Term
| What is the definition of psychosis? |
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Definition
A significant impairment in reality testing, as evidenced by
-Hallucinations
-Delusions
-Thought disorganization
-Grossly disorganized behavior |
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Term
| What is the definition of hallucination? |
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Definition
A false sensory perception
In order of prevalence;
Auditory
Visual
Tactile
Olfactory
Gustatory |
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Term
| If someone has auditory hallucinations, can you narrow down what they have to one condition? |
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Definition
NO. Could be a number of things:
Psychotic
Seizure disorder
Alcohol withdrawal |
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Term
| When do "normal" people commonly experience auditory hallucinations? |
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Definition
| When they're tired and are about to get to sleep |
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Term
| What is the definition of a delusion? |
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Definition
A fixed false belief that is:
-Based on incorrect inferences about external reality
-Not sanctioned by the individual's culture or group |
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Term
| What are hallmarks of disorganized thoughts or behavior? |
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Definition
Meaningless or chaotic speech
Loose asociations
Bizarre behavior
Poorly directed behavior
Catatonia |
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Term
| What are the diagnostic criteria for schizophrenia? |
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Definition
At least two psychotic symptoms for one month
Social or occupational dysfunction
Six month duration of symptoms |
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Term
| What are the features of catatonia? |
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Definition
Motoric immobility
Wavy flexibility
Excessive, purposeless motor activity
Extreme negativism
Peularities of movement or posture
Echoing words |
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Term
| What disorders can show signs of catotonia? |
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Definition
Schizophrenia
Post-stygal
Mood disorders
Mania |
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Term
| What are the positive symptoms of schizophrenia |
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Definition
Delusions
Hallucinations
Thought disorganization |
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Term
| What are the negative symptoms of schizophrenia? |
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Definition
Blunted affect
Alogia
Avolition/Apathy
Anhedonia
Inattention |
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Term
| In what ways is affect blunted in schizophrenics? |
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Definition
Decreased facial expression
Less vocal inflection
Poor eye contact
Lack of expressive gestures |
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Term
| What is the definition of alogia? |
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Definition
Reduced amount of speech
Reduced idea content |
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Term
| What is the definition of avolition? |
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Definition
Poor grooming, hygiene
Low energy |
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Term
| What is the definition of anhedonia? |
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Definition
Loss of recreational interests
Decreased sexual intimacy |
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Term
| What is the age of onset of schizophrenia? |
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Definition
Men: peak is 17-30
Women: bimodal. Peak at 20-40, second at 50 |
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Term
| What are prodromal symptoms of schizophrenia? |
|
Definition
Poor social adjustment
Poor school/work performance
Low IQ
Presence of negative symptoms
Pecularities of thought/behavior |
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Term
| What causes the most serious problems during schizophrenia? |
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Definition
| The negative symptoms: they are correlated with the occupational problems and respond poorly to treatment |
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Term
| When are the first symptoms of schizophrenia present? |
|
Definition
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Term
| What is the average IQ of someone with schizophrenia? |
|
Definition
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Term
| In schizophrenia, what is the main idea in management? |
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Definition
| Prevent episodes...each episode causes there to be a worse baseline of negative symptoms |
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Term
| What are complications of schizophrenia? |
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Definition
Depression: 50%
Homelessness: 33% of homeless have schizophrenia
Crime
Substance abuse: 60-90% have an addiction |
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Term
| What is the epidemiology of schizophrenia? |
|
Definition
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Term
| What is the heritability of schizophrenia? |
|
Definition
10% risk to first-degree relatives, compared to 1% in the general population
50% risk to monozygotic twins
Very much a multifactorial disease |
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Term
| What sorts of prenatal/perinatal compliations can predispose someone to schizophrenia? |
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Definition
In utero infections
Winter births
Perinatal anoxia |
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Term
| What neurotransmitters are implicated in schizophrenia? |
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Definition
Dopamine
Increased amounts of dopamine have been shown to be correlated to the positive symptoms |
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Term
| What tracts are associated with schizophrenia? |
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Definition
Nigrostriatal
Mesocortical tract
Mesolimbic tract |
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Term
| Where in the brain are dopamine levels altered in schizophrenia? |
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Definition
Increased subcortical levels
Decreased prefrontal activity |
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Term
| What structural correlates are there in schizophrenia? |
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Definition
Increased ventricle to brain ratio
Reduction in neuronal mass |
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Term
| What functional correlates are foundin schizophrenia? |
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Definition
| Auditory hallucinations due to activation of auditory cortex |
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Term
| What deveopmental abnormalities are present in schizophrenia? |
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Definition
| Aberrant neuronal processing |
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Term
| What is the treatment of schizophrenia? |
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Definition
Antipsychotics.
Atypical antipsychotics: first line
Conventional antipsychotics are the next choice
You've got to do psychosocial interventions...in order for the drugs to be effective they have to have a stable living situation |
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Term
| What are features of psychosis concurrent with mania? |
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Definition
It's congruent with the mood
Catatonia may happen
80% of manic episodes have some sort of delusion |
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Term
| What is the treatment for psychotic manic episodes? |
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Definition
Antipsychotics for the acute psychosis
Mood stabilizers: preventing the mania in the first place |
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Term
| What are the features of psychosis concurrent with a major depressive episode? |
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Definition
Congruent with the mood: nihilistic, persecutory
10% of depressed patients will get this |
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Term
| What is the 1% rule? What does it deal with? |
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Definition
Primary psychotic disorders
1% incidence of each disorder:
Schizophrenia
Bipolar I with psychosis
Major depressive diorder with psychosis |
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Term
| What is the treatment for patients with major depression who have psychosis? |
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Definition
| ECT is the most effective. |
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Term
| What is the diagnostic criteria for schizoaffective disorder? |
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Definition
Course of the illness includes periods of psychosis WITHOUT mood symptoms and periods of psychosis WITH mood symptoms
Splitting the difference between a mood disorder and psychotic disorder |
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Term
| What is the prevalence of schizoaffective disorder? |
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Definition
| Less common than schizophrenia |
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Term
| What is the treatment of schizoaffective disorder/ |
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Definition
| Antipsychotic PLUS mood stabilizer or antidepressant |
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Term
| What are the diagnostic critera for delusional disorder? |
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Definition
Isolated, nonbizarre delusions
NO IMPAIRMENTS
For example, someone having a delusion that at work someone has changed the text, so you have to go through a bunch of documents to check |
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Term
| What is the onset of delusional disorder? |
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Definition
Middle-late in life
Very, very rare.
IT SHOULD BE LOW ON THE DIFFERENTIAL |
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Term
| What is the treatment for delusional disorder? |
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Definition
Antipsychotics
The symptoms don't respond wel |
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Term
| What is the definition of brief psychotic disorder? |
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Definition
A psychosis that quickly resolves with no residual impairment
Usually in response to an acute stressor |
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Term
| What are some factors that can predispose someone to a brief psychotic disorder? |
|
Definition
Personality disorders, espeically
-Paranoid
-Borderline
-Histrionic
-Narcissistic
-Schizotypal |
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Term
| What is the definition of substance-induced psychotic disorder? |
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Definition
| Psychosis that is associated with intoxication |
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