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NMSP Exam 3 > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

1
Q

When is the onset of Schizophrenia?

A

late adolescence and early adulthood

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2
Q

What are some precipitating events of Schizophrenia?

A

Psychosocial stressors

Traumatic Events

Drug/ETOH abuse (cannabis increases risk 6x)

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3
Q

What are features of Schizophrenia that indicate a better prognosis?

A

Positive Symptoms

Mood Disorders, like Schizoaffective, Major Depression with Psychotic Features or Bipolar Disorder

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4
Q

What are some features of Schizophrenia that indicate a poor prognosis?

A

Negative Symptoms

poor cognition

poor supports

younger-onset

poor premorbid functioning, insidious onset

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5
Q

What are some prodromal s/s of Schizophrenia?

A

Schizoid/Shizotypical personalities

Few close friends in adolescence

Minimal social activities

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6
Q

What are positive symptoms?

A

These add to the presentation

Typical present in Active Phase

-Delusions

-Hallucinations

-Catatonia

-Agitation

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7
Q

What is Loosening of Associations?

A

When connections among patient’s ideas are absent or obscure. Listeners may feel as if understanding the patient’s thoughts had been suddenly lost

May have preoccupation with invisible forces

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8
Q

In addition to Loosening of Associations, Shizophrenic patient’s may also exhibit which two other forms of thought?

A

Poverty of content and speech

Though blocking: internal interruption in their speech/thoughts

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9
Q

Patient’s with Schizophrenia may experience what content of thought?

A

Delusions of persecution, influence, thought broadcasting, Grandeur, or somatic form

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10
Q

What sorts of perceptual disorders may Schizophrenia present with?

A

Hallucinations (auditory/visual_

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11
Q

What are negative symptoms and when do they normally present?

A

Present in the Residual Phase

Affective Flattening

Apathy

Social Withdrawal

Anhedonia

Poverty of Thought

Content of Speech

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12
Q

How long must symptoms of Schizophrenia be present in order for a diagnosis to be made?

A

6 months

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13
Q

What are some differential diagnosis for Schizophrenia

A

Organic Mental Disorders

Mood Disorders

Delusional Disorder

OCD

Personality Disorders

“Normal Adolescence”

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14
Q

What is the proposed pathology underlying Schizophrenia?

A

Increased in patient’s born in winter/spring (could be related to influenza virus)

Likely increased DA in neuronal tracts, increased SE and NE, decreased GABA and Glutamate receptors

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15
Q

What are the dignostic criteria for Schizophrenia according to the DSM V

A

Two or more of the following for at least most of 1 month; at least one of the first three symptoms:

Delusions

Hallucinations

Disorganized Speech

Grossly disorganized/Catatonic Behavior

Negative Symptoms

Must last for at least 6 months

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16
Q

What are the historically recognized subtypes of Schizophrenia

A

Paranoid

Disorganized

Catatonic

Undifferentiated

Residual

17
Q

Are Schizophrenic patients more likely to commit homicide or suicide?

A

Suicide-single leading cause of death in these patients

Can have a tendency towards violence, esp when coupled with antisocial or borderline personality disorder, paranoid beliefs, impulsivity, substance abuse, etc.

SI may be reduced with Clozapine

18
Q

What are the features of Catatonic Schizophrenia?

A

At least two of the following:

Motoric immobility as evidenced by catalepsy or stupor

Excessive motor activity (purposeless, without stimuli)

Extreme negativism or mutism

Peculiarities of voluntary movement such as posturing, grimacing, etc

Echolalia or Echopraxia

19
Q

What nonpharmacologic therapy is available to treat Schizophrenia?

A

Hospitalization

Group Therapy

Individual Psychotherapy

Community Treatment

Self-Help Programs

ECT

20
Q

What pharmacologic therapy can be used to treat Acute Psychosis?

A

IM injections of Haloperidol, Fluphenazine, Lorazepam

(First-generation antipsychotics)

21
Q

What drugs can be used to treat in the Stabilization Phase of Schizophrenia?

What is the goal of therapy for the Maintenance phase?

A

Newer atypical Antipsychotics

Keep patient’s free from symptoms while avoiding side effects, usually long-acting injections

22
Q

Some patient’s with Schizophrenia may be poor responders. What could this be related to?

A

Could be related to noncompliance with medications

23
Q

One concerning side effect of first generation antipsychotics includes Extrapuramidal Syndromes, which includes which signs and symptoms?

A

Acute Dystonic Reaction: sudden tonic contractures of muscles

Drug-induced Parkinsonism: Looks like Parkinson’s

Akathisia: Motor restlessness

Antipsychotic-Induced Catatonia: Mutism, motor changes

Tardive Dyskinesia: choreoathethotic movement and fasciculations

24
Q

What is a concerning side effect of Clozapine?

What is the main function?

A

Agranulocytosis

Functions to block DA receptors and affect SE activity

(2nd generation antipsychotic)

25
Q

What is a concerning side effect of the 2nd generation antipsychotic, Ziprasidone?

A

QTc prolongation

26
Q

What is the criteria for Schizoaffective disorder?

A

An uninterrupted period of illness with either a major depressive episode or manic episode concurrent with symptoms that meet Criterion A for Schizophrenia

Same period of illness, have been delusions or hallucinations for at least two weeks in the absence of mood symptoms

27
Q

What is the criteria for Brief Psychotic Disorder?

A

Presence of at least one of the following:

Delusions

Hallucinations

Disorganized Speech

Grossly Disorganized or Catatonic Behavior

Duration is at least 1 day and no more than 1 month with a return to normal functioning

28
Q

What is the criteria for Schizophreniform?

A

Meets criteria A, D and E for Schizophrenia

An episode of the disorder lasts at least 1 month but less than 6 months

29
Q

What is the criteria for Delusional Disorder?

A

Delusions of at least 1 month’s duration

Has never met criterion A for schizophrenia (for more than a few hours)

Apart from the delusions, functioning is not impaired and behavior is not odd/bizarre

30
Q

When comparing/contrasting Shizophrenia, Schizophreniform and Brief Psychotic Disorder, how can timeline help?

A

Schizophrenia > 6 months

Schizophreniform 1-6 months

Brief Psychotic Disorder <1 month

31
Q

Which second generation antipsychotics cause weight gain?

A

Clozapine

Olanzapine

Less weight gain: Ziprasidone

32
Q

What are some hints for differentiating the disorders of the “Schizo” spectrum?

A

Schizoid: very introverted, withdrawn

Schizotypical: magical thinking/odd behavior

Schizophrenia: Schizotypical + psychosis

Schizaffective: Schizophrenia + mood disorder

NMSP Exam 3 (21 decks)

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