Schizophrenia spectrum and other psychotic disorders Flashcards
(49 cards)
What is the best therapy for schizoaffective disorder?
- Antipsychotic
2. Antipsychotic + antidepressant
Why is important to establish the presence of mania in a schizoaffective patient?
Mania would change the treatment plan
- Adding mood stabilizer instead of an antidepressant
What anatomical abnormalities are seen on MRI in patient with schizophrenia?
Frontotemporal dysfunction
Left-hemisphere lateralization
Lack of energy
Anergia
What substances/medications can induce mood symptoms?
Cocaine/Amphetamines- Maina
Cocaine withdrawal- Depression
Sterods
Antiparkinsonian medications
What part of the history can help differentiate bipolar or MDD with psychotic features from schizoaffective?
In both MDD and bipolar the mood symptoms would be present long before the psychosis
What are some concerning side effects of typical antipsychotics?
Tardive dyskinesia
EPS
Neuroleptic malignant syndrome
Anticholinergic effects
Which mood stabilzers are used to treat manic symptoms of schizoaffective disorder?
Lithium
Carbamazepine
Valproic acid
What kind of psychotherapy can be used to help schizoaffective disorder?
Psychosocial rehabilitation
- Social isolation
- Apathy
- Disturbed interpersonal relationships
What is a reasonable step in an adolescent patient with mood symptoms that are resistant to treatment?
Order a urine or serum toxicology for substance abuse
How do young patients with schizoaffective disorder present differently than older patients?
Symptoms are usually worse
What are the two main diagnostic critera for schizophrenia?
Delusions (persecutory)
Hallucinations
How long do symptoms need to be present to dx schizophrenia?
6+ months
When is psychiatric admission warranted?
SI+
HI+
Patient cannot care for themselves
What are the symptoms of psychosis and how many need to be present for schizophrenia?
Delusions Hallucinations Disorganized speech Disorganized or catatonic behavior Negative symptoms
2+
What 3 disorders must be ruled out before schizophrenia can be dx?
Schizoaffective
Mood disorder with psychotic features
Substance or medical condition
Phase of schizophrenia with postitive and negative symptoms
Active-phase
Neuropsychiatric syndreom occurring in psychiatric or medical disorders that present with three or more psychomotor symptoms.
- Stupor
- Catalepsy
- Waxy flexibility
- Mutism
- Negativism
- Posturing
- Grimacing
- Mannerism
- Stereotypy
- Agitation
- Echopraxia
- Echolalia
Catatonia
Thoughts lacking logical connections between ideas (loose associations) or between the individual words (word salad)
Disorganized speech
Misinterpretation of aspects of the external environment as having a particular significance for the individual.
Ideas of reference
Negative symptoms
Lack of emotional responses and thought processes
- Decreased expression of emotion
- Flattening of affect
- Alogia- decreased spontaneous speech
- Avolition- decreased motivation
How long does the active-phase (2+: dellusions, hallucinations, or disorganized speech) of schizophrenia need to be?
1+ month
What are the risk factors for aggression?
Positive history - Violence or impulsiveness Substance abuse Young age Male Lack of treatment
What percentage of schizophrenic pateints attemp suicide? Complete?
20%
5%
