Schizophrenia Spectrum and Other Psychotic Disorders Flashcards

(36 cards)

1
Q

Brief Psychotic Disorder

list the symptom criteria for Brief Psychotic Disorder

A

at least 1 of 4
* delusions
* hallucinations
* disorganized speech (e.g., derailment, tangentiality)
* abnormal behavior (e.g., disorganized or catatonic)

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2
Q

Brief Psychotic Disorder

the duration criterion for Brief Psychotic Disorder

A

1 day but less than 1 month

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3
Q

Psychotic Disorders

this term describes a fixed false belief that cannot change despite evidence to the contrary

A

delusion

ex. being followed; possessed; thoughts being controlled; parasitic infestation

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4
Q

Psychotic Disorders

this term describes sensory perceptions that occur without any external stimuli

A

hallucinations

ex. hearing voices, seeing things, feeling sensations on skin, smelling things, tasting strange or unpleasant things

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5
Q

Psychotic Disorders

this term describes a misinterpretation of an actual external stimulus

A

illusion

ex. hearing the wind blowing and thinking it is a bird chirping is an illusion

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6
Q

Schizophreniform Disorder

list the symptom criteria for Schizophreniform Disorder

A
  1. Two of 5 characteristic symptoms
    * at least 1 symptom MUST be delusions, hallucinations, or disorganized speech
    * grossly disorganized or catatonic behavior and negative symptoms (e.g., avolition, alogia, anhedonia)
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7
Q

Schizophreniform Disorder

the duration criterion for Schizoephreniform Disorder

A

at least one month but less than 6 months

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8
Q

Schizophrenia

lsit the symptom criteria for Schizophrenia

A
  1. active phase REQUIRED
  2. at least 2 of 5 characteristic symptoms
    * 1 MUST be delusions, hallucinations, or disorganized speech
    may consist of prodromal and/or residual phases with 2+ characteristic symptoms in weakened form OR negative symptoms only (e.g., avolition, alogia, anhedonia)
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9
Q

Schizophrenia

the duration criterion for Schizophrenia

A
  • active phase: 1 month or more
  • 6 months of continuous signs of disorder
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10
Q

Schizophrenia

list 3 etiologies for Schizophrenia

A
  1. genetics
  2. neurotransmitter abormalities
  3. brain abnormalities
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11
Q

Schizophrenia

the concordance rates of Schizophrenia for twins & research outcomes

monozygotic vs. dizygotic

A
  • monozygotic: 48%
  • dizygotic: 17%
  • outcome research: inconsistent results with rates ranging from:
    .40 to .50 (monozygotic)
    .15 to .17 (dizygotic)
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12
Q

Schizophrenia

the concordance rates for child of parent(s) with Schizophrenia

one bio parent vs. two bio parents

A
  • one bio parent: 13%
  • two bio parents: 46%
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13
Q

Schizophrenia

genetic etiology has been confirmed by research investigating psychiatric outcomes for adult offspring of who?

A

discordant monozygotic and dizygotic twins (i.e., twin pairs with only 1 twin with Schizophrenia)

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14
Q

Schizophrenia

outcome research for adult offspring of discordant monozygotic and dizygotic twins found? What does this suggest about genetic liability?

A
  1. risk for offspring of monozygotic VS. discordant dizygotic twins was similar
  2. greater risk for offspring of non-affected twins
    * discordant monozygotic twins have significant gentic liability that can be transmitted to offspring even if twin parent does not manifest symptoms of Schizophrenia
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15
Q

Schizophrenia

neurotransmitter abnormalities for Schizophrenia

A
  • dopamine (dopamine hypothesis)
  • glutamate
  • serotonin
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16
Q

Schizophrenia

orignial vs. revised dopamine hypothesis

A
  1. (original) schizophrenia due to high levels of dopamine or hyperactivity of dopamine (esp. in basal ganglia)
  2. (revised) positive symptoms due to dopamine hyperactivity in subcortical regions of brain (esp. striatal areas); negative symptoms due to dopamine hypoactivity in cortical regions (esp. prefrontal cortex)
17
Q

Schizophrenia

brain abnormalities associated with Schizophrenia

A
  1. enlarged ventricles and hypofrontality (low activity in PFC)
    * linked to negative. & cognitive symptoms
  2. dysfunction in temporal-limbic-frontal network
    * negative symptoms
  3. disinhibition in subcortical areas increases release of dopmaine in caudate nucleus, putamen, and nucleus accumbens
    * positive symptoms
18
Q

