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26 Cards in this Set
- Front
- Back
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what is late onset for schizophrenia
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over 45 years
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when do men present vs. women?
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men: 18-25
women: 25-35 present equally |
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what are the biologic theories re: schizophrenia?
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genetic: inherited predisposition
brain anatomy changes: 4 consistent changes decrease in blood flow to globus pallus thinner cortex of medial temporal lobe, general decrease in grey matter dopamine hypothesis: mesolimbic tract - excessive dopamine |
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besides weight gain, what negative effect do psych meds have? (not EPS)
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diabetes
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DSM criteria for Schizophrenia
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2/5 present in one month:
delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms |
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Positive Symptoms
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Hallucinations
Delusions Thought Disorder |
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Delusions
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Persecutory: followed
Reference: events w/in environment pertain to individ Grandiose:exaggerated feeling of importance Nihilistic: nonexistent Somatic: false idea about body Religious: obsession w/relig Substitution: belief that an individual is someone else |
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Thought disorder
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disorganized speech
disorganized/catatonic behavior |
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Disorganized speech
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loose associations: idea shift to unrelated topic
world salad clang associations: words based on sound Echolalia perseveration: repeat same word/idea despite question |
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disorganized/catatonic behavior
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Catatonic Excitement - extreme motor agitation
Waxy Flexibility-rigid position, moveable Catatonic Posturing - voluntary assumption of bizarre positioning Catatonic Stupor - unaware of surround Echopraxia- pathological imitation of body movements |
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Negative Symptoms
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Affective Blunting
Anhedonia Avolition Alogia Apathy |
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Why is preventing relapse important in schizophrenia? When is a pt who is normally medicated most likely to be at risk?
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pt could commit suicide
pattern of illness in first 5 years will dictate life of condition pregnancy, b/c meds are tetragenic |
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Types of Schizophrenia
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Paranoid - prominent delusions
Disorganized - flat affected, disorg speech/behavior Catatonic - extreme psychomotor disruption Undifferentiated - Criterion A Residual - one documented episode, but not prominent positive symptoms |
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Schizophreniform Disorder?
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episode lasts 1 month, but less than 6 months
usually no impairment to social/occupational prodromal? 1/3 complete recovery |
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Schizoaffective Disorder?
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Schizophrenia + Bipolar mania
STRONG mood component more common in women, risk for suicide |
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Delusional Disorder
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1 month delusions that are stable, logical and non bizarre. Dude convinced he's a cuckold.
erotomanic jealous unspecified grandiose somatic persecutory |
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Brief Psychotic Disorder
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one ore more Criteria for schizo, for one day up to one month.
stressful event? rare |
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Folie a Deux?
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Shared psychotic disoder (father son & paper monsters)
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Treatment for Schizophrenia
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Seratonin-Dopamine Antagonists
less EPS more for negative symptoms |
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List some Seratonin-Dopamin Antagonists
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Resperidone (Risperdal)
Clozapine (Clozaril) Quetiapine (Seroquel) Olanzapine (Zyprexa) Ziprasidone (Geodon) Aripiprazole (Abilify) Paliperidone (Invega) |
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Older antipsychotics
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Dopamine Receptor Antagonists
more EPS |
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Dopamine Receptor Antagonists
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Thorazine (chlorpromazine)
Haldol (haloperidol) Prolixin (fluphenazine) Trilafon (perphenazine) Moban (molindone) Mellaril (thioridazine) Stelazine (trifluoroperazine) Navane (thiothixene) |
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Benzodiazepines
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Ativan (lorazepam)
Klonopin (clonazepam) |
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Anticonvulsants
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Depakote (valproic acid)
Tegretol (carbamazepine) Lamictal (lamotrigine) |
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EPS
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Parkinsonism
Dystonia Akathisia Tardive Dyskinesia |
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Side effects of antipsychotics
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orthostatic hypotension
elevated prolactin weight gain sedation photosensitivity diabetes agranulocytosis cardiac arrhythmias |
