Psychotic Disorders Flashcards
Hallucinations, delusions, disorganized speech/behavior/affect, agitation, aggression
More prominent and get more attention
Usually occur during psychotic episodes
Usually involve distinct abnormal behaviors
positive psychotic symptoms
Attention deficits, asociality, anhedonia, apathy, avolition (inability to initiate and persist in goal directed activities), alogia (poverty of speech and contents), anergia
Affective flattening, diminished emotional expressiveness
A lack of something expected
negative psychotic symptoms
later age of onset sudden onset female higher level of functioning prior to onset good compliance family history of mood disorders paranoid subtypes
good prognostic factors in schizophrenia
early age of onset male more negative symptoms more brain abnormalities lower level of function prior to onset substance abuse disorganized subtype
poor prognostic factors in schizophrenia
1-3% prevalence, genetic and environmental components
2+ of the following (at least 1 ), each present for a significant portion of time during a 1 month period (or less if successfully treated): delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms
social/occupational dysfunction with continuous signs of the disturbance persisting for at least 6 months, this 6 month period must include at least 1 month of symptoms
exclusions: no MDE, manic episode, or mixed episode have occurred with the active-phase symptoms; if mood episodes have occurred during the active-phase symptoms their total duration has been brief relative to the duration of the active and residual periods
the disturbance is not due to the direct physiological effects of a substance or medical condition
DSM 5 specifier: with catatonia
schizophrenia
2+ of the following (at least 1 ): delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms
social/occupational dysfunction with continuous signs of the disturbance persisting for 1 day to 1 month, with an eventual return to the premorbid level of functioning
more common in women than men
personality disorders are a risk factor
exclusions: no MDE, manic episode, or mixed episode have occurred with the active-phase symptoms; if mood episodes have occurred during the active-phase symptoms their total duration has been brief relative to the duration of the active and residual periods
the disturbance is not due to the direct physiological effects of a substance or medical condition
Brief Psychosis
Features of schizophrenia including hallucinations, delusions, and distorted thinking as well as a mood component such as depression or mania
Presence of psychotic symptoms during a 2 week period or longer in the absence of mood symptoms, majority is illness is characterized by mood symptoms
0.5% prevalence, more common in women than men
slightly better prognosis than schizophrenia
schizoaffective disorder
2+ of the following (at least 1: delusions, hallucinations, disorganized speech*, grossly disorganized or catatonic behavior, negative symptoms
social/occupational dysfunction with continuous signs of the disturbance persisting for at least 1 month but less than 6 months
seen equally in men and women
exclusions: no MDE, manic episode, or mixed episode have occurred with the active-phase symptoms; if mood episodes have occurred during the active-phase symptoms their total duration has been brief relative to the duration of the active and residual periods
the disturbance is not due to the direct physiological effects of a substance or medical condition
schizophreniform disorder
Bizarre or non-bizarre delusion lasting longer than 1 month (erotomanic, grandiose, jealous, persecutory, somatic, mixed)
0.25% prevalence with a mean age of onset of 40 years
more common in women than men
hallucinations may be present but are rare
disorganized thought/behavior is usually not present
functioning is not affected except by the delusion itself
less responsive to antipsychotic medications
symptoms must not be better explained by other mental disorders
delusional disorder
3+ of the following:
motor immobility – catalepsy (including waxy flexibility) or stupor
excessive motor activity – apparently purposeless and not infleuenced by external stimuli
extreme negativism – apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved
peculiarities of voluntary movement – posturing (voluntary assumption of inappropriate or bizarre postures)
stereotypes movements – prominent mannerisms or prominent grimacing, echolalia, or echopraxia
catatonia
