Week 1 Flashcards
What are the five domains that define schizophrenia spectrum and other psychotic disorders?
- Delusions: Fixed beliefs resistant to contradictory evidence.
- Hallucinations: Perception-like experiences without external stimuli, often auditory.
- Disorganized Thinking (Speech): Includes derailment, tangentiality, or incoherence.
- Grossly Disorganized or Abnormal Motor Behavior: Includes catatonia.
- Negative Symptoms: E.g., diminished emotional expression, avolition, alogia, anhedonia, asociality.
What are the common types of delusions in psychotic disorders?
- Persecutory: Belief of being harmed or harassed.
- Referential: Belief that certain cues are directed at oneself.
- Grandiose: Belief in exceptional abilities or fame.
- Erotomanic: False belief that another person is in love with them.
- Nihilistic: Belief of an impending catastrophe.
- Somatic: Preoccupation with bodily health or functions.
What are the prominent negative symptoms in schizophrenia?
- Diminished Emotional Expression: Reduced facial, eye, and vocal expressions.
- Avolition: Decrease in self-initiated purposeful activities.
- Alogia: Reduced speech output.
- Anhedonia: Decreased pleasure in previously enjoyable activities.
- Asociality: Lack of interest in social interactions.
What are the diagnostic criteria for Brief Psychotic Disorder?
- Presence of one or more symptoms: delusions, hallucinations, disorganized speech, or grossly disorganized/catatonic behavior.
- Duration: At least 1 day but less than 1 month.
- Full return to premorbid functioning.
- Not attributable to another condition, substance, or mood disorder.
What are the core diagnostic criteria for schizophrenia?
- Two or More Symptoms (for 1 month): Delusions, hallucinations, disorganized speech, disorganized behavior, or negative symptoms.
- Functional Impairment: Markedly below pre-onset functioning in work, relationships, or self-care.
- Duration: Continuous signs for at least 6 months.
- Exclusion of schizoaffective disorder or mood disorders with psychosis.
What are hallucinations?
Perception-like experiences without an external stimulus, vivid and involuntary.
What types of hallucinations are there?
- Auditory (most common): Hearing voices, distinct from one’s own thoughts.
- Visual, tactile, gustatory, or olfactory hallucinations.
How are hallucinations classified in psychotic disorders?
Must occur in a clear sensorium; hypnagogic (falling asleep) or hypnopompic (waking up) hallucinations are normal.
Must occur in a clear sensorium; hypnagogic (falling asleep) or hypnopompic (waking up) hallucinations are normal.
- Loose Associations/Derailment: Switching from one topic to another.
- Tangentiality: Answers unrelated or loosely related to questions.
- Incoherence/Word Salad: Severely disorganized, incomprehensible speech.
Note: Must impair communication significantly for diagnosis.
What are the features of catatonia in psychotic disorders?
- Decreased Reactivity: Resistance to instructions (negativism), mutism, stupor.
- Motor Symptoms: Rigidity, bizarre postures, purposeless excessive motor activity.
- Other Features: Grimacing, echolalia (repeating others’ speech), echopraxia (mimicking movements).
Context: Can occur in schizophrenia, mood disorders, or medical conditions.
What are the diagnostic criteria for Delusional Disorder?
- One or More Delusions: Present for at least 1 month.
- No other symptoms of schizophrenia.
- Functioning Not Markedly Impaired: Behavior is not bizarre outside the delusions.
- Excludes substance-induced or medically-related causes.
Subtypes: Erotomanic, grandiose, jealous, persecutory, somatic, mixed, or unspecified.
How does schizophreniform disorder differ from schizophrenia?
- Symptoms: Identical to schizophrenia (delusions, hallucinations, disorganized speech, etc.).
- Duration: Lasts at least 1 month but less than 6 months.
- Impairment: Social/occupational functioning impairment not required.
- May include a “provisional” diagnosis if recovery is uncertain.
What distinguishes schizoaffective disorder from schizophrenia or mood disorders?
- Criteria A of Schizophrenia: Delusions, hallucinations, or disorganized speech.
- Mood Symptoms: Depressive or manic episodes present for the majority of the illness.
- Psychosis Alone: Delusions or hallucinations for at least 2 weeks without mood symptoms.
- Excludes substance-induced or medical causes.
What are the known risk factors for developing schizophrenia?
- Genetic: Family history of schizophrenia or related disorders.
- Prenatal: Hypoxia, infection, malnutrition, or maternal stress during pregnancy.
