Schizophrenia Spectrum & Other Psychotic Disorders

Question 1

Schizophrenia Criteria A

Answer 1

2 of the following, and at least 1, 2, or 3

1) Delusions
2) Hallucinations
3) Disorganized speech
4) Grossly disorganized or catatonic behavior
5) Negative symptoms

Question 2

Schizophrenia Criteria B

Answer 2

Level of functioning decreases in work, interpersonal relations, OR self-care (no time limit, or qualifier—judgement call)

Question 3

Delusions

Answer 3

False fixed beliefs.

False belief based on incorrect inference about external reality that is firmly held despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof to the contrary.

Question 4

Hallucinations

Answer 4

False fixed perceptions

Perception-like experience without external stimulation of the relevant sensory organ

Question 5

5 Domains of Psychosis

Answer 5

1) Delusions
2) Hallucinations
3) Disorganized Thinking
4) Disorganized or Abnormal Motor Behavior
5) Negative Symptoms

Question 6

Types of Delusions

Answer 6

-Bizarre
-Thought Insertion
-Thought Withdrawal
-Thought Broadcasting
-Somatic
-Nihilistic
-Erotomania

Question 7

Bizarre Delusion

Answer 7

False fixed belief in clearly implausible phenomena occurring

Question 8

Thought Insertion

Answer 8

False fixed belief that thoughts are not one’s own and inserted into mind by others.

Question 9

Thought Withdrawal

Answer 9

False fixed belief that some thought are taking out of client’s mind.

Question 10

Thought Broadcasting

Answer 10

False fixed belief that some thoughts are being broadcast aloud so that they are perceived by others

Question 11

Somatic Delusion

Answer 11

False fixed belief pertaining to alteration or functioning of body organs

Question 12

Nihilistic Delusion

Answer 12

False fixed belief in non-existence of self or part of body

Question 13

Erotomania Delusion

Answer 13

False fixed belief that another person (usually of higher status) is in love with the individual

Question 14

Referential Delusion

Answer 14

False fixed belief that events or coincidences have strong personal significance

Question 15

Persecutory Delusion

Answer 15

False fixed belief that someone or something is out to harm, harass, attack, persecute, or conspire against the individual

Question 16

Types of Hallucinations

Answer 16

Auditory (Sound)
Visual (Sight)
Olfactory (Smell)
Tactile (Touch)
Gustatory (Taste)

Can be mood congruent or incongruent

Question 17

Echolalia

Answer 17

Mimicking another’s speech

Question 18

Echopraxia

Answer 18

Mimicking another’s movements

Question 19

Prodromal Symptoms

Answer 19

Any symptoms that signals impending onset of a disorder

Question 20

Prodromal Symptoms of Schizophrenia

Answer 20

-Deterioration in hygiene
-Social Withdrawal
-Odd behaviors
-Odd thinking
-Outbursts of anger
-Loss of volition
-Decrease in performance

Question 21

Schizophrenia Criteria C

Answer 21

6 months rule AND 1 month rule

Must note continuous signs such as prodromal/residual/psychosis for 6 months

AND 1 month must be active symptoms found in A above

The 1 moth rule is met if treatment such as medication/hospitalization is effective making the time frame less than a month

Question 22

Schizophrenia Criteria D, E, & F

Answer 22

D) Cannot have schizoaffective disorder, depressive or bipolar with psychotic features has been ruled out
E) disturbance not attributable to substance use/abuse or medical condition
F) if history of autism spectrum disorder or communication disorder of childhood onset must specify that hallucinations or delusions are present for one month
-Disorganized speech IS REMOVED FROM THE MUST HAVE LIST OF 3 in criteria A

Question 23

Hypnagogic

Answer 23

Relating to the state immediately before falling asleep–refers to hallucinations while falling asleep,

Question 24

Hypnopompic

Answer 24

Relating to the state immediately before waking up–refers to hallucinations while waking up

Question 25

Schizoaffective Disorder

Answer 25

A) Uninterrupted period of illness where there is a major mood episode concurrent with Schizophrenia—Section “A” (two forms of psychosis for 1 month or more).

B) Delusions or hallucinations for 2 OR MORE WEEKS in the absence of a major mood episode during the lifetime duration of the illness.

