Psychotic Disorders: Schizophrenia Flashcards

1
Q

Pre-natal exposure to what during the 1st trimester appears to increase the risk of developing schizophrenia by 7-fold?

A

Influenza virus

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2
Q

What does the “revised dopamine hypothesis” for schizophrenia propose?

A
  • Hyperactive dopamine transmission in mesolimbic areas
  • Hypoactive dopamine transmission in prefrontal cortex
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3
Q

Where in the brain is the dopamine system particularly overactive in schizophrenic pt’s?

A

Hippocampus

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4
Q

What 5 “negative” sx’s define psychotic disorders?

A
  • Diminshed emotional expression
  • Avolition: decrease in motivation to initiate and perform activities
  • Alogia: lack of speech
  • Anhedonia: inability to feel pleasure
  • Asociality
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5
Q

Which types of hallucinations are the most common in Schizophrenia?

A

Auditory

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6
Q

What is catatonic behavior?

A

Marked decrease in reactivity to the enviornment

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7
Q

Which sx’s account for most of the morbidity assoc. w/ schizophrenia?

A

Negative sx’s

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8
Q

Which 2 negative sx’s are particularly prominent in Schizophrenia?

A
  • Diminished emotional expression
  • Avolition: decrease in motivated self-initiated purposeful activities
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9
Q

What is the diagnostic criteria for Schizophrenia?

A
  • 2 of the following for most of 1 month; at least 1 of the first 3 sx’s
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Negative sx’s
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10
Q

How long must there be contnuous signs of disturbance for dx of Schizophrenia?

A

6 months; must include at least 1 month of sx’s from criterion A

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11
Q

The catatonic type of Schizophrenia has a clinical picture dominated by at least 2 of which 5 sx’s?

A
  • Motoric immobility as evidenced by catalepsy or stupor
  • Excessive motor activity (apparently purposeless and not influenced by external stimuli)
  • Extreme negatism or mutism
  • Peculiarities of voluntary movement such as posturing, stereotyped movements, prominent mannerisms or prominent grimacing
  • Echolalia or echopraxia
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12
Q

What is the single leading cause of death in pt’s with Schizophrenia?

A
  • SUICIDE!
  • Usually near illness onset
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13
Q

How is a patient with schizophrenia + acute psychosis managed?

A
  • Hospitilization is needed for patient safety and to get pt stabilized
  • IM injections: Haloperidol, Fluphenazine, Lorazepam
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14
Q

Which second-gen antipsychotic used for tx of Schizophrenia is more commonly associated with QTc prolongation?

A

Ziprasidone

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15
Q

Which drug class can be used for catatonic disorder of Schizophrenia?

A

Benzodiazepines

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16
Q

What is criteria for Delusional Disorder?

A
  • Presence of 1+ delusions with duration of 1 month
  • Functioning is NOT impaired and behavior is not obviously bizarre or odd
17
Q

What is the diagnostic criteria for Brief Psychotic Disorder?

A
  • Presence of 1+ of the following sx’s. At least one being the first 3.
  • Delusions, Hallucinations, Disorganized speech, Grossly disorganized or catatonic behavior
  • Duration of an episode is at least 1 day but <1 month
18
Q

What is the diagnostic criteria for Schizophrenifrom Disorder?

A
  • Two (or more) of the following, each presnt for a significant portion of time during a 1-month period. At least one must be the first 3 sx’s:
  • Delusions, Hallucinations, Disorganized Speech, Grossly disorganized or catatonic behavior, Negative sx’s
  • Episode must last at least 1 month but <6 months
19
Q

What is the diagnostic criteria for Schizoaffective Disorder?

A
  • An uninterrupted period of illness during which there is a major mood disorder (major depressive or manic) concurrent with criterion A of schizophrenia
  • Delusions or hallucinations for ≥2 weeks in absence of major mood episode (depressive or manic)
20
Q

There must be the presence of one or both of which 2 sx’s for diagnosis of substance/medication-induced psychotic disorder?

A
  • Delusions
  • Hallucinations
21
Q

What is the timeline for Schizophrenia vs. Schizophreniform vs. Brief Psychotic Disorder?

A
  • Schizophrenia: >6 months
  • Schizophreniform: 1-6 months
  • Brief psychotic disorder: <1 month