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212 Cards in this Set
- Front
- Back
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General description of psychotic disorder?
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brain-based psychiatric disorders that are grouped together because of similarity in frequent psychotic symptoms, but each has somewhat different etiologies
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Psychotic disorders are one of the most _____ classes of psychiatric disorders as determined by the degree of _____ ______ & _____ ____ of this chronic illness
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DEBILITATING FUNCTIONAL IMPAIRMENT & FINANCIAL BURDEN
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Psychotic implies inability to
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test reality
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Psychotic manifests in symptoms such as
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Hallucinations, Delusions, Disorganized thinking & speech, referential thinking, Frequent illusional perceptions
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Psychotic disorders are generally known to have a strong ____ component
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GENETIC
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Schizophrenia causes significant disturbance in many areas of functioning including
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Cognition, Perception, Emotionality, Behavior, Movement, Socialization
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Etiology of schizophrenia many theories exist, ranging from
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psychological to neurobiological
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Biological theory of etiology of schizophrenia implicates 3 areas of biological functioning
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Genetics, Neurodevelopment and Neurobiological defects
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Genetic as biological theory?
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Studies of twins have identified schizophrenia as having a strong genetic etiological component
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What gene defect is believed to exist in psychosis?
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A polygenic single nucleotide polymorphism (SNP)
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Twin studies have identified schizophrenia as having a strong
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Genetic etiological component
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Incidence increases from 1% risk of illness in general population to:
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50% risk in monozygotic twin of a person with schizophrenia
15% risk in dizygotic twin of a person with schizophrenia 40% risk in children if both parents have schizophrenia |
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Hallucinations?
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false sensory experience without a stimuli being present
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What are considered normative and do not fall under the true definition of hallucinations?
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Hypnopmpic & hypnogogic
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Most common to least common hallucinations?
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Auditory (most common)
Visual Tactile Olfactory Gustatory |
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Delusion?
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a false belief firmly maintained despite evidence to the contrary
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Types of delusions (7)?
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*persecutory
*religious *grandiosity *somatic *referential *jealousy *Erotomanic |
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Disorganized thinking is often referred to as
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Formal thought disturbance or thought disorder
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Definition of Disorganized thinking?
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Problems with information organization & interpretation that are best assessed in the speech patterns of patients
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Disorganized thinking types (4)?
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Loose association
Derailment Tangentiality Word salad |
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What is derailment?
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A shift in thinking in which ideas move from one apparently unrelated topic to another
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What is Tangentiality?
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Shifts in topics that often start as related shifts but progressively move farther away from the original topic
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What is Word Salad?
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form of very disorganized speech in which syntax is lost and word use is random & idiosyncratic
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What is Clanging?
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form of loose association in which topics change on a basis of sounds of words rather than meaning of the words
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What is Preservation?
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Persistent repetition of words or phrases
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What is Confabulation?
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Fabrication of facts and details to fill gaps in memory
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What is Echolalia?
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Echoing of words or phrases just spoken by another
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What is Echopraxia?
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Echoing of behavior of another
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What is Blocking?
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Sudden stoppage of speech attributed to losing thought or forgetting
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What is Circumstantiality?
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Inclusion of unnecessary detail and parenthetical information into the conversation
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What are Neologisms?
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Word inventions or unusual application of current words that, while having personal significance to the person, have no apparent meaning for the listener
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What is Poverty of content?
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Vague, repetitive, & abstractive form of speech that contains many words but little information
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What are Flight of ideas
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speech pattern characterized by accelerated speech and rapid shifts in topics
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What are Disorganized behaviors?
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Unusual behavior ranging from childlike silliness to anger.
A symptom of schizophrenia |
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Type of disorganized behavior
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*silliness
*unpredictable anger *difficulties w/ ADLs *disheveled *odd or unusual dress *inappropriate sexual activity *Stereotypic motor activities |
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What are referential thinking and delusions of control?
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Beliefs that events, actions or situations in the environment hold special significance or meaning
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Types of referential thinking
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*thought insertion
*thought withdrawal *thought control *thought broadcasting |
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What are Illusional perceptions?