C) Symptoms of mood disorder are present for the majority of the active and residual periods

D) Not better explained by substance use or medical condition

Question 26

Delusional Disorder

Answer 26

A) Presence of 1 OR MORE delusions for 1 month or longer

B) Criterion A for Schizophrenia has not been met.

C) Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.

D) If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.

E). Disturbance is not attributable to physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or OCD.

Question 27

Brief Psychotic Disorder

Answer 27

A) Presence of 1 OR MORE of the following symptoms. At least one of these must be (1), (2), or (3):
1. Delusions.
2. Hallucinations.
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior.

B) Duration is AT LEAST 1 DAY–BUT LESS THAN 1 MONTH with eventual full return to premorbid level of functioning

C) Disturbance is not better explained by major depressive or bipolar disorder with psychotic features or another psychotic disorder such as schizophrenia or catatonia, and is not attributable to the physiological effects of a substance (e.g., a drug of abuse, medication) or another medical condition

Question 28

Schizophreniform Disorder

Answer 28

A) TWO OR MORE of the following, each present for a significant portion of the time during 1-MONTH period (or less if successfully treated). At least one of these must be (1), (2), or (3):
1. Delusions.
2. Hallucinations.
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior.
5. Negative symptoms (i.e., diminished emotional expression or avolition).

B) An episode of the disorder lasts AT LEAST 1 MONTH BUT LESS THAN 6 months. When the diagnosis must be made without waiting for recovery, it should be qualified as “provisional.”

C) Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.

D) The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

Question 29

Waxy Flexibility

Answer 29

Able to position client’s body and it stays that way.

Question 30

Catatonic Excitement

Answer 30

Appears sped up,” restless, and agitated. They sometimes engage in self-harming behavior. This form is also known as hyperkinetic catatonia.

Question 31

Anosogosia

Answer 31

Lack of insight, unawareness of symptoms of schizophrenia (may occur during entire course of illness)

Question 32

Disorganized Thinking

Answer 32

(Formal thought disorder) inferred from speech. Switch from one topic to another (derailment or loose associations or tangential)

Question 33

Derailment or Loose Associations

Answer 33

Switches from one topic to another

Question 34

Tangentiality

Answer 34

Answers barely if at all related to question or topic

Question 35

Incoherence or Word Salad

Answer 35

Linguistic disorganization

Question 36

Catatonic Behavior

Answer 36

Marked decrease in reactivity to environment

Question 37

Negativism

Answer 37

Catatonic behavior that is resistant to instructions

Question 38

Mutism & Stupor

Answer 38

Complete lack of verbal & motor responses

Question 39

Avolition

Answer 39

Negative symptom that is a decrease in motivated self-initiated purposeful activities

Question 40

Alogia

Answer 40

Negative symptom that is diminished speech output

Question 41

Anhedonia

Answer 41

Negative symptom that is a decreased ability to experience pleasure

Question 42

Asociality

Answer 42

Negative symptom that refers to lack of interest in social interactions and may be associated with abolition or limited opportunities for social interaction.

Question 43

Delusions of Control

Answer 43

One’s body or actions are being acted on or manipulated by some outside force

Question 44

Catatonia Associated with Another Mental Disorder (Catatonia Specifier)

Answer 44

A) The clinical picture is dominated by 3 OR MORE of the following symptoms:

1. Stupor (i.e. no psychomotor activity, not actively relating to environment).
2. Catalepsy (i.e. passive induction of posture held against gravity).
3. Waxy flexibility (i.e. slight even resistance to positions by examiner).
4. Mutism (i.e. no or very little verbal response [exclude if known aphasia]).
5. Negativism (i.e. opposition or no response to instructions or external stimuli).
6. Posturing (i.e., spontaneous and active maintenance of a posture against gravity).
7. Mannerism (i.e. odd, circumstantial caricature of normal actions).
8. Stereotypy (i.e. repetitive, abnormally frequent, non-goal directed movements).
9. Agitations, not influenced by external stimuli.
10. Grimacing.
11. Echolalia (i.e. mimicking another’s speech).
12. Echopraxia (i.e. mimicking another’s movements).

Coding note: Indicated name of associated mental disorder when recording this one.