Schizophrenia Flashcards
What are the stages of illness of schizophrenia nad what is happening in the brain in each?
Premorbid-abnormal brain development
Prodromal then onset-Biochemical dysregulation and brain tissue loss
Chronic/residual-Post-deterioration, chronic/residual stage
What are 5 categories of symptoms of schizophrenia? What are the individual symptoms in each category?
Positive Symptoms Delusions Hallucinations Disorganized speech Catatonia
Negative Symptoms Flat / blunted affect Alogia (no thoughts) Avolition (can't start doing anything) , Apathy Anhedonia Social withdrawal
Mood Symptoms Depression Hopelessness Suicidality Anxiety agitation Hostility
Comorbid Substance Abuse
Cognitive Deficits Verbal & Working Memory Executive functions Attention Learning Processing speed
What are auditory hallucinations like?
• Auditory: hearing voice(s) with no one around
- Single voice or multiple voices
- Familiar or unfamiliar
- Talk to the person or about the person (commentary)
- Insulting or praising or arguing
- Command hallucinations
- To harm or kill self
- To harm or kill others
- To behave in some way
What are other kinds of hallucinations and what are they like?
- Olfactory: perceiving an odor, usually foul (also: seizure aura)
- Gustatory: perception of tastes (often unpleasant)
• Visual: seeing persons or images or inanimate objects or
animals. Lilliputian visual hallucinations (reduced size but
normal in details) can occur with substance use
- Somatic: odd sensation(s) in the body
- Hypnapompic: occurs during transition from sleep to partial wakefulness
- Hypnagogic: occurs when falling asleep , with awareness
What kind of delusions exist and what are they like?
- Bizarre: (e.g. The earth is morphing into a reptile)
- Capgras: (e.g. A familiar person is actually an identical imposter)
- Reference (e.g. Perceiving a “ meaning” in random events)
- Jealousy: (e.g. The spouse / partner is unfaithful)
- Parasitosis (e.g. being infested with parasites)
- Erotomania: (e.g. A celebrity is in love with the patient->stalking)
- Grandiose: (e.g. Having extraordinary powers or abilities)
- Nihilistic: (e.g. Part of a person’s body or the universe has ceased to exist, or that one is dead (Cotard delusion)
- Persecutory: (e.g. That a person is being threatened, harassed
or attacked by others)
- Passivity: (e.g. being controlled by an outside power)
- Hypochondriacal: (e.g. a body part has changed)
- Thought control (e.g. Thoughts are being inserted or withdrawn from someone’s mind or broadcast to everyone)
What are some examples of thought and speech disorders?
- Clang associations: rhyming words
- Derailment: Knight’s-move thinking …
- Flight of ideas: jumping rapidly from topic to topic, along with rapid speech
- Loose associations: shifts in train of thought without adequate logical connection
• Verbigeration: excessive vagueness, useless repetition,
meaningless phrases or cliches
• Word salad: associations so loose, the speech is incoherent or incomprehensible
What are some abnormalities of thought progression?
• Blocking: sudden involuntary complete interruption of speech or
thought
- Circumstantiality: tendency to digress and to insert irrelevant information or explanations and qualifications before a thought is completed
- Perseveration: repetition or persistence or a thought when it I sno longer appropriate
- Racing thoughts: thoughts so rapid they are experienced as almost out of control
- Tangentiality: digression and irrelevancy so severe, the intended goal is never reached
What are some abnormalities of grammar and vocab?
- Mannerisms: odd or eccentric expression, used recurrently
- Neologism: a new word or phrase that seems to have a private
or special meaning, and whose derivation is not readily apparent
• Paraphasia: used erroneous words that are phonetically or
semantically related to the target word
• Stereotypy: frequent, mechanical repetitions of a word or
phrase, without an apparent purpose. May seem automatic, even
involuntary
• Word approximation: idiosyncratic word usage that seems
stilted or peculiar but whose meaning is evident.
What are some abnormalities of logic and reasoning?
• Concrete thinking: excessive literalness, inability to understand
broader meaning or symbolism
• Non-sequitor: conclusions not logically supported by the
premises
• Over-inclusive thinking: inability to maintain conceptual
boundaries, incorporating irrelevant elements making it less understandable
• Past-pointing / approximate answers: person answers questions correctly but in a way that suggests that the incorrectness is intentional and that the correct answer may be known
What are 7 negative symptoms of schizo?
Affect pathology, alogia, inattentiveness, anhedonia, asociality, avolition/apathy, anosognosia
What is affect pathology in shizo?
Flat, blunted, restricted, or shallow affect as well
as incongruous or silly affect at times
Decreased spontaneous movements
Poor eye contact
Lack of vocal inflection
Failure to recognize the facial affect of others
What is anhedonia like in schizo?
Loss or reduction in capacity for experiencing
pleasure
Manifested by lack of interest in enjoyable
activities
Decrease in sexual interest, activity, or
enjoyment
Not reversible (like the anhedonia of depression)
What is alogia like in schizo?
Reduction in the quantity of thought
Decreased fluency and productivity of speech
Poverty of speech amount as well as brief,
concrete, and unelaborated verbalizations
Poverty of speech content: vague, generalized,
and conveying little information
Blocking: interruption in the train of thought
Prolonged response latency: long pauses before
responding
What is asociality like in schizo?
Absence or reduction of interest in
relationships or interaction with other
persons
Inability to feel intimacy and closeness
What is avolition/apathy like in schizo?
Loss or reduction of the ability to initiate
and persist in goal-directed activities
Typically includes poor grooming,
impersistence at work or school and
physical anergia
Often manifested by doing nothing all day
which may be misconstrued as “laziness”
