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Behavioral Health > Schizophrenia Spectrum and Other Psychotic Disorders > Flashcards

Schizophrenia Spectrum and Other Psychotic Disorders Flashcards

1
Q

What age are males and females when psychotic disorders start?

A

males 15-25yr

females 25-35yr

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2
Q

What is the most common psychotic disorder affecting 1% of the population?

A

Schizophrenic

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3
Q

What is schizophrenic disorder?

A

a massive disruption of thinking, mood, and overall behavior coupled with poor filtering of stimuli

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4
Q

What percent of pts with schizophrenia require long term hospitalization?

A

50%

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5
Q

What 3 things causes schizophrenia?

A

genetic, environmental, neurochemical

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6
Q

Who responds more successfully to medications?

A

Women than man

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7
Q

What percent of schizophrenics have no affected parent?

A

80%

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8
Q

What are two environmental influences of schizophrenia?

A
  • born in the winter, with maternal virus infection during the 3rd trimester
  • exposure to diuretics for severe maternal HTN
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9
Q

What 3 neuro changes take place in a schizo brain?

A
  • decrease glucose utilization by frontal lobe
  • Ventricle enlargement
  • Abnormalities in brain density and brain waves
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10
Q

What is the dopamine hypothesis?

A

Hyperactive dopamine in the mesolimbic tract leads to positive symptoms
Hypoactive dopamine in the mesocortical tract leads to negative symptoms

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11
Q

What creates hallucinations and delusions?

A

Serotonin agnosits

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12
Q

What can be given to improve hallucinations and delusions?

A

serotonin antagonists

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13
Q

During a psychotic episode what is intact in the patient?

A

memory (oriented to person, place, and time)

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14
Q

What characterizes schizophrenia?

A

at least 1 episode of psychosis and persistent disturbances of behavior, appearance, speech, and affect impairing them

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15
Q

When can a psychotic episode occur?

A

spontaneous or follow traumatic/ stressful event

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16
Q

What are the 5 positive symptoms?

A 
Hallucinations
Delusions
Disorganized Speech
Agitation
Talkativeness
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17
Q

What are 7 negative symptoms?

A 
diminished sociability
restricted affect
poverty of speech
lack of motivation
flat affect
cognitive disturbances
poor grooming
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18
Q

How long must schizophrenic last?

A

> 6 mo

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19
Q

What is the criteria for schizophrenic?

A

2 or more symptoms are present for a significant portion of time during a 1 month period

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20
Q

What are the 3 phases of Schizophrenia?

A

Prodromal
Psychotic
Residual

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21
Q

What 3 things are seen in the Prodromal phase?

A
  • Still functioning in reality
  • Increasing social withdrawal
  • Increasing interest in religion, the occult, and philosophy
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22
Q

What 1 thing is seen in the Psychotic phase?

A

“Psychotic break” from reality

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23
Q

What 2 things are seen in the Residual phase?

A
  • Period between psychotic episodes

- Negative symptoms are still present and patient is not back to “normal”

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24
Q

What is Alogia?

A

Poverty of speech- no informative information

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25
Q

What are delusions?

A

false beliefs not correctable by logic or reason

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26
Q

What does delusions commonly consist of?

A

paranoid thinking and preoccupation with the supposedly threatening behavior of others

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27
Q

What are somatic delusions?

A

delusions that revolve around issues of bodily decay or infestation

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28
Q

What illusions?

A

distortions of reality creating misperceptions of real external stimuli

29
Q

What are hallucinations?

A

creating stimuli where none exists. Sensory perceptions not associated with real external stimuli

30
Q

What is the most common hallucinations?

A

auditory

31
Q

What is thought blocking?

A

an abrupt stop in the train of thought

32
Q

What is polydipsia?

A

excessive water drinking without appropriate physiologic need

33
Q

What do you have to be careful with in patients that are experiencing schizophrenia?

A

“Water intoxication”

34
Q

What are the symptoms of water intoxication?

A

confusion, lethargy, psychosis, seizure, death all due to cerebral edema

35
Q

What is emergency detention?

