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Flashcards in Schizophrenia & Other Psychotic Disorders Deck (22):
1

Average onset of schizophrenia is in the late _____.

Onset is generally _______. 

teens 

insidious 

2

What is Dementia Praecox?

 premature deteriorating disorder

differentiated manic-depressive illness from progressive illness (Emil Kraeplin)

3

What was Eugen Bleuler's definition of “The Schizophrenias”?

“The group of schizophrenias” have in common a split among affect, thought, emotion & behavior 

4

What are Eugen Blueler's "4 A's" of Schizophrenia?

  • Associations
  • Affect
  • Autism
  • Ambivalence 

5

What are the “First-Rank Symptoms” of Schizophrenia as defined by Kurt Schneider?

  • Thought broadcasting
  • Thought withdrawal
  • Voices arguing or commenting
  • Somatic passivity 

 

6

Symptomatology of Schizophrenia (DSM IV)

What are the 6 components?

  • Characteristic symptoms
  • Social/Occupational Dysfunction
  • Duration 
  • Schizoaffective & Mood Disorder exclusion
  • Substance/general medical condition exclusion 
  • Relationship to a Pervasive Developmental Disorder 

7

What are the characteristic symptoms of Schizophrenia? 

2 or more of the following, each present for a significant portion of time during a 1-month period

  • Delusions
  • Hallucinations
  • Disorganized speech (frequent derailment or incoherence)
  • Grossly disorganized or catatonic behavior
  • Negative symptoms (affective flattening, alogia or avolition) 

8

What is the definition of social/occupation dysfunction in Schizophrenia? 

For a significant portion of the time since the onset of the disturbance, one or more major areas of functioning such as work, interpersonal relations, or self-care are markedly below the level achieved prior to the onset 

9

What is the requirement for duration of symptoms in Schizophrenia?

  • Continuous signs of the disturbance persist for at least 6 mo
  • This 6 mo period must include at least 1 mo of symptoms that meet criterion A & may include periods of prodromal or residual symptoms
  • During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or 2 or more symptoms listed in criterion A present in an attenuated form 

10

Schizoaffective & Mood Disorder exclusion

No major _________, _____ or _____ episodes have occurred concurrently w/ the active-phase symptoms

depressive

manic

mixed 

11

If there is a history of __________ or another ________ __________ disorder, the additional diagnosis of Schizophrenia is made only if prominent delusions or hallucinations are also present for at least a month  

autistic disorder

pervasive developmental 

12

Definitions

  • Positive Symptoms
  • Negative Symptoms
  • Cognitive Symptoms 

  • Positive symptoms
    • Delusions, hallucinations, behavioral disturbance
  • Negative symptoms
    • Social isolation, withdrawal, poor grooming, anergy, loss of interest, blunted affect
  • Cognitive symptoms
    • Impaired abstract thinking, impaired problem-solving, disturbed memory

13

What are the 5 historical classifications of Schizophrenia? (DSM IV)

  • Catatonic
  • Disorganized
  • Paranoid
  • Residual
  • Undifferentiated 

14

What are the 4 theories of the etiology of Schizophrenia?

  • Genetic predisposition important
    • Shown in twin studies
  • Anatomic changes present
    • Enlarged lateral ventricles
    • Increased width of 3rd ventricle
    • Sulcal enlargement
  • Physiologic changes present
    • Dorsolateral prefrontal cortex poorly activated
    • Thalamus & cerebellum possibly involved
  • Biochemical factors involved
    • Dopamine D2 receptors blocked by all anti-psychotics 

15

What are these PET scans demonstrating in relation to Schizophrenia?

  • PET scans from identical (monozygotic) twins who are discordant for schizophrenia (only 1 has disorder)
  • Demonstrates that individuals w/ schizophrenia have reduced brain activity in the frontal lobes 

16

How is Schizophrenia treated

  • Medications
  • Psychosocial Interventions

17

What medications are used to treat Schizophrenia? 

What are some common side effects?

  • Atypical anti-psychotics (dopamine-serotonin antagonists)
    • Olanzapine, Risperidone, Quetiapine
  • Old-style neuroleptics (dopamine antagonists)
    • Haloperidol, Chlorpromazine, Fluphenazine
  • Side effects a problem
    • Acute dystonia
    • Akathisia
    • Tardive dyskinesia
    • *less w/ atypical anti-psychotics 

18

What are the various psychosocial interventions in treatment of Schizophrenia?

  • Essential
  • Housing case management w/ emphasis on medication compliance & community involvement
  • Supportive psychotherapy
  • Vocational training 

19

What is the prognosis of Schizophrenia?

  • Exacerbations & remissions common
  • Residual impairment the rule
  • Positive symptoms less severe over time
  • Negative symptoms more severe over time 

20

Patients w/ schizophrenia living w/ families characterized by high expressed emotion (EE) tend to do more ______ over time than others 

poorly 

21

What is the long-term prognosis of Schizophrenia?

  • 20-30% - somewhat normal lives
  • 20-30% - moderate symptoms
  • 40-60% - significantly impaired 

22

Schizophrenia Spectrum & Other Psychotic Disorders