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Misperception of actual environmental stimuli
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Types of illusions?
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Auditory
Visual Tactile Olfactory Gustatory |
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What is a Hypnompic hallucination?
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a false perception that occurs when one is waking up. Not considered pathological
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What are Hypnogogic hallucinations?
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a false perception that occurs when one is falling asleep. Not considered pathological
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Neurodevelopment etiology of schizophrenia (Genetics)
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Genetic defects are believed to cause abnormal neuronal cell development, connection, organization and migration.
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These Intrauterine insults may contribute to etiological picture of Schizophrenia?
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Prenatal exposure to toxins, including viral agents
Oxygenation deprivation Maternal malnutrition Substance use |
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Several abnormal brain structures have been identified in individuals with schizophrenia such as:
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*enlarged ventricles
*smaller frontal and temporal lobes *cortical atrophy *decreased cerebral blood flow *hippocampal reduction |
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Suspected alteration in chemical neuronal signal transmission due to brain abnormalities in schizophrenia are
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Excess dopamine in mesolimbic pathway
Decreased dopamine in the mesocortical pathway Excess glutamate Decreased gamma-aminobutyric acid Decreased serotonin |
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Schizophrenia prevalence
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1%-1.5% of US population
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What are some Geographic and historical variations in incidence that give insight into etiological factors of schizophrenia?
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Higher rates in urban born individuals
Higher rates in 1st born individuals Higher rates in individuals with lower socioeconomic status |
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Schizophrenia prevalence and gender?
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equally prevalent in men and women
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Age of onset in schizophrenia with men
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18-25
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Male schizophrenics tend to have more…?
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NEGATIVE symptoms
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Age of onset in women with schizophrenia?
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25-35 years
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Women with schizophrenia have more?
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POSITIVE SYMPTOMS
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Usually experience more dsyphoria in schizophrenia
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females
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Who tends to have poorer prognosis in schizophrenia?
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males
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Who tends to have more hospitalizations associated with schizophrenia?
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males
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Who tends to have less responsiveness to medication in schizophrenia?
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Males
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Tend to have more paranoid delusions in schizophrenia?
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Females
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Tend to have more hallucinations in schizophrenia?
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females
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Age of onset in women with schizophrenia?
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onset 25-35
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Characteristics of Earlier Age Onset of schizophrenia? (6)
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1. Tend to be men
2. Have more evidence of structural brain abnormalities 3. Have poorer premorbid functioning 4. Have more prominent negative symptoms 5. Have more cognitive impairment 6. Have poorer prognosis |
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Characteristics of later age of onset Schizophrenia (4)?
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1. Tend to be women
2. Have less evidence of structural abnormalities 3. Have less cognitive impairment 4. Have better prognosis |
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Possible risk factors for schizophrenia (5)?
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1. Genetic loading (1st degree relative with schizophrenia)
2. Prenatal exposure to flu or virus 3. Prenatal malnutrition 4. Obstetrical complications 5. CNS infection in a little kid |
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What are the usually mild manifestations of schizophrenia symptoms are seen in prodromal period such as..?(8)
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1. Odd or unusual beliefs but not to delusional proportion
2. Feel unliked or picked on but not to delusional proportions 3. Odd speech patterns but not illogical (digressions and tangentially) 4. Overly concrete or abstractive thinking 5. Odd behavior but not disorganized 6. Collects odd or worthless items 7. Mumbles to self 8. Isolates self and avoids interaction w/ others |
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There is no single pathognomonic symptom of schizophrenia but rather
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a constellation of clustered symptoms
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Schizophrenia is a disease of _______ processing
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INFORMATION
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The clusters of symptoms are ______ and __________ in schizophrenia
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BEHAVIORAL & COGNITIVE
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Schizophrenia is associated with marked _____ or ______ dysfunction
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SOCIAL & OCCUPATIONAL
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Interpersonal relationships and schizophrenia?
