Schizophrenia Spectrum D/o

Question 1

Positive symptoms?

Answer 1

Things added to normal experience

• hallucinations
• delusions
• disorganized speech
• grossly disorganized or catatonic

Question 2

Negative symptoms

Answer 2

Taken away from normal existence

• flattened affect
• loss of motivation
• anhedonia (loss of pleasure)
• A-sociality (antisocial)
• alogia (decreased verbal communication)

Question 3

The a’s of schizophrenia spectrum disorders?

Answer 3

All the negative symptoms start with A
Affect
A-motivation
Anhedonia
Anti-social
Alogia (verbal comms)

Question 4

Diagnostic criteria for Schizophnreia spectrum disorders?

Answer 4

Abnormalities in 1 or more of the following 5:

• Delusions
• Hallucinations
• Disorganized thinking
• Grossly disorganized/abnormal motor behavior
• Negative symptoms

Question 5

What do antipsychotic mess treat?

Answer 5

Positive symptoms only

Question 6

What treats negative symptoms?

Answer 6

Nothing

Question 7

Criterion A for schitzophrenia and other psychotic disorders?

Answer 7

Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic
Negative symptoms

Question 8

Essentials of diagnosis for schizophrenia spectrum and psychotic diagnosis?

Answer 8

• 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

Question 9

Clinical findings for schizophrenia spectrum and psychotic diagnosis?

Answer 9

• 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

Question 10

DDX for schizophrenia spectrum and psychotic do?

Answer 10

Bipolar - responds well to lithium
Manic episodes - mimics schizophrenia
Psychotic depression - brief psychosis
Medical - thyroid, adrenal, pituitary, toxins

Question 11

Treatment for schizophrenia spectrum and psychosis?

Answer 11

Hospitalization
Antipsychotics
- pines, dones, azines and azoles

Question 12

Prognosis for schizophrenic spectrum and psychosis?

Answer 12

Psychosis - good relief for positive symptoms
Negative symptoms - harder to treat
Cognitive deficits - dont respond well

Question 13

Schizophrenia diagnosis has?

Answer 13

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

Question 14

Ddx for schizophrenia?

Answer 14

Schizoaffected d/o

Bipolar w psychotic features

Question 15

Tx for schizophrenia?

Answer 15

1st line - pharmacotherapy
- antipsychotics

Psychotherapy is Supportive therapy

Question 16

Prognosis for schizophrenia?

Answer 16

Guarded

• possibly controllable
• Not curable

Question 17

What is schizoaffective d/o?

Answer 17

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

Question 18

Prognosis for schizoaffective disorder?

Answer 18

Good, symptoms are not permanent

Question 19

What is schizophreniform disorder?

Answer 19

Similar to schizophrenic d/o except for duration

- ssx are 1-6 mo

Question 20

What is delusional disorder?

Answer 20

• Delusions for 1+ month
• Criterion A for schizophrenia are never met
• Hallucinations if present are not prominent (i.e. bugs etc)

Question 21

Clinical findings for delusional d/o?

Answer 21

Function is not markedly impaired

Behavior is not obviously bizarre or odd

Question 22

Prognosis for delusional d/o?

Answer 22

Fair

• controllable
• not curable

Question 23

Types of delusional d/o?

Answer 23

• Ertomanic
• Grandiose
• Jeallous
• Persecutory
• Somatic (body functions)
• Mixed type
• Unspecified

Question 24

What is brief psychotic d/o?

Answer 24

1 or more of the schizophrenia symptoms

Symptoms last 1 day - 1 month

Question 25

Prognosis for brief psychotic disorder?

Answer 25

Excellent - curable

Question 26

What if i develop new onset psychosis when i’m older?

Answer 26

Look at substances - its uncommon to develop schizophrenia over 35 so its more likely:

1. Substance medication-Induced psychotic disorder
2. Psychotic d/o due to medication condition

Question 27

Prominent symptoms in psychosis due to medical condition?

Answer 27

Hallucinations or delusions

Question 28

A catatonic pt can be suffering from?

Answer 28

• Neurodevelopment
• Psychotic
• Bipolar
• Depressive d/o
• Medical conditions

Its not an independent class but is associated with other diagnoses

Question 29

Essential features of catatonia?

Answer 29

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

Question 30

Catatonia diagnosis requires?

Answer 30

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