Psychotic disorders Flashcards
(61 cards)
Schizophrenia characteristic symptoms
2 of following for >=1 mo
- delusions
- hallucinations
- disorganized thinking/speech
- grossly disorganized/abnormal motor behaviour
Negative symptoms
Social/occupational dysfunction
Schizophrenia diagnosis duration
6 mo
with 1 mo of characteristic symptoms
Tragedy of schizophrenia
catastrophic illness tends to persist 10% suicide rate very common: 0.5-1% of popn "cancer of mental illness"
Complexity of schizophrenia
no single defining feature multiple characteristic symptoms symptoms from multiple domains: - emotion - personality - cognition -motor activity probably multisystem disorder
Negative symptoms of schizophrenia
Alogia
Affective blunting
Avolition
anhedonia
Types of hallucinations in psychosis
auditory: common in schizophrenia, but also in alcohol withdrawal
visual: more common in drug-induced psychosis
tactile: more common in cocaine
olfactory: more common in temporal lobe epilepsy
Persecutory delusions
theme of being followed/harassed etc
obstructed in pursuit of goals
Somatic delusions
that the person has some physical defect/general medical condition
Attenuated psychosis syndrome
A: at least 1/3 core psychosis symptoms with relatively intact reality testing, and warrants clincial attention
B: symptoms >=1x/week in past month
C: symptoms began or worsened in past year
D: not better explained by other mental disorder
E: criteria for another psychotic disorder never met
Schizophreniform dx
symptoms of schizophrenia confusion/perplexity good premorbid functioning absence of blunted affect acute onset >=1 month, but
Schizoaffective disorder
Characteristic symptoms of schizophrenia + depressed, manic/mixed episode of mood
Delusions/hallucinations for >=2 weeks in absence of mood symptoms
Combination of schizophrenia + mood disorder
Specifiers: bipolar, depressive
Schizoaffective prognosis
better than schizophrenia but worse than mood disorder
Schizoaffectve treatment
usually require antipsychotics
Delusional disorder diagnosis
non-bizarre delusions (paranoia, infection, deception, or having a disease) >=1 mo
Absence of meeting criteria for schizophrenia
FUnctioning not impaired
subtypes
Delusional disorder treatment
poor response
Brief psychotic disorder diagnosis
> =1 of:
delusions, hallucinations, disorganized speech ,disorganized behaviour
episode cannot be a culturally sanctioned response/better explained by another mental disorder, substance, or medical condition
often concurrent with severe stressors
=1 day but
Medical conditions that may present with psychosis
temporal lobe epilepsy tumor stroke trauma endocrine/metabolic abnormalities infections MS AI disease
Substance-induced psychotic disorder features
specific onset during intoxication/withdrawal
prominent hallucinations/delusions without insight
evidence symptoms develop during/within 1 mo of substance intoxication or withdrawal
Amphetamines, marijuana, hallucinogens, cocaine
Schizotypal personality disorder features
Pervasive pattern of social/itnerpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationsihps
cognitive/perceptual distortions, eccentricities of behaviour
beginning by early adulthood and present in a variety of context, as indicated by >=5 of:
ideas of reference, odd beliefs/magical thinking, unusual perceptual experiences, odd thinking and speech, suspiciousnessor paranoid ideation, inappropriate or constricted affect, behaviour/appearance that is odd, lack of close friends or confidants, excessive social anxiety
Syndrome does not occur exclusively during courseo f schizophrenia, a mood disorder with psychosis, other psychotic disorders, or autism spectrum disorder
Major depressive disorder with psychotic features
MDD - >=5 symptoms, 2 week period with functional impairment
cannot be attributable to substance use, other medical conditions, or other psychiatric illnesses including schizoaffective disorder/bipolar disorder
Bipolar disorder with psychotic features
Mania - >=1 week with functional impairment
cannot be attributable to substance use, other medical conditions
Neurodevelopmental hypothesis of schizophrenia
developmental “insult” occurs during fetal period but is only manifested as psychotic symptoms after puberty
one or more insults may occur in utero, perinatal, childhood, or adolescence
Developmental changes lead to altered brain structure/function
Child development - schizophrenia
impairments of motor, cognitive and social function in childhood, years before onset of psychosis
delyaed walking, speech problems and lower scores on school tests
Birth complications - schizophrenia
greater number of birth complications than controls
e.g. Rh incompatibility, preeclampsia, low birth weight, hypoxia, gestational diabetes
