Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
91 Cards in this Set
- Front
- Back
How long does the person need to have the symptoms to diagnose schizophrenia?
|
6 months
|
|
How is Schizophrenia different from other psychiatric problems?
|
- It tends to affect all the aspects of an individuals life
- worst prognosis - 1/3 don't go back to their normal state continue w/ Dz |
|
What are the risk factors?
|
men get Dz younger 15-25
women 25-35 |
|
What is the worst prognosis?
|
the younger the patient gets a Dz the worst pronosis
so men have a worst prognosis |
|
What is the neurotransmitter unbalance of schizophrenia?
|
Increase levels of DOPA
Also serotonins (New drugs work on both) |
|
How do patients develop Schizophernia? Theories?
|
Double Bind
Mother talked to you like an adult but treated you like a baby mixed message from mother you don't know what to do... in a bind |
|
ANother theroy is High EE family? Expressed Emotions
|
A family that has high emotions (Italians?)
family very critical, intrusive, emotional |
|
WHat is important about High EE family and relapse?
|
Chances are very high that you will relapse and return to hospital
you go back to the same environment |
|
Viral Theory for Schizophrenia?
|
They belive that viruses infect patients when they are born since lots of patients are born in winter and early spring
|
|
Downward Drift or Social Causation theory?
|
Schizophrenia in low-socioeconomic status (low SES)
|
|
Social Causation Theory?
|
Different stress levels
- low SES with high stress |
|
Prevalence vs. genetics?
|
Monozygotic (47%)increase
Dizygotic 12% |
|
What is schizophrenia percentage in the general population?
|
1%
|
|
One parent w/ schizophernia what is the chance?
|
12%
|
|
Two schizophrenic parents??
|
40%
|
|
Monozygotic Twins?
|
47%
|
|
Dizygotic Twins?
|
12%
|
|
First-degree relative w/ schizophrenia?
|
12%
|
|
Second-degree relative w/ schizophrenia?
|
5-6% chance
|
|
What percentage was the chance for bipolar disorder? two parents having bipolar
|
50-75%
|
|
Symptoms of Schizophrenia?
|
Auditory Hallucinations (2/3's)
Visual Hallucinations Bad voices You are evil, terrible kill yourself |
|
Command voice hallucinations?
|
Tell you to do things
most patients hears voice and don't pay attention to it but there are some that do |
|
What is a delusion?
|
false belief
mostly bizarre not believable (makes no sense in what they believe) |
|
What is catatonia?
|
not moving
|
|
What are negative symptoms?
|
flat affect
social withdrawal cognitive defects |
|
Are Schizophrenics functional?
|
No, usually loos jobs
Withdrawal |
|
What is a saccadic eye movement?
|
Irregularity of eye movements
REM like trade mark (Pathognomonic) |
|
What is another characteristic of schizopchrenic behavior?
|
Scanning behavior
Hypervigilance (Paranoid) |
|
What is a common finding in a CT scan of the head?
Or MRI |
Lateral and Third Ventricular Enlargement
|
|
What other patients have ventricular enlargement?
|
Alzheimer patients have it
|
|
What is associated with ventricular enlargment?
|
the larger the enlargement
the greater the negative symptoms worst prognosis |
|
What do you find in a PET scan?
|
hypoactivity of frontal lobes
no areas of pickup no red/yellow black areas (frontal) |
|
What is the frontal lobe responsible for?
|
- personality
- abstract thinking - higher order func - ability to change |
|
What kind of answers do you get in abstract thinking?
|
what does a rolling stone gathers no moss
it is rolling so nothing sticks |
|
How is schizophrenia correlate w/ IQ?
|
low IQ
|
|
Schizophrenia associated w/ problems in neuropsychological tests?
|
problems in frontal lobe
|
|
What psychological tests are worst in Schizophrenia?
|
Personality test
Projective tests are worst since they will give bizarre answers Ink blot |
|
Tx of Schizophrenia?
|
Antipsychotics
typical newer atypicals |
|
What is the first line tx of schizophrenia?
|
Atypical Drugs
since less side effects (better compliance) |
|
What is special abouth the atypical drugs?
|
both positive and negative symptoms
|
|
What symptoms do the typical antipsychotics cover?
|
Only positive symptoms
|
|
What is the theory of therapy?
|
the sicker the patient the less intrusive the therapy
the sicker the patient the more intrusive therapy |
|
What is the most intrusive therapy?
|
Psychoanalisis
therapist sits behind you patient says whatever is on their mind free association |
|
What is supportive psychotherapy?
|
how is your job
the sickest patient since you want to gain their trust |
|
What is differential diagnosis for Schizophrenia?
|
Rule out organic
Drugs (psychostimulants cocaine/amphetamine) Looks paranoid/scanning the room |
|
What is the first test?
|
Urine test
Cocaine stays in body for 3-4 days |
|
What does hallucinogens produce?
|
LSD
Alcohol withdrawal |
|
What other medical condition is associated with bizarre disorders, hallucinations in the brain?
