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57 Cards in this Set

  • Front
  • Back
Schizophrenia is a chronic mental disorder characterized by what?
• Abnormal affect (ex. blunted, flat, inappropriate)
• Disturbed thoughts, speech, and behavior
• Odd appearance
• Social withdrawal
• Poor grooming
True/False: Patients with schizophrenia are usually disoriented and have impaired memory
• Schizophrenics are usually well oriented to person, place, & time
• Memory is intact
• The correct answer is: False
According to the DSM-IV, what must be present for a diagnosis of schizophrenia?
• Symptoms have been around for six months
• At least one period of actual psychosis occur within those six months
• Impairment of occupational or social functioning must have occurred during this time period
What are prodromal signs of schizophrenia?
• Avoids social activities
• Daydreams
• Few friendships
• Interest in the occult, religion, or philosophy
• Quiet
• Passive or irritable
• Somatic complaints
What are thought disorders present during the acute psychotic episode of schizophrenia?
• Disorders of perception (ex. hallucinations)
• Disorders of thought content (ex. delusions, ideas of reference, loss of ego boundaries)
• Disorders of thought processes
• Disorders of form of thought
What are signs & symptoms of the residual phase of schizophrenia?
• flat affect
• peculiar thinking & behavior
• social withdrawal

* minor symptoms of their illness
What hallucinations are most commonly seen in schizophrenia (from most common to least common)?
• Auditory
• Visual
• Tactile
• Gustatory
• Olfactory
• Cenesthetic (visceral sensation)
- most commonly deals w/ intestines
What is the dopamine hypothesis?
the theory that symptoms of schizophrenia is due to dopamine overactivity
What is the definition of delusion?
• false beliefs that remain despite evidence to the contrary
• not based on simple ignorance or shared by a culture or subculture
What is the most common delusion seen in schizophrenia?
delusions of persecution
What are examples of disorders of thought processes?
• Blocking: abrupt halt in the train of thought, often due to hallucinations
• Neologisms: deficiencies in thought or content of speech [making up new words]
What are examples of disorders of form of thought?
• Incoherence, word salad (unrelated combinations of words or phases)
• Loose associations (ideas shift from one subject to another- in unrelated fashion)
• Echolalia (repeating a word over and over)
What are the 5 types of schizophrenia?
• disorganized
• catatonic
• paranoid
• undifferentiated
• residual
What are characteristics of disorganized schizophrenia?
• Age of onset is before 25
• Disinhibited
• Inappropriate emotional responses
• Poor organization
• Poor appearance and grooming
What are characteristics of catatonic schizophrenia?
• Bizarre posturing (waxy flexibility) or extreme excitability
• Rare since introduction of antipsychotic meds
What are characteristics of paranoid schizophrenia?
• Better functioning than other types
• Delusions of persecution
• Older age of onset
What are characteristics of undifferentiated schizophrenia?
• characteristics of more than one type
• can have hallucination, delusion, and active psychosis
• most common type of schizophrenia
What are characteristics of residual schizophrenia?
• has one schizophrenic episode
• subsequently shows residual symptoms but in remission from acute psychosis
What are examples of negative symptoms?
loss of function:
• flattened affect
• lack of motivation
• poor grooming
• poor speech content
• social withdrawal
• thought blocking
Negative symptoms respond better to which medication?
Clozapine (Clozaril)
What are examples of positive symptoms?
• Agitation
• Delusions
• Strange behavior
• Hallucinations
• Talkativeness
What are physiologic abnormalities seen in schizophrenia?
• Eye movement (poor in 50 – 80 % of the patients)
• Neuroendocrinology (ex. Decrease in LH and FSH, abnormal regulation of cortisol)
• elevated levels of homovanillic acid (metabolite of dopamine) in body fluids
What are EEG changes seen in schizophrenia?
• decreased alpha waves
• epileptiform activity
• increased theta and delta waves
What are medical illnesses that can mimic schizophrenia?
• endocrine disorders
• neurologic disease or trauma
• poisoning
• temporal lobe epilepsy
What are psychiatric illnesses that can mimic schizophrenia?
• Brief psychotic disorder
• Manic phase of bipolar
• Schizophreniform disorder
• Schizoaffective disorder
• Schizoid and schizotypal personality disorders
• Substance abuse (amphetamines and hallucinogens)
Which class of drugs are effective against positive symptoms? against negative symptoms?
• traditional antipsychotics for positive symptoms
• atypical antipsychotics for negative symptoms
What are examples of traditional (low-potency) antipsychotics?
• Chlorpromazine (Thorazine)
• Thioridazine (Mellaril)
What are examples of traditional (high-potency) antipsychotics?
• Haloperidol (Haldol)
• Perpherazine (Trilafon)
• Pimozide (Orap)
• Trifluoperazine (Stelazine)
Which antipsychotic is used to treat depression with intense anxiety OR agitation?
