Psychotic Disorders

Question 1

What is the common onset of schizophrenia?

3 common precipitating events for schizophrenia?

Answer 1

Later teen early adulthood

Psychosocial stressors, traumatic events, alcohol and drug abuse (marijuana!)

Question 2

What is the prodromal picture of schizophrenia patients?

Answer 2

Not a lot of friends during teen years

Very little social life

Question 3

What is the 1-2 punch etiology of schizophrenia he talked about?

Answer 3

Genetic and early life complications

Question 4

2 viruses implicated in increasing the risk for schizophrenia?

Answer 4

Prenatal exposure to influenza during first trimester

Copenhagen perinatal cohort maternal upper respiratory infection

Question 5

What does the revised dopamine hypothesis propose for schizophrenia?

Answer 5

Hyperactive dopamine transmission in the mesolimbic areas and hypoactive dopamine transmission in the prefrontal cortex

In addition, dopamine dysregulation is also observed in the amygdala and prefrontal cortex

Question 6

What is going on with the dopamine system in the hippocampus in schizophrenia patients?

Answer 6

Overactive

Question 7

4 positive symptoms of schizophrenia?

Answer 7

Delusions
Hallucinations
Disorganized thinking and speech
Abnormal motor behavior (including Catalonia)

Question 8

5 negative symptoms of schizophrenia?

Answer 8

Reduced emotional expression
Avolition
Alogia
Anhedonia
Asociality

Question 9

Good definitions of delusions?

Answer 9

Fixed beliefs in something untrue

Question 10

How do we define hallucinations?

What are the most common hallucinations in schizophrenia patients?

Answer 10

Perceptions that occur without external stimuli

They can occur in any sensory modality, but auditory is the most common

Question 11

What is the disorganized motor behavior to know for schizophrenia patients?

Answer 11

Catatonic

Question 12

What type of symptoms account for most of the morbidity in schizophrenia patients?

Answer 12

The negative symptoms

Question 13

What are the two most prominent negative symptoms in schizophrenia patients?

Answer 13

Diminished emotional expression

Avolition

Question 14

What is the a,b,c,d,e f diagnostic critters for schizophrenia?

Answer 14

A. Two or more of the following symptoms and at least 1 of the first 3 for most of 1 month: delusions, hallucinations, disorganized speech, catatonic behavior, and negative symptoms.
B. Overall functioning is way less after onset of symptoms than before.
C. Continuous signs persist for at least 6 months
D. Other mood disorders with psychotic features ruled out.
E. No substance abuse or drug cause
F. If autistic first, need delusions or hallucinations

Question 15

What is the diagnostic criteria for catatonic type of schizophrenia?

Answer 15

At least 2 of the following
Motoric immobility
Excessive motor activity
Extreme negativsm or mutism
Peculiar voluntary movement
Repeating words or actions of others

Question 16

What is the single leading cause of death in schizophrenia patients and the risk is increased in what 3 settings?

Answer 16

Suicide

Substance abuse, comorbid major depression, and previous high functioning

Question 17

4 differentials for schizophrenia

Answer 17

Bipolar, major depressive disorder, delirium, and dementia

Question 18

What 3 meds to use to treat acute psychosis?

Answer 18

Haloperidol, fluphenazine, and lorazepam

Question 19

What are the 2 phases of treating schizophrenia patients?

Answer 19

Stabilizing phase, consider newer atypical antipsychotics

Maintenance phase, keep patients symptom free

Question 20

What is the adverse effect to know of clozapine and ziprasidone?

Answer 20

Agranulocytosis

QTC prolongation

Question 21

What family of drugs to give for catatonic disorder?

Answer 21

Benzos

Question 22

What is the hallmark criteria for delusional disorder?

Answer 22

1 or more delusions for 1 month or longer with the absence of criteria A being met

Question 23

What is the diagnostic criteria for brief psychotic disorder?

Answer 23

Presence of 1 or more of the following symptoms: delusions, hallucinations, disorganized speech and catatonic behavior

….at least 1 day but less than 1 month

Question 24

Diagnostic criteria for schizophreniform disorder?

Answer 24

Two or more of the following for at least 1 month to 6 months:
Delusions, hallucinations, disorganized speech, catatonic behavior and negative symptoms (need 1 from the first 3).

Question 25

Diagnostic criteria for schizoaffective disorder?

Answer 25

Uninterrupted period of illness that has a Major mood episode concurrent with criteria A and 2 or more weeks of delusions or hallucinations in the absence of the mood episode in the same period of illness.

Question 26

What is the diagnostic criteria for substance/medication induced psychotic disorder?

Answer 26

Presence of hallucinations or delusions or both with symptoms of criteria A after exposure/withdrawal of the medicine and it is known the med can cause those symptoms. About a month of symptoms

Question 27

Criteria for psychotic disorder due to another medical condition?

Answer 27

Prominent hallucinations or delusions and evidence that the disturbance is because of another medical conditon

Question 28

As far as timelines, what are we thinking for schizophrenia, schizophreniform, and brief psychotic disorder?

Answer 28

More than 6 months 1-6 months Less than 1 month

Question 29

``` What two conditions to think of that add up to each one of these? Schizoid? Schizotypal? Schizophrenia? Schizoaffective? ```

Answer 29

Introverted and voluntarily withdraws from social scene Schizoid + odd behavior/magic thinking Schizotypal + psychosis Schizophrenia + mood disorder