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60-70% of clients do not marry
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What are some Social or Occupational Functioning in Schizophrenia? (4)
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1. “Downdrift functionality” is noted over time ”
2. Go less far in school than unaffected siblings 3. Have difficulty holding jobs 4. Are underemployed relative to intellectual capacity |
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Self-care deficits in schizophrenia? (3)
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Poor hygiene
Poor money management Limited ability for independent living |
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Characteristic symptom clusters for schizophrenia? (3)
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Positive symptoms
Negative symptoms Associated symptoms |
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Explanation of Positive symptoms? (3)
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1. Symptoms that respond positively to and that can be controlled by typical antipsychotic meds
2. Reflect excess or distortions of normal brain functioning 3. Caused by increased dopamine in the mesolimbic pathway |
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Clinical manifestations positive of positive symptoms of Schizophrenia? (8)
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1. Hallucinations
2. Delusions 3. Referential thinking 4. Disorganized behavior 5. Hostility 6. Grandiosity 7. Mania 8. Suspiciousness |
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Explanation of Negative symptoms of schizophrenia? (3)
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1. Symptoms less responsive to typical antipsychotic meds but may respond to and be controlled by atypical antipsychotic meds
2. Represent a decrease or loss of normal functioning 3. Caused by decreased dopamine in the mesocortical pathway |
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Clinical manifestations of negative symptoms? (7)
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1. Affective flattening
2. Alogia or poverty of speech 3. Avolition 4. Apathy 5. Abstract thinking problems 6. Anhedonia 7. Attention deficits |
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What are associated symptoms?
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Symptoms not required to be present to diagnose condition but often are present and a focus of treatment
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Clinical Manifestations of Associated Symptoms? (5)
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1. Inappropriate affect
2. Dysphoric mood 3. Depersonalization 4. Derealization 5. High anxiety |
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"Blunted" is affect that is….?
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present but only with minimal degrees of emotions evident
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DSM-IV criteria for schizophrenia?
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2 or more of the following frequently are present during a 1 month period (only one need if delusions are bizarre or hallucinations consist of a voice that is running commentary of 2 or more voices conversing with each other)
Duration of symptoms last at least 6 months |
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What are delusions?
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Bizarre and unorganized type; examples include delusions that manifest as loss of control over mind or body:
Thought withdrawal Thought insertion |
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Delusions are..?
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false beliefs that cannot be dislodged by logic or contradictory evidence not congruent with normative culture or religious beliefs
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Persecution delusion?
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other people have malevolent intentions toward self or are conspiring against the person
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Delusions of reference?
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other people's thoughts, words or actions refer to self
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Religious delusions?
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Unrealistic special relationship with God
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Nihilistic delusions?
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Destruction of self, world, or body part
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Subtypes of schizophrenia (5)?
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Disorganized type
Paranoid type Catatonic type Undifferentiated type Residual type |
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Subtype identification is of limited clinical value because….?
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Illness course, response to treatment and prognosis appear unrelated to subtype
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Most severe type of schizophrenia
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disorganized type
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Least severe type of schizophrenia
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paranoid type
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What is uncommon in schizophrenia?
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Complete Remission
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What type of symptoms tend to appear 1st in schizophrenia as the illness develops?
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Negative symptoms
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____ symptoms appear to decrease over time, but _____symptoms persist
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Positive
Negative |
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Factors predictive of good prognosis in Schizophrenia? (11)
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1. Good premorbid functioning
2. Acute onset 3. Later age of onset 4. Clear precipitating event 5. Married 6. Good support system 7. Positive symptoms 8. Short interval between treatment and onset of 1st symptoms 9. Absence of structural brain abnormalities 10. Family history of mood disorder 11. No family history of schizophrenia |
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Prominence of disorganized speech, disorganized behavior and flat or inappropriate affect?
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Paranoid
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Prominence of motor symptoms, including immobility as evidenced by catalepsy or stupor, excessive motor movement that is purposeless and not influenced by environmental stimuli, extreme negativity, mutism, oddities of posturing,echolalia and echopraxia?
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Catatonic
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Undifferentiated subtype of schizophrenia?
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Presence of symptoms consistent with schizophrenia but not a prominence of symptom consistent w/ any of the other subtypes
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Residual subtype of schizophrenia?
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Absence of prominent delusions
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Physical exam findings in schizophrenia?
