Schizophrenia Spectrum & Psychotic Disorders Flashcards
What is the diagnostic criteria for Schizophrenia
Two or more of the following symptoms (at least one must be 1, 2, or 3):
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment, incoherence)
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (e.g., diminished emotional expression, avolition)
6. Symptoms persist for at least 6 months, with at least 1 month of active-phase symptoms.
7. Significant impairment in social, occupational, or self-care functioning.
8. Symptoms are not attributable to a substance or medical condition.
What are positive symptoms in Schizophrenia?
Delusions: Fixed, false beliefs (e.g., persecutory, grandiose, referential).
Hallucinations: Sensory perceptions without external stimuli, most commonly auditory.
Disorganized speech: Incoherence, tangentiality, or loose associations.
Disorganized or catatonic behavior: Unpredictable agitation or immobility.
What are negative symptoms in Schizophrenia
Diminished emotional expression: Reduced facial expressions, eye contact, and gestures.
Avolition: Decreased motivation to initiate or sustain activities.
Anhedonia: Inability to experience pleasure.
Alogia: Poverty of speech.
Asociality: Lack of interest in social interactions.
What is the difference between Schizophrenia and Schizophreniform Disorder
Schizophrenia: Symptoms persist for 6 months or more.
Schizophreniform Disorder: Symptoms persist for 1-6 months.
What are the phases of Schizophrenia
Prodromal Phase: Subtle symptoms (e.g., social withdrawal, odd beliefs, reduced functioning).
Active Phase: Prominent symptoms (e.g., delusions, hallucinations, disorganized speech/behavior).
Residual Phase: Reduced severity of symptoms, often negative symptoms remain.
What is the prevalence and typical onset of Schizophrenia
Prevalence: Approximately 1% of the population.
Onset: Late adolescence to early adulthood; typically earlier in males (late teens to early 20s) than females (mid-20s to early 30s).
What are common co-occurring conditions with Schizophrenia
Substance use disorders (e.g., nicotine dependence, cannabis use).
Anxiety disorders (e.g., social anxiety).
Depressive disorders.
Cardiovascular and metabolic conditions (e.g., diabetes).
How is Schizoaffective Disorder differentiated from Schizophrenia
Schizoaffective Disorder: Includes a mood episode (manic or depressive) concurrent with psychotic symptoms and at least 2 weeks of psychosis without mood symptoms.
Schizophrenia: Mood symptoms, if present, do not dominate the clinical picture.
What is the role of genetics in Schizophrenia
Schizophrenia has a strong genetic component.
Risk:
10% risk in first-degree relatives.
50% risk in identical twins if one twin has the disorder.
Likely involves polygenic factors and environmental interactions.
What are cognitive deficits in Schizophrenia
Impaired working memory.
Poor executive functioning (e.g., planning, decision-making).
Difficulty maintaining attention.
Often more persistent than positive symptoms and significantly affect functioning.
What is the distinguishing feature of Delusional Disorder compared to Schizophrenia
Delusional Disorder: Presence of one or more delusions for at least 1 month without prominent hallucinations, disorganized speech, or negative symptoms.
Functioning is generally not markedly impaired apart from the delusions.
What is the diagnostic criteria for Brief Psychotic Disorder
One or more of the following symptoms: (at least one must be 1, 2, or 3):
Delusions
Hallucinations
Disorganized speech (e.g., frequent derailment, incoherence)
Grossly disorganized or catatonic behavior
Symptoms last at least 1 day but less than 1 month with a full return to premorbid functioning.
Symptoms are not better explained by a mood disorder with psychotic features, schizophrenia, or the effects of a substance/medical condition.
What are the subtypes of Brief Psychotic Disorder
Subtypes (DSM-5):
With marked stressor(s): Symptoms occur in response to a significant stressor (e.g., trauma, loss).
Without marked stressor(s): Symptoms are not linked to an identifiable stressor.
