Schizoprenia, MacIntyre Flashcards
delusion
fixed, false belief non consistent w/ cultural or religious background
bizarre or non bizarre
hallucination
false sensory perception not assoc with real external stimuli
olfactory common!
do personality disorders have hallucinations
no
DDX psychosis
SLE, acute intermittent porphyria, major depressive disorder, bipolar disorder, seizures, schizophrenia, substance intoxication, delirium, dementia, adverse drug reaction
4 As of schizophrenia
Associations
Autism
Ambivalence
Affect
demopgraphics schizophrenia
men=women
onset late teens to late 20s
men earlier than women
signs schizophrenia
wide range mental disturbances
increased suicide risk
more likely to be victim of violence
Dx of exclusion
what is prodromal period schizo
first break can be mild to severe
dx of schizophrenia
>2 for >1 mo delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative Sx Signs persits for at least 6 mo
what must be ruled out to Dx schizophrenia
schizoaffective, mood disorders, substances, general medical conditions, autism spectrum
positive Sx of schizo
hallucinations and delusions
usually auditory hallucinations!!!
disorganized speech/behavior
negative Sx schizo
lack of motivation
affective blunting
cognitive blunting
impaired social funcitnoing and social withdrawal
reason for genetic consideration schizo
inc in monozygotic twins
imaging in schizo
enlarged 3rd and lateral ventricles
which area of brain affected in schizophrenia
prefrontal Cx connections (last cortical area to develop)
NT thought to be involved in schizophrenia
DA
serotonin
glutamate
1st line Tx in schizophrenia
antipsychotics
monitor what if on antipsychotic
movement disorders, dystonia, akathisia, tremor, rigidity, tardive dyskinesias
neuroleptic malignant syndrome
anticholinergic effects
sedation
metabolic consequences (DM, weight gain, dyslipidemia)
what is akathisia
inability to sit still
risks with clozapine
agranulocytosis– restricted use
can dec suicidality!!!!!!!
what occurs with noncompliance to meds in schizo
decompensation, brain tissue may be lost with each relapse
schizophreniform disorfer
Sx of schizophrenia but only last
schizoaffective disorder
both schizophrenia and depression or bipolar illness
Dx schizoaffective disorder
2 weeks schizophrenia Sx in absence of mood Sx
AND
presence of mood Sx for substantial part of lifetime illness course
Tx schizoaffective disorder
psychosis with antipsychotics
mania with mood stabilizers
depression with antidepressants
brief psychotic disorder
psychosis > 1 day but
Tx brief psychotic disorder
antipsychotics
what is a type of brief psychotic disorders
post partum psychosis
postpartum psychosis
emergency!!!
keep mother and baby safe
mother may have bipolar Hx
delusional disorder
> 1 mo of delusion
behavior and function usually not affected
W>M mid late life
Tx delusional disorder
psychotherapy, poor response to antipsychotics
