizo brain?

A
  • decrease glucose utilization by frontal lobe
  • Ventricle enlargement
  • Abnormalities in brain density and brain waves
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10
Q

What is the dopamine hypothesis?

A

Hyperactive dopamine in the mesolimbic tract leads to positive symptoms
Hypoactive dopamine in the mesocortical tract leads to negative symptoms

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11
Q

What creates hallucinations and delusions?

A

Serotonin agnosits

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12
Q

What can be given to improve hallucinations and delusions?

A

serotonin antagonists

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13
Q

During a psychotic episode what is intact in the patient?

A

memory (oriented to person, place, and time)

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14
Q

What characterizes schizophrenia?

A

at least 1 episode of psychosis and persistent disturbances of behavior, appearance, speech, and affect impairing them

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15
Q

When can a psychotic episode occur?

A

spontaneous or follow traumatic/ stressful event

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16
Q

What are the 5 positive symptoms?

A 
Hallucinations
Delusions
Disorganized Speech
Agitation
Talkativeness
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17
Q

What are 7 negative symptoms?

A 
diminished sociability
restricted affect
poverty of speech
lack of motivation
flat affect
cognitive disturbances
poor grooming
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18
Q

How long must schizophrenic last?

A

> 6 mo

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19
Q

What is the criteria for schizophrenic?

A

2 or more symptoms are present for a significant portion of time during a 1 month period

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20
Q

What are the 3 phases of Schizophrenia?

A

Prodromal
Psychotic
Residual

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21
Q

What 3 things are seen in the Prodromal phase?

A
  • Still functioning in reality
  • Increasing social withdrawal
  • Increasing interest in religion, the occult, and philosophy
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22
Q

What 1 thing is seen in the Psychotic phase?

A

“Psychotic break” from reality

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23
Q

What 2 things are seen in the Residual phase?

A
  • Period between psychotic episodes

- Negative symptoms are still present and patient is not back to “normal”

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24
Q

What is Alogia?

A

Poverty of speech- no informative information

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25
What are delusions?
false beliefs not correctable by logic or reason
26
What does delusions commonly consist of?
paranoid thinking and preoccupation with the supposedly threatening behavior of others
27
What are somatic delusions?
delusions that revolve around issues of bodily decay or infestation
28
What illusions?
distortions of reality creating misperceptions of real external stimuli
29
What are hallucinations?
creating stimuli where none exists. Sensory perceptions not associated with real external stimuli
30
What is the most common hallucinations?
auditory
31
What is thought blocking?
an abrupt stop in the train of thought
32
What is polydipsia?
excessive water drinking without appropriate physiologic need
33
What do you have to be careful with in patients that are experiencing schizophrenia?
"Water intoxication"
34
What are the symptoms of water intoxication?
confusion, lethargy, psychosis, seizure, death all due to cerebral edema
35
What is emergency detention?
removing the patient's rights and ability to checkout form care for 48hrs due to potential threat to their own or others safety
36
In Texas who can place a person on emergency detention?
police officer or judge
37
What is the treatment of choice for schizophrenia?
antipsychotic meds
38
What are the 2 common 1st generation antipsychotics used in the txt of schizophrenia?
Haloperidol and Chlorpromazine (Thorazine)
39
What are two extrapyramidal side effects of 1st gen antipsychotics?
acute dyskinesias and dystonia
40
How can dyskinesia and dystonia be treated?
Diphenhydramine (Bendryl)
41
What syndrome can develop due to the extrapyramidal side effects of typical antipsychotics?
Neuroleptic malignant syndrome
42
A life threatening neurologic emergency characterized mental status change, rigidity, fever, and autonomic dysfunction?
Neuroleptic malignant Syndrome
43
What are 3 common 2nd generation antipsychotics used in the txt of schizophrenia?
Clozapine, Olanzapine, Risperidone
44
What is the difference between the typical and atypical antipsychotics?
extrapyramidal side effects- much less severe in 2nd generation
45
What are sde of atypical antipsychotics?
weight gain, QTC prolongation, Myocarditis, Sexual dysfunction
46
Which meds are more expensive?
2nd gen antipsych
47
There is a inverse relationship between what two things?
stability of living situation and amount of antipsychotic meds
48
In prognosis what symptoms can be treated successfully with meds?
positive symptoms
49
Which two symptoms contribute more to long term disability
negative symptoms and cognitive
50
What is delusional disorder?
a psychosis in which the predominant symptom is a persistent delusion for > 1mo
51
What two things are not affected in delusional disorder?
intellectual and occupational activities
52
What is the month criteria for delusional disorder?
presence of >1 delusions with a duration of one 1 MONTH
53
What is a erotomanic type delusion?
the pt believes that another person, who is usually famous or in some kind of higher status, is secretly in love with her or him
54
What is grandiose type?
pt believes he/she has special prominence or talent, unusual fame, or major achievements
55
What is jealous type?
pt believes that a spouse or lover is unfaithful and finds "evidence" to support the delusion, accuses them, and relentlessly ties to substantiate the offense
56
What is persecutory type?
pt is typically preoccupied by a delusion that he or she is being persecuted, conspired against, or potentially harmed
57
What is somatic type?
pt believes that something awful is wrong w/ his/her body
58
What is mixed type?
no one delusional theme predominates
59
What is unspecified type?
dominant delusional belief cannot be clearly determined
60
What is the 1st Txt for delusional disorder?
2nd gen antipsychoitc
61
There have been no clinical trials of what two things in delusional disorder?
cognitive behavioral or psychosocial therapy
62
What are schizoaffective disorders?
cases that fail to fit within either schizophrenic or affective (depressive)
63
What is the month criteria for schizoaffective disorder?
psychotic symptoms linger for longer than 2wks, but are not permanent
64
What three meds can be used for schizoaffective disorder?
mood stabilizers, antidepressants, 2nd gen antipsychotics
65
What is schizophreniform disorder?
similar symptoms to schizophrenia except that the duration of prodromal, acute, and residual symptoms is longer than 1 month but less than 6mo
66
What is the month requirement for schizophreniform?
symptoms last at least 1 mo but less than 6 mo
67
What is schizophreniform disorder treated with?
long term therapy and 2nd gen antipsychotics
68
What is the requirement for brief psychotic disorder?
symptoms lasting less than 1 mo (at least 1 day)
69
Treatment for brief psychotic disorder?
therapy long term and 2nd generation antipsychotics while symptoms are active

Behavioral Health (14 decks)

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