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Abnormal smooth pursuit eye movement
Abnormal saccadic eye movement Poor eye-hand coordination Patient is identified as "clumsy or awkward" |
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Presence of neurological nonlocalizing soft signs: (5)?
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Asterognosis: loss of ability to judge the form of an object by touch
Dysdidochokinesia: impairment of the ability to perform rapidly alternation movements Impaired fine-motor movement Left-right confusion Mirroring |
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Presence of neurological localizing "hard signs" (2)?
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Weakness
Decreased reflexes |
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Other abnormalities that may be noted: (3)
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Highly arched palate
Narrow or wide set eyes Subtle malformation of the ears |
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Appearance of a schizophrenic (3)?
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Odd
Unusual Peculiar |
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Speech of a schizophrenic (4)?
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Bizarre content
Disorganized Tangential Loose association |
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Affect of schizophrenic (3)?
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Blunted
Flat Inappropriate |
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Memory of a schizophrenic?
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impaired short term
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Concentration of a schizophrenic?
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Impaired during acute episodes
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Abstraction of a schizophrenic?
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concrete on formal testing
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Judgment of a schizophrenic?
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impaired for self-welfare
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What abnormalities are noted in structural studies in Schizophrenia?
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1. Enlargement of lateral ventricles
2. Widened cortical sulci 3. Diffuse decrease in volume of white and gray matter 4. Decreased volume of temporal lobe 5. Hypovolume in hippocampus, amygdala, and thalamus |
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Neurological localizing Hard signs?
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Weakness
Decreased reflexes |
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Neurological nonlocalizing soft signs in schizophrenia on physical exam? (6)
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Astereognosis: loss of ability to judge the form of an object by touch
Dydiadochokinesia: impairment of the ability to perform rapidly alternating movements Weakness Impaired fine motor movement Left-right confusion Mirroring |
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Affect with Schizophrenia?
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Blunted
Flat Inappropriate |
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Mood with Schizophrenia?
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*subjectively felt by patient*
Blandness Impoverished |
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Thought process with Schizophrenia?
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Hallucination
Delusion Referential Thought control, insertion, or withdrawl Paranoia |
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Forms of thought processes with Schizophrenia?
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Neologisms
concrete thinking Tangentiality (never get back to the point) Perservation (look up) du-du-du-duration |
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Psychomotor behavior with Schizophrenia?
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Waxy flexibility
Posturing Pacing and rocking |
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Orientation with Schizophrenia?
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Usually intact
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Memory with Schizophrenia?
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Impaired short term
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Abstraction with Schizophrenia?
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Concrete on formal testing
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What is the mood in schizophrenics?
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Baldness
Impoverished |
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Psychotherapeutic Interventions with Schizophrenia?
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CBT
Skills training Family therapy Group therapy |
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What is group therapy with Schizophrenia?
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Clubhouse and clozapine (Clozaril) groups particularly effective
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Primary treatment modality for Schizophrenia?
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Pharmacological therapy
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First choice in psychopharmacology medication with Schizophrenia?
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Atypical Antipsychotic because tey effectively treat positive and negative symptoms and cause less EPS
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What do atypical antipsychotics antagonize?
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Both 5-HT(2a) serotonin and dopamine D2, D3, D4 receptors
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How are positive symptoms decreased in Psychosis?
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by the blockage of dopamine in the mesolimbic pathway. Serotonin inhibits dopamine.
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How are negative symptoms decreased in Psychosis?
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when serotonin dopamine antagonists (SDAs) block serotonin; therefore, dopamine increases in the mesocortical pathway
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What is the Mesolimbic Pathway?
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SDAs block dopamine, cuasing decreased positive symptoms
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What is the Mesocortical Pathway?
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SDAs increase dopamine in this pathway, causing decreased negative symptoms
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What is the Nigrostriatal Pathway?
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Dopamine has a reciprocal relationship with ACh. When serotonin is blocked by the SDA, dopamine increases; therefore, ACh decreases, which decreases EPS
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What is EPS caused by?
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Increased ACh
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Tuberoinfundibular Pathway?
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Dopamine inhibits prolactin. The blockade of dopamine by SDAs cause prolactin to increase, causing galactorrhea
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What must be measured with use of antipsychotics?
