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30 Cards in this Set
- Front
- Back
Schizophrenia |
*Range of cognitive, behavioral, and emotional dysfunctions. *Recognition of a constellation of signs and symptoms associated with impaired occupational or social functioning *Heterogeneous (several causes) clinical syndrome *Positive symptoms (presence of): delusions, hallucinations, disorganized thinking/motorized behavior *Negative symptoms (lack of): volition, decrease in attendance to ADLS (activity of daily living skills) |
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What are the marked disturbances found in thought disorders? |
Affect (flat, inappropriate) |
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When is the onset of schizophrenia? |
Late adolescents (20s) - first psychotic episode |
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What are the Diagnostic Criteria of Schizoprenia? 1 of 2 |
1. Two or more active-phase symptoms such as: 2. Since onset, functioning in one or more areas are below level before onset (work, relationships, self-care) 3. Symptoms must last at least 6 months with at least 1 month of following symptoms, may include periods of residual symptoms |
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What are the Diagnostic Criteria of schizophrenia? 2 of 2 |
4. Schizoaffective, depressive/bipolar disorders with psychotic features are ruled out because - a) no major depressive or manic episodes occurred with active-phase, b) if mood episodes have occurred during active-phase, they have been present for a minority of total duration 5. Not due to physiological or substance effects, or another medical condition 6. If hx of autism or communication disorder of childhood onset, this diagnosis is given only if delusions or hallucinations, and other symptoms, are present for at least one month. |
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Delusional disorder |
Pt has delusions that do not impair functioning |
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Brief psychotic disorder |
*Pt returns to pre-morbidity level *Lasts more than one day, but remits by one month |
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Psychotic disorder not otherwise specified |
Pt with psychosis (loss of reality, delusions, hallucinations, inability to assess internal/external environment accurately; a way to cope with intense confusion/anxiety) that does not meet criteria of other diagnoses. |
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What are the 3 dimensions of psychopathyology in schizophrenia? |
Disorganized (speech, behavior, incongruent affect) |
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Nihilistic |
Delusion involving death |
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What are the types of delusions seen in schizophrenia? |
Persecutory |
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What are the positive symptoms of schizophrenia? |
Hallucinations |
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Clanging (def.) |
Speaking words that rhyme and don't make sense |
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Perserervation (def) |
"Stuck in mud" continuous repetition of words or movements |
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Anhedonia (def) |
no longer enjoys pleasure; often seen in depression |
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What are the 5 primary symptoms/domains of schizophrenia? |
1. Delusions 2. Hallucinations |
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5 Domains of SCHIZOPHRENIA |
*Fixed beliefs that are no likely to change, even w/ evidence. * Content include themes of persecution, belief that things are directed at oneself, grandiose ideas, that another person is in love with them, nihilistic thoughts (catastrophe will occur), and somatic (health function) *Bizarre in nature, not realistic
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5 Domains OF SCHIZOPHRENIA |
*Vivid w/out external stimulus *Occur in any sensory modality, but auditory are most common; voices, not own |
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5 Domains OF SCHIZOPHRENIA |
*May switch from one topic to another *Unrelated responses, incomprehensible *Must impair effective communication
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5 Domains OF SCHIZOPHRENIA |
*Childlike silliness or unpredictable agitation *Catatonic is a decrease in reactivity to environment; purposeless motor activity (echoing of speech, staring) |
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5 Domains OF SCHIZOPHRENIA |
* Diminished emotional expression; face, eye contact, speech, movements *Avolition-decrease in motivated self-initiated purposeful activities *Alogia-less talking, anhedonia-less pleasure, asociality-less social |
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What are the goals of antipsychotic medications? |
Manage acute positive psychiatric symptoms |
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ANTIPSYCHOTIC DRUGS USED TO TX SCHIZOPHRENIA |
"Old Meds"
Primary used to tx hallucinations and delusions Side effects include extrpyramidal and tardive dyskinesia |
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ANTIPSYCHOTIC DRUGS USED TO TX SCHIZOPHRENIA |
"New Meds" |
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What are the tips and overall goals of tx for schizophrenia? |
-Don't argue with client's delusions; can challenge later after relationship is built. -Try to understand emotion/event -Empathize - they might not know what they are saying either. -Focus on what would help now? No power struggles. -Be careful in taking away delusions. They could serve a self-esteem function. Must build up support first. -Safety in all settings |
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Key features that define Psychotic Disorders: |
1. Delusions 2. Hallucinations 3. Disorganized Thinking (speech) 4. Grossly Disorganized or Abnormal Motor Behavior (including Catatonia) 5. Negative Symptoms |
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Schizophrenia Spectrum and Other Psychotic Disorders Considerations: |
1. Conditions that do not reach full criteria for a psychotic disorder or limited to one domain of psychopathology 2. Time-limited conditions 3. Requires the exclusion of another condition that may give rise to psychosis |
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Schizotypal Personality Disorder |
*Full description is under personality disorders. *Captures a pervasive pattern of social and interpersonal deficits, including reduced capacity for close relationships; cognitive or perceptual distortions; and eccentricities of behavior, usually beginning by early adulthood, but some times in childhood and adolescence. |
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Delusional and Catatonia Disorders: |
Limited to one domain of psychosis
Catatonia can occur in several disorders |
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Psychotic Disorders - introduction |
*May be induced by another condition *If substance/medication induced, symptoms will cease after the substances are gone |