A

removing the patient’s rights and ability to checkout form care for 48hrs due to potential threat to their own or others safety

36
Q

In Texas who can place a person on emergency detention?

A

police officer or judge

37
Q

What is the treatment of choice for schizophrenia?

A

antipsychotic meds

38
Q

What are the 2 common 1st generation antipsychotics used in the txt of schizophrenia?

A

Haloperidol and Chlorpromazine (Thorazine)

39
Q

What are two extrapyramidal side effects of 1st gen antipsychotics?

A

acute dyskinesias and dystonia

40
Q

How can dyskinesia and dystonia be treated?

A

Diphenhydramine (Bendryl)

41
Q

What syndrome can develop due to the extrapyramidal side effects of typical antipsychotics?

A

Neuroleptic malignant syndrome

42
Q

A life threatening neurologic emergency characterized mental status change, rigidity, fever, and autonomic dysfunction?

A

Neuroleptic malignant Syndrome

43
Q

What are 3 common 2nd generation antipsychotics used in the txt of schizophrenia?

A

Clozapine, Olanzapine, Risperidone

44
Q

What is the difference between the typical and atypical antipsychotics?

A

extrapyramidal side effects- much less severe in 2nd generation

45
Q

What are sde of atypical antipsychotics?

A

weight gain, QTC prolongation, Myocarditis, Sexual dysfunction

46
Q

Which meds are more expensive?

A

2nd gen antipsych

47
Q

There is a inverse relationship between what two things?

A

stability of living situation and amount of antipsychotic meds

48
Q

In prognosis what symptoms can be treated successfully with meds?

A

positive symptoms

49
Q

Which two symptoms contribute more to long term disability

A

negative symptoms and cognitive

50
Q

What is delusional disorder?

A

a psychosis in which the predominant symptom is a persistent delusion for > 1mo

51
Q

What two things are not affected in delusional disorder?

A

intellectual and occupational activities

52
Q

What is the month criteria for delusional disorder?

A

presence of >1 delusions with a duration of one 1 MONTH

53
Q

What is a erotomanic type delusion?

A

the pt believes that another person, who is usually famous or in some kind of higher status, is secretly in love with her or him

54
Q

What is grandiose type?

A

pt believes he/she has special prominence or talent, unusual fame, or major achievements

55
Q

What is jealous type?

A

pt believes that a spouse or lover is unfaithful and finds “evidence” to support the delusion, accuses them, and relentlessly ties to substantiate the offense

56
Q

What is persecutory type?

A

pt is typically preoccupied by a delusion that he or she is being persecuted, conspired against, or potentially harmed

57
Q

What is somatic type?

A

pt believes that something awful is wrong w/ his/her body

58
Q

What is mixed type?

A

no one delusional theme predominates

59
Q

What is unspecified type?

A

dominant delusional belief cannot be clearly determined

60
Q

What is the 1st Txt for delusional disorder?

A

2nd gen antipsychoitc

61
Q

There have been no clinical trials of what two things in delusional disorder?

A

cognitive behavioral or psychosocial therapy

62
Q

What are schizoaffective disorders?

A

cases that fail to fit within either schizophrenic or affective (depressive)

63
Q

What is the month criteria for schizoaffective disorder?

A

psychotic symptoms linger for longer than 2wks, but are not permanent

64
Q

What three meds can be used for schizoaffective disorder?

A

mood stabilizers, antidepressants, 2nd gen antipsychotics

65
Q

What is schizophreniform disorder?

A

similar symptoms to schizophrenia except that the duration of prodromal, acute, and residual symptoms is longer than 1 month but less than 6mo

66
Q

What is the month requirement for schizophreniform?

A

symptoms last at least 1 mo but less than 6 mo

67
Q

What is schizophreniform disorder treated with?

A

long term therapy and 2nd gen antipsychotics

68
Q

What is the requirement for brief psychotic disorder?

A

symptoms lasting less than 1 mo (at least 1 day)

69
Q

Treatment for brief psychotic disorder?

A

therapy long term and 2nd generation antipsychotics while symptoms are active

Behavioral Health (14 decks)

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