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the time between the Q wave and T wave interval in the heart (QT interval) prolongation (not over 470)
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What is Olanzapine and 3 facts?
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Zyprexa
1. 5-20mg/day 2. Rapidly dissolving oral form (Zydis) for acute agitation 3. Most highly implicated in weight gain and diabetes |
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What needs to be monitored with Olanzapine?
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BMI
Waist circumference Lipids Elevated Blood sugar Elevated serum lipids |
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What is Risperdone and 3 facts?
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1. Risperdal 2-6mg/day
2. Some sexual dysfunction 3. Some EPS when taking over 6mg/day *Greatest prolactin elevation among atypical antipsychotics* |
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What are the signs and symptoms of Risperidone?
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1. Hypotension
2. Galactorhea 3. Nausea 4. Insomnia |
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What is Ziprasidone and dosage?
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Geodon and it is given 40-160mg/day
Tablets and injectables |
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4 facts of Ziprasidone?
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Low in weight gain
IM form for active agitation Use cautiously with high cardiac risk check QTCs **Take with food (increases absorption two-fold)** |
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What are the side effects of Ziprasidone?
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*Geodon*
1. Hypotension 2. Sedation 3. Dizziness Rare: Prolongation of QTc interval |
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What is Quetiapine?
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Seroquel given 150-600mg/day
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What should be monitored with Quetiapine?
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Potential for eye changes
Monitor for cataract development |
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What is Aripipazole and dosage?
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Abilify and is given 5-30mg/day
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How does Aripipazole work?
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*Abilify*
as a partial agonist of dopamine D2 and 5HT(2a) receptors and a complete antagoinist of 5HT2a serotonin receptor |
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What can Aripipazole produce?
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1. Akathesia which usually dissipates by short-term benzodiazepines
2. Weight gain 3. Elevated lipids |
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What is Clozapine and dosage?
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Clozaril given 25-900mg/day
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Major comments about Clozapine?
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1. Only drug for treatment resistant schizophrenia
2. WBC monitoring due to agranulocytosis 3. Significant weight gain and risk of diabetes |
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What is the lab schedule of WBC when taking Clozapine?
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During the first 6 months weekly
During the second 6 months every two weeks Then monthly if all was normal |
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What is Paliperidone and dosage?
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Invega and given 3-12mg/day
*Extended-release risperidone* |
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What are the side effects of Paliperidone?
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*Invega*
1. Orthostatic hypotension 2. Hyperprolactinemia 3. GI upset 4. Akathisia 5. GI problems |
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What is the dosage of Quetiapine?
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*Seroquel*
50-800mg per day |
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What are some side effects of quetiapine?
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1. Sedation and hypotension
2. Weight gain 3. *Rare: cataract formation* |
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Important facts with quetiapine?
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1. Less weight gain than with Clozaril or Zyprexa
2. Transient and asymptomatic elevated LFTs 3. Divided doses: bid or tid 4. No prolactin elevation |
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Typical antipsychotics are useful for treating positive symptoms by blocking dopamine in the mesolimbic pathway, but
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can make negative symptoms worse by blocking dopamine in the mesocortical pathway
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What can diminish antipsychotic effects of typicals?
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Caffeine and nicotine
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What is EPS caused by?
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D2 receptor antagonism (when Dopamine receoptors are blocked, ACh increases, which causes EPS; a reciprocal relationship exists between ACh and dopamine
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What is EPS treated with?
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Anti-Parkinsonian drugs
1. Anticholinergics 2. Antihistamines 3. Dopamine agonists 4. Benzodiazepines |
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What is Tardive Dyskinesia?
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a potentially irreversibel movement disorder that may occur in individuals who are treated for more than 1 year with typical antipsychotics
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What is the first-line treatment of TD?
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prevention and use of atypical antipsychotics
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How often should an AIMs be done when on typical antipsychotics?
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every 3-6 months
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What is EPS syndrome akathisia?
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motor restlessnes, inability to remain still and often confused with increased anxiety
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What is EPS syndrome akinesia?
