Schizophrenic disorder Flashcards

1
Q

define psychosis

A

impairment of reality testing

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2
Q

disorders with psychotic symptoms/differential diagnosis

A
  • brief psychotic disorder: psychotic symp less than 1 month
  • schizophreniform disorder: symp > 1 month but < 6 month

-schizophrenia: symp for > 6 month

-mood disorder with psychotic features

-schizoaffective disorder:initially present with mood disorder + psychosis,mood disturbance disappears but psychotic symptoms persist for more than 2 weeks

-delusional disorder ( non bizarre unshakeable false beliefs with no hallucinations)

-psychotic disorder due to gen medical cond/prescribed meds (levodopa,steroids,bromocriptine)/illicit drug use inclusing alcohol

-post partum psychosis

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3
Q

phases of schizo

A

prodromal phase: negative symptoms
acute phase: positive symptoms
residual phase ( aft antipsychotics):negative symptoms

-relapses,remission or residual phase throughout life

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4
Q

Negative symptoms of schizophrenia:5A

A

1)Affective blunting (x emotional expressions
2)Alogia (poverty of speech)
3)Avolition (Lack of motivation)
4)Asocial (social withdrawal)
5)Apathy (detachment fr rest of the world/ lose interest in everything)

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5
Q

positive symptoms

A

-Delusions
-hallucinations
-disorganised speech (incoherence with looseness of association)
-disorganised or catatonic behaviour

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6
Q

schneider’s first rank symptoms of schizophrenia ( any 1 for diagnosis aft ruling out mood disorder,organic causes)

A
  1. thought echo: voices telling aloud what patient thinks

2.running commentary

3.3rd person auditory hallucination: 2 or more voices critically discussing about the patient

4.thought broadcasting/accessible thought:belief that his thoughts are conveyed to others

5.though withdrawal:belief in an external force removing one’s thoughts

6.thought insertion/alienation:beleif in an external force putting thoughts into one’s mind

  1. delusion of control(passivity phenomena)/made act, made affect:belief that ones feelings and emotions are under control by an external force

8.delusional perception: the unshakeable belief that normal events occuring around have a special meaning or convey a special message to the patient

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7
Q

elicit thought echo

A

do u hear voices that tell u aloud what you are thinking?

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8
Q

elicit running commentary

A

do you hear voices that critically comment on your action

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9
Q

elicit 3rd person auditory hallucination

A

do u hear 2 or more voices critically discussing about you

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10
Q

elicit thought broadcasting/accessible thought

A

do u believe that whatever u think is accessible to others and they come to know them

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11
Q

elicit though withdrawal

A

do you believe that an external force is taking away your thoughts and you are devoid of thoughts

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12
Q

elicit thought insertion/alienation

A

do you believe that your thoughts are not yours but put into u by an external agency or force

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13
Q

elicit delusion of control(passivity phenomena)/made act, made affect

A

do u believe that your emotions n actions are not under your ctrl but controlled by an external force and you are passively receiving them?

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14
Q

elicit delusional perception

A

do you believe that events occurring around you have a special meaning to you or convey a special message to u.

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15
Q

paranoid schizo

A

delusions + auditory hallucinations

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16
Q

disorganized/ hebephrenic schizo

A

disorganised behaviour + disorganised speech + affective blunting

17
Q

catatonic schizophrenia

A

2 or more catatonic symptoms

18
Q

residual schizo

A

no longer positive symptoms,only negative symptoms

19
Q

simple schizophrenia

A

only negative symptoms

20
Q

undifferentiated schizo

A

symptoms not fitting in any other types

21
Q

elicit delusion of persecution

A

do u believe that others are plotting to harm u or working against u to endanger your life? if yes explain further

22
Q

elicit delusion of reference

A

do u believe that wherever u go people are talking about u and making gestures referring to u
OR
do u think the programs in TV and radio are about u or have reference to u

23
Q

delusion of infidelity

A

do u believe that your spouse/partner is unfaithful to u and having and affair with someone else?
if yes,explain further

24
Q

true hallucinations: 5 req to dif fr pseudohallucination
1) must be perceptions without stimulus

A

when u hear the voices can you see the persons who are speaking
OR
when u hear the voices can others around you hear these voices

25
2) experience must be objective*
is the voice coming fr out there(objective) or within u
26
3) perceiving through sense organs*
are the voices perceived through the ears?
27
4)should occur in the awakened state whether clear or clouded consciousness
when do u hear the voices? is it related to sleep?
28
5) lack of insight*
is it a real experience or can it be your imagination
29
types of auditory hallucination
2nd person hallucination 3rd person hallucination command hallucination
30
symptoms of paranoid schizo
bizzare delusions only OR any delusions + prominent auditory hallucinations OR prominent auditory hallucination only
31
what is meant by disorganised speech
incoherent with thought derailment - looseness of association
32
symptoms in catatonic schizo:2 or more catatonic symp
1.motor immobility stupor (mutism+akinesia) posturing waxy flexibility 2.catatonic excitement (opp to 1)- excessive purposeless motor activity 3.odd behaviour/speech which is repetitive automatic obedience negativism mannerism stereotypes perseveration ambivalence/ambitendence echolalia/echopraxia
33
how to maximize compliance
psychoeducation to patient and family depot antipsychotic injection home visits antipsychotic drops
34
comorbidities
depression/post psychotic depression substance use disorder including alcohol
35
good prognostic indicators
female late onset good premorbid func in edu,job,marriage no fam history acute onset prominent positive symp duration of untreated psychosis less than a year