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21 Cards in this Set
- Front
- Back
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Schizophrenia-Type I
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Positive Symptoms
Good premorbid Functioning Favorable response to tradational Antipsychotic Drugs Due to neurotransmitter adnormalities |
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Schizophrenia-Type II
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Negative Symptoms
Relatively poor premorbid adjustment Poor response to traditional antipsychotic meds Structural brain abnormalities |
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Schizophrenia Associated Features
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Inappropriated affect
Anhedonia Dysphoric mood Abnormalities in motor behavior Somatic complaints IQ may be relatively unaffected -some degree of confusion-memory impairment-depersonalization poor insight Anosognosia High risk of suicide-men-under 30-unemployed-recently d/c from hosp. Substance Dependence No evidence of >aggression |
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Gender-Age-Culture
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Higher for males
Onset males 18-25 negative symptoms Females onset 25-35 >affective symptoms-paranoid delusions and halluinations Africian-American due to misdiagnosis experience hallucinations/delusions as symptoms of depression |
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Course and Prognosis
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Chronic remission rare
Better prognosis w/ good premorbid adjustment-acute and late onset-female gender-presence of precipating event-brief duration of active phase symptoms-insight into illiness-fm hx of mood disorder-no fm hx. |
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Etiology
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Genetic component
Higher 1st degree biological relative-sibling 10% fraternal twin-17% Identical twin 48%-Child of schizophrenic parents. General pop odds 5%-1.5% Brain abnormalities-Diffuse or focal neocortical atrophy-progressive decline diminished size of hippocampus-amygdala-globus pallidus Increased voloume of the lateral and 3rd ventricles reduced volume of limbic system structures 15-30% ventricular enlargement>in males more neg symptoms hypofrontality-lower than normal activity in the prefrontal cortex-negative symptoms and poor performance on cognitive tasks |
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Dopamine Hypothesis
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Due to either elevated dopamine levels or to excess or oversensitive dopamine receptors
Phenothiazines-used to reduce symptoms-believed to block dopamine receptors. Amphetamines-increase dopamine,increase symptoms Elevated levels of norepinephrine and serotonin and low levels of GABA and glutemate. |
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Family Factors
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Double-bind Communication-
High Expressed Emotion Born in Late Winter or early spring-Increased exposure to an influenza virus. |
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Treatment
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Antipsychotic (neuroleptic) drugs-eliminate positive symptoms
Potential for severe side effects-Tardive Dyskinesia Clozapine (Atypical antipsychotics) Less severe side effects reduce negative symptoms reduce secondary symptoms of depression and hostiality Family Interventions-reducing stress and nonbenefical emotional expression social skills training and supported employment |
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Differential Diagnosis
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Must distinquish b/t amphetamine and cocaine use
Mood disturbances common Schizophrenia-mood disturbances are brief. Schizoaffective Disorder 2 wks with only psychotic symptoms. |
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Schizophreniform Disorder
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Disturbances present at least 1 month <than six mos-impaired social/occupational functioning
2/3 of people eventually receive diag of Schizophrenia |
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Delusional Disorder
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1 or > nonbizzare delusions at least 1 month long
Psychosocial functioning not impaired any disturbance inf functioning related to delusions. |
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Delusional Disorder-Subtypes
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erotomanic-someone in love w/them
grandiose- Jealous persecutory somatic mixed unspecified |
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Brief Psychotic Disorder
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Present 1 day <than 1 month
eventual return to premorbid functioning often, but not always follows overwhelming stressor |
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Mood Disorders and Suicide
Major Depressive Episode |
Depressed mood loss of interest or enjoyment
change from previous functioning persist at least 2 wks at least 5 symptoms depressed mood every day diminished interest feelings of worthlessness loss of interest in appetite significant weight loss/gain fatigue sleep problems reduced ability to concentrate |
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Manic Episode
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Mood abnormally elevated, expansive and irratable.
at least 3 symptoms increased goal directed activity flight of ideas decreased need for sleep grandiosity restlessness involvement in pleasurable activities w/ high potential for neg consequences significant impairment in occupational or social functioning need to be hospitalized and/or presence of psychotic features |
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Hypomanic Episode
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Elevated expansive or irritable mood.
at least 4 days - 3 symptoms change in mood and functioning not enough to hospitalize absence of psychotic symptoms. |
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Mixed Episodes
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at least 1 week
rapidly alternating symptoms manic/depressive marked impairment or requires hospitalization or psychotic symptoms. |
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Depressive Episode-Major Depressive Disorder
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1 or > depressive episodes w/o hx of manic or hypomanic or mixed episodes
Double depression Masked depression Postpartum Onset 10-20% of women 1 in 500 Develop Psychosis including delusions |
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Gender/Age/Culture
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Average onset mid 20's
Childhood=rates /gender Somatic Complaints -irritablility-social withdrawal preadolescents (boys=aggressiveness and destuctiveness more common w/disruptive Behavior Disorder ADHD or Anxiety Adolescence-2xs >female Disruptive Behavior Disorder-ADHD-Anxiety-Substance Related Disorders and eating Disorders Elderly=Mem loss distractability-disorientation and other cognitive symptoms difficult to distinquish pseudodementia from demetia |
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Course/Prognosis
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Symptoms may last 6 mos or longer most cases remit w/ full return to premorbid functioning
20%-30% symptoms remain for months to yrs. 50% exp > than 1 episode. |