Thioridazine (Mellaril)
Which antipsychotic is used to treat nausea, vomiting, and hiccups?
Chlorpromazine (Thorazine)
Which antipsychotic is used to treat psychosis (secondary to organic syndrome) and Tourette disorder?
Haloperidol (Haldol)
Which antipsychotic is used to treat nausea/vomiting?
Perphenazine (Trilafon)
Which antipsychotic is used to treat Tourette disorder and body dysmorphic disorder?
Pimozide (Orap)
Which antipsychotic is used to treat non-psychotic anxiety?
Trifluoperazine (Stelazine)
What are examples of atypical antipsychotics?
• Clozapine (Clozaril)
• Olanzapine (Zyprexa)
• Risperidone (Risperdal)
What are the clinical uses for atypical anti-psychotics?
• effective for negative symptoms
• Clozapine (Clozaril) is effective for chronic & refractory symptoms
What are side effects of low-potency anti-psychotics?
mainly anticholingergic side effects
What are side effects of high-potency anti-psychotics?
neurologic side-effects
• acute dystonia
• akathisia (can't sit still)
• neuroleptic malignant syndrome
• parkinsonian effects
• tardive dyskinesia
What are side effects of atypical antipsychotics?
• agranulocytosis
• seizures
What are examples of anti-cholinergic side effects?
• blurred vision
• constipation
• dry mouth
• severe agitation & confusion
• urinary retention
What are factors that contribute to a better prognosis of schizophrenia?
• female
• has good emplyment history
• has positive symptoms
• has had few relapse
• pt has mood symptoms
• older at onset
• married or has social relationships
What are disorders other than schizophrenia that present with psychotic symptoms?
• brief psychotic disorder
• delusional disorder
• schizophreniform disorder
• schizoaffective disorder
• shard psychoti disorder (Folie a deux)
What are characteristics of brief psychotic disorder?
• at least one psychotic symptom lasting 1 day but less than 1 month
• more common in patients w/ concomitant borderline & histrionic personality disorders
• duration of symptoms is shorter than schizophrenia
• no family history of schizophrenia
• symptoms often follow expousre to psychosocial stressor
27 y/o woman whose brother died recently of HIV disease is brought by relatives to the hospital. They claim that over the past week sha has begun to show bizarre, dramatic behavior and claims that she hears her brother "talking to her inside her head." This is a typical presentation for what psychotic disorder?
brief psychotic disorder
What is the treatment for brief psychotic disorder?
• short hospital stay
• antipsychotics
• benzodiazepines
• psychotherapy
What are characteristics of schizophreniform disorder?
• two or more psychotic symptoms lasting at least 1 month but not more than 6 months
• duration of symptoms is shorter than schizophrenia
• pt is relatively normal in the pre-morbid period
• symptoms come on more suddenly & terminate more abruptly than in schizophrenia
26 year-old man with no previous history of psychiatric illness is brought to the emergency room by his girlfriend. She tells you that about 3 months ago, he suddenly began to show bizarre behavior, often seemed preoccupied as though he was listening to something and showed abrupt mood changes. This is a typical presentation for what psychotic disorder?
Schizophreniform disorder
What are characteristics of schizoaffective disorder?
• fits criteria for both mood disorder & schizophrenia
• chronic impairment in functioning between episodes
• meets criteria for mania or depression as well as for schizophrenia
35 year-old man with a history of psychotic symptoms and severe depression has never held a job for more than 3 months. He is brought to the emergency room by his sister, with whom he lives, when he begins to show increasingly strange behavior. This is a typical patient presentation for what psychotic disorder?
schizoaffective disorder
What are treatment options for schizoaffective disorder?
• hospitalization
• antidepressants
• anti-manic
• antipsychotic agents
What are characterisitics of delusional disorder?
• fixed non-bizarre delusional symtpom (often paranoid)
• pts functions relatively normally
Delusional disorder is more common in which people?
• immigrants
• hearing impaired
• pts older than 40 y/o
55 year –old patient tells you that his neighbor has been plotting for years to get him arrested by listening in on all of his phone conversations. The patient is married and has been in the same job for 25 years. This is a typical presentation for what disorder?
delusional disorder
What are treatment options for delusional disorder?
• psychotherapy
• Pimozide (Orap): esp. for somatic delusions
• Haldol
What are characteristics of shared psychotic disorder?
• aka Folie a Deux
• development of psychotic symptoms in a persion in a close relationship w/ another person
• more common in women and in people from low socio-economic groups
• symptoms occur only after exposure to the inducer
20 year-old woman whose psychotic mother believes that the landlord is trying to poison her now begins to believe the same thing. This is a typical presentation of which psychotic disorder?
shared psychotic disorder
What are treatment options for shared psychotic disorder?
• remove the patient from the influence of the inducer
• social support & psychotherapy
• anti-psychotic medications