Term
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Definition
| significant impairment in reality testing, as evidenced by hallucination, delusions, thought disorganization, grossly disorganized behavior |
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Term
| Differential diagnosis of psychosis |
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Definition
1. primary disorders - schizoaffective, brief psychotic, and delusional disorders; schizophrenia; bipolar I and major depression
2. secondary - substance induced psychosis, secondary to general medical condition (thyroid, adrenal, steroid), delirium, dementia |
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Term
| definition of schizophrenia |
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Definition
| chronic or recurrent disorder characterized by sustained periods of psychosis and long-term functional deterioration - difficulty continuing roles in society |
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Term
| schizophrenia epidemiology |
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Definition
1. prevalence and incidence is 1/100
2. affects men and women equally
3. use 25% of all hospital beds |
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Term
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Definition
four A's:
1. autism
2. loose associations
3. affective disturbance
4. ambivalence |
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Term
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Definition
1. audible thoughts
2. more than one voice arguing or discussing the patient
3. voices commenting on patient's activities
4. thought insertion - feeling that thought is not your own
5. thought broadcasting
6. somatic passivity
7. delusional perception |
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Term
| DSM 4 criteria for diagnosis |
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Definition
a. characteristic symptoms, 2 or more/month
1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganized or catatonic behavior
5. negative symptoms
->only 1 required if delusions are bizarre or if running commentary voice or 2 or more voices conversing
b. social/occupational dysfunction
c. duration: at least 6 months
d. schizoaffective/mood disorder exclusion
e. substance/GMC exclusion
f. relationship to pervasive developmental disorder |
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Term
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Definition
1. preoccupation with one or more delusions or frequent auditory hallucinations
2. no disorganized speech, disorganized or catatonic behavior, flat or inappropriate affect
3. more favorable outcome |
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Term
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Definition
all are prominent:
1. disorganized speech
2. disorganized behavior
3. flat or inappropriate affect
-least favorable outcome |
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Term
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Definition
at least 2 of the following:
1. motoric immobility as evidenced by catalepsy
2. excessive, purposeless motor activity
3. extreme negativism or mutism
4. peculiarities of voluntary movement
5. echolalia or echopraxia |
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Term
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Definition
includes elements from more than one subtype, none of which predominates
most common subtype |
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Term
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Definition
-absence of prominent delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior
-continuing evidence of disturbance - negative symptoms, attenuated psychotic symptoms, odd beliefs, unusual perceptual experiences |
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Term
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Definition
delusions
hallucinations
thought disorganization
catatonia
-occur later in development of illness
-respond well to treatment, may stabilize or improve |
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Term
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Definition
blunted affect
anhedonia/asociality
alogia
inattention
avolition/apathy
-occur early, often as prodrome
-tend to progress, correlated with functional impairment, difficult to treat |
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Term
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Definition
1. positive symptoms are due to overactivity of dopaminergic pathways
2. efficacy of antipsychotics correlates with dopamine D2 blockade
3. psychotic symptoms can be induced by dopamine agonists |
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Term
| neurodevelopmental hypothesis |
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Definition
the primary events resulting in schizophrenia are due to changes that occurred in utero or in the perinatal period that disrupt the developmental aspects of brain structure and function such as myelination or synatpic pruning
->reduced synaptic density in prefrontal and other areas of associated cortex in schizophrenics
->higher rate of ventricular enlargement and greater los of frontal, parietal and temporal gray matter |
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Term
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Definition
1. obstetric complications found to occur 2x more frequently in schizophrenic patients than controls
2. seems to play larger role in early-onset schiz. |
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Term
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Definition
1. viral-maternal exposure to influenza epidemics in 2nd trimester associated with increased rate of occurrence, especially in female offspring
2. nutrition - maternal famine during pregnancy associated in increase in schiz. |
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Term
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Definition
1. autoimmunity may be a factor in brain injury leading to schiz
2. genetic defect may influence susceptibility of brain to early viral infection, associated immature responses, or both |
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Term
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Definition
more likely to have:
1. earlier onset
2. poorer premorbid function
3. poorer outcome
4. minor physical anomalies
5. greater structural brain abnormalities |
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Term
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Definition
1. greater susceptibility to 1st trimester dietary insufficiency
2. greater susceptibility to 2nd trimester influenza
3. protective effect of estrogens via their attenuated dopamine blocking effect at D2 receptors |
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Term
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Definition
1. pharmacotherapy
2. psychotherapy (symptom control) and cognitive-behavioral therapy (irrational thoughts)
3. family evaluation and therapy
3. |
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