|
Temporal Lobe Epilepsy/Seizures
|
|
What other psychiatric disorders are part of the differential?
|
Personality
Schizoaffective |
|
What other disorders are involved?
|
Malingering
Factitious Disorder (physical and psychological symptoms) |
|
How long do mood disorders last in schizophrenia?
|
brief/short
so different |
|
What are some medical causes of schizophrenia like?
|
- HIV (psychotic)
- Steroids (rage) - tumors - CVAs |
|
What personality disorder is involved in the differential?
|
- Schizotypal
- Schizoid (short live psychotic episodes) - Borderline (short live psychotic episodes) they go back to normal though functioning patients in society |
|
Types of Schizophrenia?
|
- Paranoid
- Disorganized type - Catatonic Type - Undifferentiated type - Residual |
|
What is the MC type of Schizophrenia?
|
Paranoid Type
Later in Life (so better prognosis) |
|
What is characteristic of Disorganized type?
|
Bizarre behavior
dressed inappropiate making faces laughing making animal noises masturbating in public |
|
What is the prognosis of disorganized type?
|
they have the worst prognosis since they get it a young age
<25 y.o. |
|
What is the hallmark of Residual type?
|
Negative symptoms
flat affect, anhedonia, attention deficit, isolation they don't hear voices (but they use to probably) |
|
What is the theme in Paranoid Schizophrenia?
|
Persecution
|
|
What is the theme catatonic type?
|
psychomotor
excitation or not moving |
|
What is the theme of disorganized type of schizophrenia?
|
Weird
everything is weird/bizarre look/talk/behave |
|
What is the theme of Residual type?
|
No hallucinations/delutions
Homeless Negative Symptoms |
|
What is the theme for Undifferentiated type?
|
not clear
|
|
What is the schizophreniform disorder?
|
duration of symtpoms is 3 months
hallucination (auditory) delusions (bizarre) disorganized speech negative symptoms Duration needs to be less than 6 months |
|
What is the pronosis of schizophreniform disorder?
|
Better than schizophrenia since the duration is less
|
|
What is a risk factor of schizophreniform disorder?
|
Suicide
|
|
What is the tx? How long is the Tx
|
Antipsychotics
3-6 months |
|
What is schizoaffective disorder?
|
Waste paperbasquet patient
Mood symptoms Psychotic Symptoms can differentiate patient pure garabage both mood disorder and schizophrenia major depression, mania |
|
What is better major depression or schizophrenia?
|
better is to have major depression
better prognosis |
|
Major Depression vs. Schizoaffective Dz?
|
Major depression has a better prognosis
all mood |
|
Schizoaffective vs. schizophrenia?
|
Schizoaffective is better prognosis
since has mood disorder |
|
Family history of Mood Disorder vs. Psychotic Disorders?
|
Hx of Mood Disorder has a better prognosis on the patient
|
|
Tx for Schizoaffective Dz?
|
Tx w/ Schizo part w/ antipsychotic and Antidepressant
First Antipsychotic since worse symptoms treated first If you start w/ mood tx then you worsen the psychosis |
|
Delusional disorder?
|
Scenario is possible
Delusions are believable - like wife trying to kill patient |
|
Delusion Disorder patients characteristic?
|
Reliable
no impairment of level of fx thoughts are logical and coherent |
|
Delusional vs. Schizophrenia?
|
Non-bizarre dilusion 1 month
schizophernics not working not functioning |
|
What are the types of delusional disorders?
|
erotomanic
jeleaous grandiose somatic mixed |
|
What are erotomanic delusional disorder?
|
Pat. believe that a famous person is in love with them
- brad pitt - Billy Jean think Michael Jackson made the song for her Stalker |
|
MC type of Delusional Disorder?
|
Persecutory Delusional Disorder
|
|
MC type of schizophrenia?
|
Paranoid
|
|
What are the risk factors for delusional disorder?
|
- onset about 40 years
Prognosis better - women (MC) - recent immigration |
|
Which part of the brain is affected in delusional disorder?
|
- limbic system
or - basal ganglia |
|
What is the Tx of Delusional Patient?
|
Not really Tx
unless stalker antipsychotics Delusions very hard to treat Try to give individual psychotherapy get the pat. trust Confront the delusion |
|
What is brief psychotic disorder?
|
hallucination
delusion Disorganized speech very similar to schizophrenia |
|
What is responding to internal stimuli?
|
Turn their head as if to listen to someone
|
|
How long does the brief psychotic disorder?
|
Symptoms last 1 day but <30 days
|
|
If symtoms last for more than 6 weeks?
|
Schizophreniform
|
|
If psychotic symptoms last for 7 months or more?
|
Schizophrenia
|
|
What are the risk factors of breif psychotic sx?
|
Low SES
Accident and hear voices Pat in a fire and then he hear voices |
|
Tx for Brief Psychotic Disorder?
|
Hospitalized
1st line antipsychotics also treat with |
|
Haloperidol vs. Risperidone?
|
Always choose Risperidone
Less Side Effects |