Schizophrenia

common comorbid conditions with Schizophrenia

A
  • anxiety disorders
  • OCD
  • tobacco use disorder
19
Q

Schizophrenia

% of people who have co-occuring Schizophrenia & tobacco use disorder

A

70% to 85%

over HALF meet criteria for tobacco use disorder

20
Q

Schizophrenia

onset of psychotic symptoms; peak age of onset

gender differences

A
  • initial: late teens to early 30’s
  • onset - males: early- to mid-20’s
  • onset - females: late-20’s
21
Q

Schizophrenia

course over lifespan of psychotic symptoms vs. negative & cognitive symptoms?

A
  • psychotic: decrease with increasing age
  • negative & cognitive: persist despite aging
22
Q

Schizophrenia

characteristics of a better prognosis

gender differences

A
  • female gender
  • an acute and late onset of symptoms
  • comorbid mood symptoms (esp. depression)
  • predominantly positive symptoms
  • precipitating factors
  • family history of mood disorder
  • good **premorbid adjustment **
23
Q

Schizophrenia

characteristics of a worse prognosis

A
  • anosognosia (lack of insight or awareness of disorder)
  • family members with high expressed emotion (emotional response of family members to patient), esp. high levels of criticism and hostility & emotional overinvolvement
24
Q

Schizophrenia

onset, course, and prognosis for non-Western developing countries VS. Western industrialized countries

geographic location; acculturation

A
  • non-Western developing countries: acute onset, shorter course, & higher rates of remission (than western industrialized countries)
25
# **Schizophrenia** first-line **treatment**
***multimodal*** * psychosocial interventions * antipsychotic drugs * adjunctive medications to treat comorbid disorders
26
# **Schizophrenia** list 8 evidence-based **psychosocial interventions** | psychotherapy; skills-based; community support
1. CBT for psychosis 2. cognitive remediation for Schizophrenia 3. ACT 4. assertive community treatment 5. family psychoeducation 6. illness self-management training 7. social skills training 8. supported employment services
27
# **Schizophrenia** **factors to consider** when prescribing antipsychotics drugs
* drug's likely **benefits & side effects** * potential **interactions **with other drugs * patient's **preferences** * **past response** to antipsychotics * **health conditions** impacted by side effects
28
# **Schizophrenia** **clozapine** (2nd gen) found to be most effective drug for what type of Schizophrenia?
**treatment-resistant Schizophrenia** (e.g., symptoms show no, partial, or suboptimal response to 2 antipsychotics meds trialed for 6 wks each at an adequate dosage)
29
# **Schizophrenia** factors **increasing** medication adherence & **decreasing** risk for relapse
involvement of **family & other support system(s)**
30
# **Schizophrenia** **multicompetent early interventions** for individuals in early stages of disorder and/or are high risk
1. NAVIGATE: * team-based program that targets ppl in first episode psychosis * includes: family education, individual resiliency training, supported employment & education, and individualized medication treatment
31
# **Schizophrenia** describe **individualized resiliency training**
* based on **CBTp** * teaches **skills to manage illness** * helps patients process **precursors, triggers, and effects of psychotic episodes** * uses **cognitive restructuring** * teaches **strategies to improve well-being** by strengthening positive feelings, thoughts, and behaviors
32
# **Schizoaffective Disorder** **symptom** criteria
* symptoms of Schizophrenia * a major depressive **OR** manic episode * presence of **delusions or hallucinations**
33
# **Schizoaffective Disorder** **duration** criteria
* depression/mania present for **most of the duration of illness** * delusions or hallucinations present for **2 or more weeks without mood symptoms**
34
# **Delusional Disorder** **symptom** criteria
1. one or more **delusions** 2. overall functioning **has not been** markedly impaired except for direct effects of delusion
35
# **Delusional Disorder** **duration** criteria
at least 1 month
36
# **Delusional Disorder** **subtypes** and descriptions | 5
1. **erotomanic** - believe another person is in love with them 2. **grandoise** - believes they have great but unrecognized talent or insight 3. **jealous** - believes partner is unfaithful 4. **persecutory** - believes they are being conspired against, spied on, poisoned, maliciously maligned 5. **somatic** - involves bodily functions or sensations