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absence of movement, difficulty initating motion and often confused with laziness or lack of interest
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What is EPS syndrome dystonia?
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muscle spasm, spasticity of muscle groups and often mistaken for agitation or unusual movements
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Acute dystonia is life threatening and can be treated by...?
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Diphenhydramine IM or IV
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What is Chlorpromazine?
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Typical antipsychotic Thorazine
Thorazine given 50-2,000mg/day Causes sedation |
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What is Fluphenazine?
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Typical Antipsychotic Prolixin
Very High EPS |
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What is Haldoperidol?
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Typical antipsychotic Haldol
Very high anticholinergic and sedation *Monitor for oculogyric crisis and pneumonia in the elderly* |
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Neurological side effects of Typical antipsychotics?
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Lowering of seizure threshold
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What should be done if symptoms are evident during the AIMS?
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Ascertain client's awareness of them and if the symptoms are interfering with daily functioning
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After observing the client during AIMS, rate symptoms on a scale of:
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0 = None
1 = Minimal 2 = Mild 3 = Moderate 4 = Severe |
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What is NMS?
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1. Rare but potentially life threatening
2. Can occur at any point during treatment 3. Most common with typical but has been reported with atypical antipsychotics |
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What are some risk factors of NMS?
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1. Rapid dose escalation
2. Use of high-potency typical antipsychotics 3. Parental administration of antipsychotics |
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What abnormal labs are assessed with NMS?
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1. Elevated CPK
2. Elevated WBC 3. Elevated liver function test |
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What symptoms are know to occur first with NMS?
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1. Altered sensorium
2. Hyperthermia 3. Hyper-reflexia |
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With NMS assess for symptoms of autonomic instability such as:
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1. Hypotension
2. Extreme muscular rigidity 3. Hyperthermia 4. Tachycardia 5. Diaphoresis 6. Tachypnea 7. Coma and potentially death |
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What is the treatment for NMS?
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1. Immediate medical intervention
2. Discontinuation of antipsychotic medications 3. Supportive therapies 4. Administration of Dantrium (dantrolene) or Parlodel (bromocriptine). |
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What is akathisia?
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motor restlessness; inability to remain still; rocking, pacing, constant motion of unilateral limb
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What is akinesia?
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absence of movement, difficulty initiating motion, subjective feeling of lack of motivation to move
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What is dystonia?
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muscle spasm; spasticity of muscle group, especially back or neck muscles; subjectively painful but generally not clinically significant except as it affects adherence
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What is Pseudo-Parkinson's?
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presence of symptoms of Parkinson's disorder produced by D2 blockade; includes shuffling gait, motor slowing, mask-like facial expression, pill rolling, tremors, and muscle rigidity
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What is Loxitane?
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Loxapine
Capsule: 20-250mg/day High for EPS |
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What treatment is useful for management of hallucinations and delusions?
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CBT
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What are the rates of substance abuse and dependency related to Schizophrenia?
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20-40%
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Suicide and schizophrenia?
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1. Suicide rates are high so assess for suicidal ideations at every visit
2. 10% commit suicide 3. 20-40% attempt suicide |
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What are the BMI categories?
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Underweight: 18.5 or less
Normal weight: 18.5-24.9 Overweight: 25.0 to 29.9 Ovese: 30.0 to 39.9 Severly obese: 40 and higher |
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What are some considerations with children and schizophrenia?
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1. Visual hallucinations more common than auditory
2. Hallucinatory and delusional content less rich, elaborate, and bizarre |
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What is the prognosis with older adults and schizophrenia?
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Usually better, more responsive to medications due to dominance of positive symptom cluster
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What are some scales utilized for schizophrenia?
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1. Positive and Negative Syndrome Scale (PANSS)
2. Brief Psychiatric Rating Scale (BPRS) 3. Scale for Assessment of Positive Symptoms (SAPS) 4. Scale for Assessment of Negative Symptoms (SANS) |
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What are two of the differences of Schizophreniform Disorder and Schizophrenia?
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1. Duration is at least 1 month but less than 6 months, including prodromal, active illness period, and residual symptom phase
2. Does not require for diagnosis that there be impaired social or occupational functioning, although may be present |
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When assessing for history of Schizophreniform Disorder what must be present?
