11. Specific Disorders - Schizophrenia and Other Psychotic Disorders Flashcards Preview

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Flashcards in 11. Specific Disorders - Schizophrenia and Other Psychotic Disorders Deck (15):
1

What disorders are included in schizophrenia spectrum and other psychotic disorders?

Schizotypal (Personality) Disorder
Delusional Disorder
Brief Psychotic Disorder
Schizophreniform Disorder
Schizophrenia
Schizoaffective Disorder

Substance/Medication Induced Psychotic Disorder
Psychotic Disorder Due to Another Medical Condition
Catatonia Associated w/ Another Mental Disorder
Catatonia Associated w/ Another Medical Condition
Unspecified Catatonia
Other specified schizophrenia spectrum and other
psychotic disorder
Unspecified schizophrenia spectrum and other psychotic
disorder

2

To be diagnosed with a schizophrenia spectrum and other psychotic disorder, you must have abnormalities in what?

Abnormalities in one or more of the five domains:
Delusions
Hallucinations
Disorganized thinking (speech)
Grossly disorganized motor behavior
Negative symptoms

3

What are the three phases of schizophrenia?

Prodromal, Active, and Residual

4

What is the prodromal phase of schizophrenia?

It involves early changes like social withdrawal, lack of self-care, odd thoughts, vague speech, and not acting "themselves"

5

What is the active stage of schizophrenia?

The presence and prevalence of positive symptoms.

6

What is the residual phase of schizophrenia?

It occurs following an active episode, and they return to prodromal level. Positive symptoms are absent or minimal, and negative symptoms are attenuated or in residual form.

7

What are the 5 subtypes of schizophrenia?

5 subtypes of schizophrenia (Captain Picard Doesn’t Respond Unethically)
(1) Paranoid
(2) Disorganized - presence of unorganized
delusions and hallucinations, no overall theme,
disorganized speech and behavior, flat affect
(3) Catatonic - motor disturbances, immobile to
severe agitation and pacing, cataplexy
(4) Undifferentiated - prevalence of pos and negative
symptoms but not clearly differentiated
(5) Residual - negative symptoms are lessened, no
clear positive symptoms

8

What are the diagnostic criteria for Schizophrenia?

A. Two or more during a 1 month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms

B. Level of functioning markedly lower after onset, or failure to achieve expected level of functioning when onset is in childhood or adolescence

C. The disturbance must have lasted at least 6 months, and during this time at least 1 month must have been active

D. R/O Schizoaffective disorder and depressive bipolar disorder w/ psychotic features

E. Not due to substance/other medical condition

F. If Hx of autism spectrum disorder or a communication disorder of childhood, additional diagnosis is made only if prominent delusions or hallucinations are also present for at least 1 month

9

Schizophrenia prevalence?

.3 - .7%

10

Gender differences in schizophrenia?

Males - negative symptoms and longer duration of disorder associated with bad outcomes

Equivalent for males and females - more mood symptoms and brief presentations associated with better outcomes

11

Onset of schizophrenia?

late teens - mid 30's

first psychotic episode - early to mid 20's for males, late 20's for females

12

Risk/prognostic factors for schizophrenia?

Environmental - season of birth has been linked; higher for children growing up in an urban environment and for some minority ethnic groups

Genetic/physiological - most diagnosed have no family Hx of psychosis; pregnancy and birth complications

13

Culture-related Dx issues for schizophrenia?

Delusional ideas in one culture, like witchcraft, may be normal in another.

Visual/auditory hallucinations with religious content for normal in some cultures.

14

What needs to be ruled out for diagnosis of schizophrenia?

Schizoaffective disorder - requires a major depressive or manic episode coincide with active phase symptoms

Schizophreniform disorder and brief psychotic disorder - shorter duration; schizophreniform lasts less than 6 months, and in brief psychotic disorder present at least one day, but less than 1 month

Delusional disorder - only delusions, not the other symptoms

Schizotypal personality disorder - subthreshold symptoms that are associated with personality features

OCD/BDD - obsessions and compulsions

PTSD - reliving/re-enacting

Autism spectrum/communication disorders - respective deficits in social interaction with repetitive and restricted behaviors and other cognitive and communication deficits

Other mental disorders associated with a psychotic episode - like delirium, neurocog disorder, those due to SA

15

What is known about the comorbidity of schizophrenia and other disorders?

It is high with substance use disorders

w/ anxiety disorders is also increasingly recognized

schizotypal or paranoid PD may precede the onset

Life expectancy reduced due to associated medical conditions