School Psychopharmacology Flashcards
What is psychosis?
Psychosis is a psychiatric syndrome characterized by hallucinations (perceptions in the absence of stimulation) and delusions (beliefs held tenaciously despite contradictory evidence).
Which disorders can include psychotic symptoms?
Psychotic symptoms can occur in schizophrenia, major depressive disorder, bipolar disorder, and substance-induced mental health conditions.
What are primary psychotic disorders?
Primary psychotic disorders (schizophrenia-spectrum disorders) are those in which psychosis is the core feature, not restricted to mood disturbance, organic brain deterioration, or substance use.
What are common symptoms of primary psychotic disorders?
Hallucinations, delusions, disorganized behavior, and negative symptoms such as anhedonia.
What is the prevalence of schizophrenia and psychosis?
Schizophrenia affects about 1% of the population, while psychosis affects nearly 3.5% of individuals worldwide.
At what age does psychosis commonly onset?
The first episode of acute psychosis typically occurs between 18 and 25 years old, with earlier onset in males.
How common is early-onset schizophrenia?
Schizophrenia with onset between 13-18 years affects approximately 0.1% of the population, while onset before 13 years is about 0.01%.
What are the phases of psychotic disorders?
Psychotic disorders progress through several phases, including the prodromal phase, psychotic phase, and recovery/stabilization.
What characterizes the prodromal phase?
The prodromal phase involves mild psychotic symptoms, such as perceptual abnormalities and unusual thoughts, that are not yet fully impairing.
How does the psychotic phase differ from the prodromal phase?
The psychotic phase involves loss of insight into symptoms, more elaborate delusions, and significant impairment in daily functioning.
Why is early intervention important in psychosis?
Early intervention within the first 3-5 years of illness can facilitate recovery and stabilization.
What percentage of schizophrenia patients experience only one episode?
10-15% of individuals with schizophrenia experience only a single episode, while another 10-15% remain persistently psychotic.
How does psychosis affect school functioning?
Psychosis can interfere with academic performance, social relationships, and school attendance due to symptoms and hospitalizations.
What are the two main classes of antipsychotic medications?
First-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs).
Which SGAs are FDA-approved for schizophrenia in youth?
Aripiprazole, risperidone, olanzapine, quetiapine, paliperidone, and lurasidone.
Why are FGAs less commonly used in youth?
FGAs have a higher risk of adverse effects, such as extrapyramidal symptoms (EPS).
What is the estimated prevalence of antipsychotic use in youth?
In 2010, antipsychotic use was estimated at 0.1% for ages 1-6, 0.8% for ages 7-12, and 1.19% for ages 13-18.
What is the most common reason for antipsychotic prescriptions in youth?
Most antipsychotic prescriptions in youth are for conditions other than psychosis, such as ADHD, bipolar disorder, and autism.
What are the primary mechanisms of action for antipsychotics?
Most antipsychotics are dopamine type 2 (D2) receptor antagonists, though some have serotonin receptor antagonism or partial D2 agonism.
How effective are antipsychotics in treating psychosis?
A meta-analysis found antipsychotics reduce psychotic relapse rates from 64% to 27% over a 12-month period.
What are common side effects of antipsychotics in youth?
Somnolence, headache, dizziness, agitation, weight gain, extrapyramidal symptoms, and metabolic changes.
Why is adherence to antipsychotic medication challenging in youth?
Side effects, stigma, and lack of insight into illness often reduce adherence to prescribed antipsychotic treatment.
What are the benefits of combining psychosocial interventions with medication?
Psychosocial interventions help engage youth, address barriers to adherence, and improve school and social functioning.
What role can schools play in identifying psychosis?
Teachers and school staff can help identify early symptoms and refer students for psychiatric evaluation.
What tools can be used to assess psychosis in youth?
The Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) and Brief Psychiatric Rating Scale for Children.
Why is psychoeducation important for students with psychosis?
Psychoeducation helps students and families understand the illness, medication effects, and strategies for managing symptoms.
What are key recommendations for school personnel?
Schools should foster a supportive environment, use screening tools, provide psychoeducation, and collaborate with families and clinicians.