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1. 2 or more of the following frequently present during a 1-month period (Delusions, Hallucinations, Disorganized Speech, Disorganized behavior, presence of negative symptoms
2. Duration of symptoms for at least 1 month and for no longer than 6 months |
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What is the usual outcome with Schizophreniform Disorder?
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1. Occurs much less often than schizophrenia with 0.03% of U.S. population
2. Approximately one-third recover completely within 6 months 3. Remaining two-thirds develop schizophrenia or schizoaffective disorder |
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What is schizoaffective disorder?
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an uninterrupted period of illness in which the individual experiences psychotic symptoms similiar to those seen in schisophrenia as well as mood symptoms similiar to MDD or bipolar disorder
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With schizoaffective disorder what symptoms of schizophrenia must be present during a 1-month period? must have at least 2
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1. Delusions
2. hallucinations 3. Disorganized speech 4. Grossly disorganized behavior 5. Presence of negative symptoms but usually less severe than those in schizophrenia |
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Schizoaffective disorder must have one or more of the following mood disorders:
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1. Major Depressive episode
2. Manic episode 3. Mixed-mood episode |
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Schizoaffective disorder must have the presence of delusions or hallucinations for at least 2 weeks in the...?
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*Absence of prominent mood symptoms*
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What are the 2 subtypes differentiated by type of mood-related symptoms in Schizoaffective Disorder?
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1. Depressive: when predominant mood symptoms are of the depressive type only
2. Bipolar: when predominant mood symptoms are manic or mixed type |
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What is Delusional Disorder?
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1. Presence of one or more nonbizarre delusions lasting for at least 1 month
2. Psychosocial functiooning and daily behavior not at all impaired except as they surround content of delusion 3. Seldom any other symptoms; in rare cases may have hallucinations or mood distrubances |
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How might one present with a delusional disorder?
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Well organized and potentially believable
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What is an Erotomanic delusion?
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1. Delusional content focused on false belief that another person is in love with the client
2. Focus of love usually famous or powerful individual who does not usually know the client 3. Leads to obsessive behaviors such as surveillance or stalking |
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Whati s a grandiose delusion?
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1. Delusional content focuses on the client having some great talent, skill, or knowledge
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What is a jealous delusion?
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Delusional content focuses on false belief that client's spouse or partner is being unfaithful with someone else
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What is a persecutory delusion?
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Delusional content focuses on client's belief that others are out to harm or spy on client
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What is a somatic delusion?
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Delusional content focuses on bodily functions and sensations
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What is a mixed delusion?
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No clear predominant theme for the delusional content
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What is a brief psychotic disorder?
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disorder with sudden onset of psychotic symptoms lasting at least 1 day but less than 1 month
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What do you assess in the history with psychotic disorders?
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1. Age of onset in adolescence or early adulthood
2. Positive-type psychotic symptoms 3. Can occur with or without identified stressor 4. Individual always returns to premorbid level of functioning |
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What is a shared psychotic disorder?
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*Folie a Deux*
-characterized by development of a delusion in a client who has a close relationship with another individual who already has a psychotic disorder with a prominent delusion |
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With a shared psychotic disorder the client is in close contact with an individual who already has a delusion and:
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1. That individual usually has schizophrenia
2. That individual usually is the dominant person in the relationship 3. That individual gradually imposes his or her delusion on the client 4. Usually the relationship is long term and very close *Aside from delusional content, the client's behavior otherwise normal* |
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What is the chronic disease course of a shared psychotic diosrder?
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1. Poor prognosis if relationship continues, especially if the individual with delusion goes untreated
2. Good prognosis if the client can be separated from individual with the delusion |
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The neurotransmitter deregulation theory of the etiology of psychotic disorders such as schizophrenia supports that psychosis is caused, in part, by....
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An excess of dopamine
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The positive-negative model of classifying the symptoms of schizophrenia describes positive symptoms as...
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Symptoms that positively respond to antipsychotic medicaitons
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What is the relationship with seizures and typical antipsychotic medications?
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Typical antipsychotic medications can lower seizure threshold
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