Psychotic Disorders Flashcards Preview

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Flashcards in Psychotic Disorders Deck (55):
1

Emil Krapelin

1st person to categorize schizophrenia, which he called dementia praecox

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Eugen Blueler

Coined term "schizophrenia"

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Diagnostic criteria for schizophrenia

Two of following symptoms for 1 month: delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms
Some symptoms present for 6 months

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Delusion

Belief that has no basis in reality

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Common delusions

Persecution
Grandeur
Reference

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Persecution delusion

Belief that people are out to get you

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Grandeur delusion

Belief that you are someone who is greater than who you really are (royalty, celebrity, etc.)

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Reference delusion

Belief that environmental stimuli have different meaning for you (stimuli are real)

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Capgras syndrome

Unusual delusion
Belief that something/someone in your life has been replaced with an exact replica

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Cotard syndrome

Unusual delusion
Belief that you are dead and decaying, yet still active

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Thought insertion

Unusual delusion
Belief that thoughts are being externally inserted into your head

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Delusions of control

Unusual delusion
Belief that you can control outcomes around you

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Hallucinations

Sensory experiences without input from the surrounding environment

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Types of hallucinations

1. Auditory (ex- music playing, voices talking, command hallucinations)
2. Visual (ex- people around you, shadowy figures)
3. Tactile (ex- feeling like insects are crawling under your skin)
4. Olfactory (ex- burnt toast, rotting meat)

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Wernicke's area

Language reception area of brain
Has increased activity during auditory hallucination

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Broca's area

Speech production area of brain
Has increased activity during auditory hallucination

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4 A's of negative symptoms of schizophrenia

Anhedonia
Alogia
Avolition
Affective flattening

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Anhedonia

Negative symptom of schizophrenia
Loss of interest/pleasure in things that were once enjoyed

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Alogia

Negative symptom of schizophrenia
Lack of productive speech (stuttering, stammering, 1 word answers)

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Avolition

Negative symptom of schizophrenia
Lack of willful or goal-directed behavior

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Affective flattening

Negative symptom of schizophrenia
Loss of emotion

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Disorganized speech symptoms of schizophrenia

Loose associations
Poverty of content and circumlocation
Tangentiality
Word salad and neologisms
Echolalia, perseveration, clang, rhyming

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Loose associations

Disorganized speech symptom of schizophrenia
Not tracking (not staying on topic)

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Poverty of content and circumlocation

Disorganized speech symptom of schizophrenia
Talking a lot without actually saying anything
Not answering directly

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Word salad

Disorganized speech symptom of schizophrenia
Using a bunch of words in random order

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Neologisms

Disorganized speech symptom of schizophrenia
Using words that are made up

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Echolalia

Disorganized speech symptom of schizophrenia
Repeating what someone else says

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Perseveration

Disorganized speech symptom of schizophrenia
Talking about the same thing over and over

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Clang

Disorganized speech symptom of schizophrenia
Focusing on the sound of words rather than their meaning

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Disorganized behavior symptoms of schizophrenia

Stereotypy
Echopraxia
Inappropriate affect

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Stereotypy

Disorganized behavior symptom of schizophrenia
Doing the same thing over and over again

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Echopraxia

Disorganized behavior symptom of schizophrenia
Copying someone else's movements

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Inappropriate affect

Disorganized behavior symptom of schizophrenia
Affect that doesn't match the situation

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Movement symptoms of schizophrenia

Catatonic immobility
Waxy flexibility

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Catatonic immobility

Movement symptom of schizophrenia
Stay in same position for hours or days

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Waxy flexibility

Movement symptom of schizophrenia
When put in a new position, stays in that position

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DSM IV subtypes of schizophrenia

1. Paranoid type (main symptoms are positive ones)
2. Disorganized type (main symptoms are disorganized thoughts/speech/behavior)
3. Catatonic type (main symptoms are movement related)
4. Undifferentiated (meet criteria for schizophrenia, but don't have a clear set of predominant symptoms)
5. Residual (symptoms come and go)

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Epidemiology of schizophrenia

Lifetime prevalence: 1%
Gender: equal (men most often have negative symptoms, whereas women most often have positive symptoms)
Age of onset: 18-25

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Course of schizophrenia

Premorbid phase -> prodromal phase -> active phase -> residual phase

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Premorbid phase

First phase of schizophrenia
Childhood
Mild motor, cognitive, social issues
Non-specific risk factor (not specific to schizophrenia)

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Prodromal phase

Second phase of schizophrenia
1-2 years before full development of schizophrenia
Slow deterioration
Common symptom: magical thinking

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Active phase

Third phase of schizophrenia
Person receives diagnosis
Prominent symptoms are present

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Residual phase

Fourth phase of schizophrenia
Reduction of prominent symptoms
Pre-morbid functioning never achieved

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Causes and contributors to schizophrenia

Strong genetic link (parents can be carriers of disorder)
Dopamine hypothesis: too much dopamine (antipsychotics are dopamine antagonists)
Increased glutamate (activator neurotransmitter)
Enlarged lateral ventricles (large open spaces in brain)
Pre-birth exposure to toxins or viruses
Environmental stressors
Expressed emotion (loved ones react to diagnosis in a negative way: increases relapse)

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Tardive dyskinesia

Uncontrolled, jerky movements
Side effect of antipsychotics: reduction of dopamine
Parkinson's is caused by lack of dopamine

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Mythical schizophrenia causes

Schizophrenogenic mother (no evidence that parenting influences schizophrenia)
Double blind communication (telling people to do things that are impossible)

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Previous biological treatments of schizophrenia

Psychosurgery (cut out part of brain)
Pre-frontal lobotomy (scramble frontal lobes)
Insulin shock therapy
Electroconvulsive treatment (doesn't work well for schizophrenia)

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Medications used to treat schizophrenia

Traditional antipsychotics (thorazine, haldol): marginally effective (60%), but negative side effects (movement-related)
Atypical antipsychotics (risperdal, seroquel): slightly more effective (60-80%), fewer side effects, but still considerable (some movement-related, tiredness, increased appetite)

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Psychological treatments for schizophrenia

Behavioral: reinforce normal behavior, social and job skills training, coping skills
Family: education and supportive skills, decrease expressed emotion

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Schizophreniform disorder

Same symptoms as schizophrenia except not as long as schizophrenia and lack of impairment
Sometimes can turn into schizophrenia

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Brief psychotic disorder

One or more positive/disorganized symptoms of schizophrenia
Longer than 1 day but less than 1 month
Normal functioning following episode
Often preceded by stressful life events or drug use

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Delusional disorder

One or more delusions persisting for longer than 1 month
No other symptoms of schizophrenia
No impairment outside of delusion

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Erotomanic delusion

Belief that a celebrity is in love with you

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Somatic delusion

Intense anxiety about a medical condition/bodily function that isn't actually a problem

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Schizoaffective disorder

Meet criteria for schizophrenia and mood episode
Psychotic symptoms occur in absence of mood symptoms
Different from mood disorder with psychotic features (psychotic symptoms only occur during mood episode)