W4_Schizo Flashcards
Schizophrenia Spectrum Disorder is commonly confused with ???
Multiple Personality Disorder
Psychosis
Think HDD!
A form of severe mental disturbance where the individual loses touch with reality
Characterized by:
1. Hallucinations
2. Delusions
3. Disorganized thoughts & behavior
It is possible for patients to display all three of the above
Delusions
Fixated, False & Unshakeable personal belief
Hallucinations
False perceptions in the absence of a real external stimulus
Disorganized Thinking
Thoughts that doesn’t make sense or follow an idea.
Schizoaffective Disorder
Symptoms of schizophrenia with addition of a **mood disorder ** (Depression, Bipolar)
Brief Psychotic Disorder
Symptoms of schizophrenia for < 1 month
Schizophreniform Disorder
Symptoms of Schizophrenia for 1-6 months
Schizophrenia
Persists > 6 months
Positive Symptoms: Delusions, Hallucinations, Disorganized speech, Catatonic behavior
Negative Symptoms: 5As
Schizoid Personality Disorder
Avoid social interaction
Lack friends
Lack of sexual interest
Lone Wolf
Not caused by paranoia or social anxiety
(Overlaps with negative symptoms of Schizophrenia)
Schizotypal Personality Disorder
Excessive Magical Thinking
(linking unrelated events, fixation on personal destiny)
Beliefs cause overconfidence, poor social perception,
still want to maintain relationships.
Delusional Disorder
Fixed False Belief that lasts > 1 month without other schizophrenia criteria.
Rank the following in terms of duration of symptoms.
- Delusional disorder
- Schizoaffective disorder
- Schizophrenia
- Brief psychotic disorder
- Schizophreniform disorder
Schizoaffective Disorder, Schizophrenia + Mood Disorder (Depression, Bipolar)
Schizophreniform >= 6mth, Positive & Negative (5As)
Schizophreniform disorder 1-6mth, w schizo symptoms
Brief psychotic disorder < 1 mth, w schizo symptoms
Delusional Disorder < 1 mth, w/o schizo symptoms
Schizoaffective Disorder should not be mistakened as _
Mood Disorder
Positive Symptoms of Schizophrenia
Hallucinations
Delusions
Negative Symptoms (5As)
Lack of facial expression (Flatten Affect)
Lack of speech (Alogia)
Lack of drive and energy (Apathy)
Lack of interest (Avolitional)
Lack of pleasure (Anhedonia)
Diagnostic Criteria of Schizophrenia
A
B
C
D
Different symptoms dimensions
Schneider 1St Rank Symptoms
ABCD:
Auditory Hallucinations
Broadcasting of Thoughts
Controlled Thoughts (Delusions of Control), Delusional Perception.
Diagnostic Criteria for Schizophrenia
A,B,C
**A. Characteristic Symptoms **
**(2 or more of the following) in < 1 month **
HDD NG
Each present for a significant portion of time during a 1-month period
(or less if successfully treated):
Hallucinations
Delusions
Disorganized speech
(e.g., frequent derailment or incoherence)
Negative symptoms, i.e., affective flattening, alogia or avolition
Grossly disorganized or catatonic behaviour
Do we really need to follow the Diagnostic criteria strictly?
Only One Criterion A symptom is required if delusions are bizarre or hallucinations consist of a voice keeping up a running commentary on the person’s behavior or thoughts, or two or more voices conversing with each other.
Exclusions for Schizophrenia
1) Schizoaffective and Mood Disorder exclusion
2) Substance / general medical condition exclusion
3) Relationship to a Pervasive Developmental Disorder (ASD or another pervasive developmental disorder)
Significant observations during MSE
for Schizophrenia patients
A: Unkempt, Dirty, Unshaved, long finger nails
S: Loosening of association, tangential, over-inclusive
E (Mood): Overtly expressive or totally none
E (Affect): Blunted affect
P: Auditory hallucinations, delusion (persecutory, passivity, reference)
T: -
I: Lack of insight of symptoms
C: -
Suicidal ideation may be present
Cause of Schizophrenia
Genetic (Sibling, parents)
Environmental (Maternal viral infection/ malnutrition. Obstetric issues, subtance abuse)
Brain structure & Chemistry (Dopamien hypothesis)
- Cause is unknown
- Caused by interaction of genetic & environmental factors
What are the pharmacology treatment goals in treating Schizophrenia patients?
To treat positive/ negative symptoms?
Manage acute positive psychiatric symptoms
What are the common medical treatment for schizophrenia?
1st -Gen anti-psychotics includes:
Thorazine, Fluanxol, and Haloperidol.
Effective in treating the positive symptoms of schizophrenia.
But not useful in treating the 5As.
2nd -Gen anti-psychotics include:
Risperdal, Clozaril, and Aripiprazole etc. Recommended for first-line treatment & are excellent at reducing negative symptoms.
Can target both positive & negative symptoms with better side effect profile.
