Schizophrenia Spectrum D/o Flashcards
Positive symptoms?
Things added to normal experience
- hallucinations
- delusions
- disorganized speech
- grossly disorganized or catatonic
Negative symptoms
Taken away from normal existence
- flattened affect
- loss of motivation
- anhedonia (loss of pleasure)
- A-sociality (antisocial)
- alogia (decreased verbal communication)
The a’s of schizophrenia spectrum disorders?
All the negative symptoms start with A Affect A-motivation Anhedonia Anti-social Alogia (verbal comms)
Diagnostic criteria for Schizophnreia spectrum disorders?
Abnormalities in 1 or more of the following 5:
- Delusions
- Hallucinations
- Disorganized thinking
- Grossly disorganized/abnormal motor behavior
- Negative symptoms
What do antipsychotic mess treat?
Positive symptoms only
What treats negative symptoms?
Nothing
Criterion A for schitzophrenia and other psychotic disorders?
Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic Negative symptoms
Essentials of diagnosis for schizophrenia spectrum and psychotic diagnosis?
- Social withdrawal
- Decreased personal care
- Disorganized behaviors
- Decreased reactivity
- Disorganized thinking
- auditory hallucinations
- Delusions - fixed false beliefs
- Massive disruption in thinking, mood and behavior
- Poor filtering of stimuli
Clinical findings for schizophrenia spectrum and psychotic diagnosis?
- Appearance - bizarre, unkempt
- Motor - reduced
- Social behavior - marked withdrawal, poor relationships, reduced pleasure
- Verbal utterances - variable
- Affect - flattened
- Depression - most of the time
- Thought content - variable
- Delusions - paranoid
- Perceptual distortions - auditory hallucinations (common)
Tendency toward polydipsia and substance abuse
DDX for schizophrenia spectrum and psychotic do?
Bipolar - responds well to lithium
Manic episodes - mimics schizophrenia
Psychotic depression - brief psychosis
Medical - thyroid, adrenal, pituitary, toxins
Treatment for schizophrenia spectrum and psychosis?
Hospitalization
Antipsychotics
- pines, dones, azines and azoles
Prognosis for schizophrenic spectrum and psychosis?
Psychosis - good relief for positive symptoms
Negative symptoms - harder to treat
Cognitive deficits - dont respond well
Schizophrenia diagnosis has?
A. 2 or more of
- delusions
- hallucinations
- disorganized speech
- grossly d/o or catatonic
- negative symptoms
B. Level of function is below previous
C. 1 month of symptoms but disturbance for 6 months
D. Must have delusions or hallucination
Ddx for schizophrenia?
Schizoaffected d/o
Bipolar w psychotic features
Tx for schizophrenia?
1st line - pharmacotherapy
- antipsychotics
Psychotherapy is Supportive therapy
Prognosis for schizophrenia?
Guarded
- possibly controllable
- Not curable
What is schizoaffective d/o?
Uninterrupted period of illness during which there is a major episode (depressive or manic) concurrent w criterion A of schizophrenia
- Fails to fit into either schizophrenia or affective disorder
- Start as affective symptoms (MDD, manic/hypomanic) and develop into psychosis
Prognosis for schizoaffective disorder?
Good, symptoms are not permanent
What is schizophreniform disorder?
Similar to schizophrenic d/o except for duration
- ssx are 1-6 mo
What is delusional disorder?
- Delusions for 1+ month
- Criterion A for schizophrenia are never met
- Hallucinations if present are not prominent (i.e. bugs etc)
Clinical findings for delusional d/o?
Function is not markedly impaired
Behavior is not obviously bizarre or odd
Prognosis for delusional d/o?
Fair
- controllable
- not curable
Types of delusional d/o?
- Ertomanic
- Grandiose
- Jeallous
- Persecutory
- Somatic (body functions)
- Mixed type
- Unspecified
What is brief psychotic d/o?
1 or more of the schizophrenia symptoms
Symptoms last 1 day - 1 month
Prognosis for brief psychotic disorder?
Excellent - curable
What if i develop new onset psychosis when i’m older?
Look at substances - its uncommon to develop schizophrenia over 35 so its more likely:
- Substance medication-Induced psychotic disorder
- Psychotic d/o due to medication condition
Prominent symptoms in psychosis due to medical condition?
Hallucinations or delusions
A catatonic pt can be suffering from?
- Neurodevelopment
- Psychotic
- Bipolar
- Depressive d/o
- Medical conditions
Its not an independent class but is associated with other diagnoses
Essential features of catatonia?
Marked psychomotor disturbance that may involve:
- decreased motor activity
- decreased engagement (during interview/PE)
- excessive and peculiar motor activity
Ranges from marked unresponsiveness to marked agitation
Tends to wax and wane
Catatonia diagnosis requires?
3 or more of:
- Stupor
- Catelepsy - passive induction of posture (against gravity)
- Waxy flexibility - slight resistance to posturing
- Mutism
- Negativism
- Posturing
- Sterotypy - repetitive pointless movements
- Agitation
- Grimacing
- Echolalia - mimicking speech
- Echopraxia - mimicking movments