- Environmental: Urban upbringing, minority ethnicity, and late winter/early spring birth.
- Physiological: Advanced paternal age and perinatal complications.
What distinguishes delusional disorder from schizophrenia?
- Single Symptom: Presence of one or more delusions lasting 1+ month.
- No Schizophrenia Criterion A: Hallucinations are rare or minimal.
- Functioning: Relatively preserved outside delusional context.
What are the diagnostic criteria for schizoaffective disorder?
- Uninterrupted illness with active psychosis meeting Criterion A for schizophrenia.
- Major mood episode (depressive or manic) concurrent with psychosis.
- At least 2 weeks of delusions or hallucinations without mood symptoms.
- Mood symptoms present for the majority of the illness duration.
How is schizophrenia differentiated from related disorders?
- Brief Psychotic Disorder: Duration <1 month.
- Schizophreniform Disorder: Duration 1-6 months.
- Delusional Disorder: Delusions without other Criterion A symptoms.
- Schizoaffective Disorder: Prominent mood symptoms with psychosis.
- Substance-Induced Psychotic Disorder: Psychosis linked to substance use.
What are common functional consequences of schizophrenia?
- Impaired educational progress and employment.
- Social isolation and difficulty maintaining relationships.
- Persistent self-care challenges due to negative symptoms (e.g., avolition).
Delusions
Fixed beliefs that are resistant to contradictory evidence. They can be persecutory, referential, grandiose, erotomanic, nihilistic, or somatic.
Avolition
Decreased motivation to initiate and sustain goal-directed activities, leading to long periods of inactivity or lack of interest in social or work activities.
Disorganized Speech
Speech that reflects disorganized thinking, such as loose associations, tangentiality, or incomprehensible “word salad.”
Negative Symptoms
Symptoms characterized by a loss or reduction in normal functions, including diminished emotional expression, avolition, alogia, anhedonia, and asociality.
Catatonia
A state of motor immobility or excessive motor activity that includes resistance to movement, bizarre postures, or purposeless movements.
Persecutory Delusions
A belief that one is being harmed, harassed, or conspired against by others, which is the most common type of delusion.
Grandiose Delusions
A belief in having exceptional abilities, wealth, or fame beyond reality.
Brief Psychotic Disorder
A psychotic episode characterized by delusions, hallucinations, or disorganized speech lasting at least one day but less than one month, with a full return to premorbid functioning.
Schizophreniform Disorder
A condition identical to schizophrenia in symptoms but lasting between 1 and 6 months, with or without significant functional impairment.
Schizoaffective Disorder
A disorder characterized by symptoms of schizophrenia combined with mood disorder episodes, such as major depressive or manic episodes.
Anhedonia
The diminished ability to experience pleasure from previously enjoyable activities or a decreased capacity to recall such pleasure.
Asociality
Apparent lack of interest in social interactions, which may stem from limited opportunities or a genuine disinterest.
Substance/Medication-Induced Psychotic Disorder
Psychosis directly caused by the physiological effects of a substance, such as drugs, medication, or toxin exposure, which resolves after removal of the agent.
Schizophrenia
A disorder lasting at least 6 months, marked by delusions, hallucinations, disorganized speech, catatonia, or negative symptoms, and significant functional impairment.
Delusional Disorder
A psychotic disorder with persistent delusions for at least 1 month, without other schizophrenia Criterion A symptoms, and with preserved functionality.
Types of Delusions
Persecutory, referential, grandiose, erotomanic, nihilistic, somatic
Auditory Hallucinations
Hearing voices distinct from one’s own thoughts
Word Salad
Incoherent speech resembling severe linguistic disorganization.
Catatonic Excitement
Purposeless, excessive motor activity
Prodromal Symptoms
Early signs of schizophrenia, like odd beliefs and withdrawal.
Mixed Delusional Disorder
Multiple delusional themes with no dominant type.
Grandiose Type (Delusional Disorder)
Belief in unrecognized exceptional talent or importance.
Tangentiality
Speech that veers off-topic and does not return.
Negative Symptoms Examples
Avolition, alogia, anhedonia, asociality
Functional Impairment in Schizophrenia
Poor self-care, unemployment, social withdrawal.
First Episode, Acute (Schizophrenia)
Initial presentation meeting diagnostic criteria.
Risk Factors for Schizophrenia
Urban upbringing, family history, prenatal complications.
Brief Psychotic Disorder Duration
Lasts 1 day to less than 1 month.