With postpartum onset: Onset occurs during pregnancy or within 4 weeks postpartum.
What is the typical course and outcome of Brief Psychotic Disorder
Course: Symptoms develop abruptly and remit within 1 month.
Outcome: Most individuals return to their baseline level of functioning. Some may develop longer-lasting psychotic disorders (e.g., schizophrenia) in rare cases.
What is the prevalence of Brief Psychotic Disorder
Prevalence (DSM-5):
Rare, affecting approximately 0.1% of the population.
More common in females than males.
Higher prevalence in individuals with low socioeconomic status or those exposed to extreme stress.
What are common risk factors for Brief Psychotic Disorder
Stressful life events: Trauma, significant loss, or natural disasters.
Postpartum period: Increased vulnerability during pregnancy or shortly after birth.
Family history: Increased risk if there’s a family history of psychotic disorders or mood disorders.
How is Brief Psychotic Disorder differentiated from Schizophrenia
Duration: Brief Psychotic Disorder lasts less than 1 month, while Schizophrenia lasts 6 months or more.
Functional Decline: Brief Psychotic Disorder usually resolves with a return to baseline functioning, while Schizophrenia involves persistent functional impairments.
Prodromal Symptoms: Schizophrenia often has a prodromal phase; Brief Psychotic Disorder has an abrupt onset.
What is the difference between Brief Psychotic Disorder and Delusional Disorder
Brief Psychotic Disorder: Involves multiple psychotic symptoms (e.g., delusions, hallucinations, disorganized speech), with symptoms lasting less than 1 month.
Delusional Disorder: Involves only persistent delusions lasting 1 month or more without other psychotic symptoms like hallucinations or disorganized speech.
What is the differential diagnosis for Brief Psychotic Disorder
Conditions to Differentiate:
Substance/medication-induced psychotic disorder (e.g., intoxication, withdrawal).
Psychotic disorder due to a medical condition (e.g., seizure disorder, CNS infection).
Mood disorders with psychotic features (e.g., major depressive disorder, bipolar disorder).
Schizophrenia-spectrum disorders (based on duration and other criteria).
What is the diagnostic criteria for Schizoaffective Disorder
Uninterrupted period of illness during which there is a major mood episode (depressive or manic) concurrent with Criterion A for Schizophrenia (delusions, hallucinations, disorganized speech, etc.).
Delusions or hallucinations must occur for at least 2 weeks in the absence of a major mood episode during the illness.
Symptoms of the major mood episode are present for the majority of the total duration of the active and residual phases.
Symptoms are not attributable to substance use or another medical condition.
What are the subtypes of Schizoaffective Disorder
Bipolar Type: Includes a manic episode (with or without depressive episodes).
Depressive Type: Includes only major depressive episodes.
What are the distinguishing features of Schizoaffective Disorder compared to Schizophrenia and Bipolar Disorder?
Schizoaffective Disorder vs. Schizophrenia: Schizoaffective Disorder requires prominent mood symptoms for the majority of the illness duration.
Schizoaffective Disorder vs. Bipolar Disorder: In Schizoaffective Disorder, psychotic symptoms persist even in the absence of mood episodes for at least 2 weeks.
What is the prevalence and typical onset of Schizoaffective Disorder
Prevalence: Less common than schizophrenia and mood disorders, affecting approximately 0.3% of the population.
Onset: Typically in early adulthood, but can vary based on mood subtype (manic onset is often earlier).
What are the common symptoms of Schizoaffective Disorder
Mood symptoms: Depressed mood, anhedonia, manic episodes (elevated or irritable mood).
Psychotic symptoms: Delusions, hallucinations, disorganized speech, grossly disorganized behavior.
Cognitive impairments: Trouble with memory, attention, and decision-making.
What are the risk factors for Schizoaffective Disorder
Family history of schizophrenia or mood disorders.
Childhood trauma or stress.
Substance use disorders.
Environmental stressors or life events
