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Psychotic disorders Flashcards

(40 cards)

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1
Q

Describe the course of schizophrenia

A
  • chronic illness
  • relapsing + remitting pattern
  • sx change with time
  • functional deterioration over time
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2
Q

What defines an episode of schizophrenia?

A
  • observed signs of psychosis

- of unknown etiology

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3
Q

What changes will be observed in a schizophrenic patient? 4 A’s

A
  • associations
  • affect
  • ambivalence
  • asociality / autistic isolation
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4
Q

Describe the age of onset of schizophrenia

A
  • male younger - 10-25yo

- females older - 25-35yo with 2nd peak in middle age

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5
Q

What is meant by late onset schizophrenia?

A

Onset > 45 yo

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6
Q

Which factors contribute to a higher mortality rate?

A
  • Medical illness - SE Rx, comorbidities

- Suicide - risk incr during 1st yr after Dx

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7
Q

Explain the etiology of Schizophrenia

A
  • heterogenous etiology
  • interaction between genes + environment
  • causing neurodevelopmental disorder
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8
Q

List some genetic risk factors for Schizophrenia

A
  • 1st degree fam hx

- no specific genetic marker

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9
Q

List some environmental risk factors for Schizophrenia

A
  • Prenatal - maternal infections
  • Child abuse
  • Migration / urbanization (adversity + discrimination)
  • Cannabis use - more prone to psychosis
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10
Q

What are the 4 stage of Schizophrenia?

A
  1. Risk
  2. Prodrome
  3. Onset of Psychosis
  4. Chronic disability stage
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11
Q

What are the signs of the Risk stage?

How do you mx them?

A
  • early childhood behavioral + cognitive problem (1-10yo)
  • quite, introverted, few friends
  • no intervention at this stage
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12
Q

What characterizes the Prodrome stage?

What interventions are used?

A
  • changes in thought - disordered, paranoia
  • social isolation
  • fxn impairment
  • intervention = Psychotherapy (CBT), polyunsaturated fatty acids
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13
Q

What characterizes the onset of psychosis?

A
  • acute psychotic state
  • positive sx
  • Negative sx (5 A’s)
  • Cognitive sx
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14
Q

Which sx are responsible for long term morbidity + functional outcome?

A
  • Negative sx

- Cognitive sx

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15
Q

What complicates the chronic disability stage?

A
  • incr suicide rate

- incr obesity + smoking

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16
Q

List the DSM-V criteria for Schizophrenia

A
  • 2 or more of the following
  • present for majority of time during 1 month period
  • at least 1 must be (1)/(2)/(3)
  1. Delusions
  2. Hallucinations
  3. Disordered speech (derailment / incoherence)
  4. Disordered / catatonic behavior
  • social + occupation dysfunction
  • Not due to MMS
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17
Q

What is the duration of sx for Schizophrenia?

Study These Flashcards
A
  • continuous disturbances
  • for at least 6 months
  • incl 1 month of sx meeting criteria A
18
Q

What are Positive sx?

Study These Flashcards
A
  • Delusions
  • Hallucinations (auditory)
  • Disorganized speech + behavior
19
Q

What are Negative sx?

5 A’s

Study These Flashcards
A
  • Affective blunting
  • Alogia (pov of speech)
  • Avolition (no drive)
  • Anhedonia
  • Asociality
20
Q

What are Cognitive sx?

Study These Flashcards
A
  • Attention
  • Memory
  • Executive fxn
21
Q

What are some common mood sx seen in schizophrenia?

Study These Flashcards
A
  • Depression
  • Anxiety
  • Suicidality
22
Q

What leads to resistance to acute Rx + involuntary hospitilaztion?

Study These Flashcards
A
  • loss of insight

- poor judgment

23
Q

What percentage of Schizophrenic pts have good outcome?

24
Q

What percentage of Schizophrenic pts have poor outcome

Study These Flashcards
A

50%

  • repeated hospitalization
  • suicide
25
What percentage can live "normal" lives?
20-30%
26
List the GOOD prognostic factors for Schizophrenia
- late onset - acute onset - obvious ppt factor - good premorbid fxn - mood d/o sx - fam hx mood d/o - positive sx - married - good support systems
27
List the POOR prognostic factors for Schizophrenia
- young onset - insidious onset - no ppt factor - poor premorbid fxn - hx of perinatal trauma - withdrawn autistic behavior - negative sx - neurological signs + sx - many relapses - no remission in 3 years - single / divorced / widowed - poor support systems
28
What is meant by remission in Schizophrenia?
- Full = no sx present for about 6 mo | - Partial = some sx still present
29
What constitutes Schizophreniform Disorder?
- sx identical to schizophrenia - > 1 month but < 6 months all phase - rapid onset of prodomal sx
30
What is the outcome of Schizophreniform disorder?
- return to baselines fxn level - > 6mo - 2/3 progress to schizophrenia (high suicide risk) - 50% repeat psychotic episode - negative sx = poorer outcome
31
What defines Brief Psychotic disorder and Acute Transient Disorder?
- hallucinations and/or delusions - + disorganized thinking, speech, behavior - > 1 day but < 1 month - with/without preceding severe stressor - or post partum onset
32
Describe the Epidemiology of Brief psychotic disorder
- Female > male | - younger pts
33
Define Schizoaffective Disorder
- spectrum between schizophrenia + mood disorder - uninterrupted illness - schizophrenia criteria A met - at least 2 wks delusions + hallucinations WITHOUT mood sx - mood episode must be present for majority of dis duration (>50%)
34
What are the subtypes of schizoaffective disorder?
- Bipolar | - Depressive
35
How do you Rx schizoaffective disorder?
- Mood stabilizers | - AP
36
Define Delusional disorder
- non bizarre delusions - > 1 months - criteria A for schizophrenia not met - normal fxn + behavior
37
What is a shared Psychotic disorder
- transfer of delusions from one person (ill) to another | - delusion abandoned when separated
38
What is a Culture Bound Syndrome?
- culturally based signs + sx of mental distress / maladaptive behavior - must be in keeping with culture
39
When is a psychotic episode NOT substance induced
- sx precede substance use - sx >1 mo after cessation - substantially in excess of what is expected
40
What are the clinical features of Schizotypal personality disorder?
- frank psychosis absent - eccentric - magical thinking - ideas of reference, paranoid - few friends, social anxiety

Psychiatry (6 decks)

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