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91 Cards in this Set

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  • Back
How long does the person need to have the symptoms to diagnose schizophrenia?
6 months
How is Schizophrenia different from other psychiatric problems?
- It tends to affect all the aspects of an individuals life

- worst prognosis

- 1/3 don't go back to their normal state continue w/ Dz
What are the risk factors?
men get Dz younger 15-25

women 25-35
What is the worst prognosis?
the younger the patient gets a Dz the worst pronosis

so men have a worst prognosis
What is the neurotransmitter unbalance of schizophrenia?
Increase levels of DOPA

Also serotonins
(New drugs work on both)
How do patients develop Schizophernia? Theories?
Double Bind

Mother talked to you like an adult but treated you like a baby

mixed message from mother
you don't know what to do...
in a bind
ANother theroy is High EE family? Expressed Emotions
A family that has high emotions (Italians?)

family very critical, intrusive, emotional
WHat is important about High EE family and relapse?
Chances are very high that you will relapse and return to hospital

you go back to the same environment
Viral Theory for Schizophrenia?
They belive that viruses infect patients when they are born since lots of patients are born in winter and early spring
Downward Drift or Social Causation theory?
Schizophrenia in low-socioeconomic status (low SES)
Social Causation Theory?
Different stress levels

- low SES with high stress
Prevalence vs. genetics?
Monozygotic (47%)increase
Dizygotic 12%
What is schizophrenia percentage in the general population?
One parent w/ schizophernia what is the chance?
Two schizophrenic parents??
Monozygotic Twins?
Dizygotic Twins?
First-degree relative w/ schizophrenia?
Second-degree relative w/ schizophrenia?
5-6% chance
What percentage was the chance for bipolar disorder? two parents having bipolar
Symptoms of Schizophrenia?
Auditory Hallucinations (2/3's)

Visual Hallucinations

Bad voices
You are evil, terrible
kill yourself
Command voice hallucinations?
Tell you to do things
most patients hears voice and don't pay attention to it

but there are some that do
What is a delusion?
false belief

mostly bizarre

not believable (makes no sense in what they believe)
What is catatonia?
not moving
What are negative symptoms?
flat affect
social withdrawal
cognitive defects
Are Schizophrenics functional?
No, usually loos jobs
What is a saccadic eye movement?
Irregularity of eye movements

REM like

trade mark (Pathognomonic)
What is another characteristic of schizopchrenic behavior?
Scanning behavior

What is a common finding in a CT scan of the head?

Lateral and Third Ventricular Enlargement
What other patients have ventricular enlargement?
Alzheimer patients have it
What is associated with ventricular enlargment?
the larger the enlargement
the greater the negative symptoms

worst prognosis
What do you find in a PET scan?
hypoactivity of frontal lobes

no areas of pickup
no red/yellow
black areas (frontal)
What is the frontal lobe responsible for?
- personality
- abstract thinking
- higher order func
- ability to change
What kind of answers do you get in abstract thinking?
what does a rolling stone gathers no moss

it is rolling so nothing sticks
How is schizophrenia correlate w/ IQ?
low IQ
Schizophrenia associated w/ problems in neuropsychological tests?
problems in frontal lobe
What psychological tests are worst in Schizophrenia?
Personality test

Projective tests are worst

since they will give bizarre answers

Ink blot
Tx of Schizophrenia?

newer atypicals
What is the first line tx of schizophrenia?
Atypical Drugs

since less side effects
(better compliance)
What is special abouth the atypical drugs?
both positive and negative symptoms
What symptoms do the typical antipsychotics cover?
Only positive symptoms
What is the theory of therapy?
the sicker the patient the less intrusive the therapy

the sicker the patient the more intrusive therapy
What is the most intrusive therapy?

therapist sits behind you

patient says whatever is on their mind free association
What is supportive psychotherapy?
how is your job

the sickest patient since you want to gain their trust
What is differential diagnosis for Schizophrenia?
Rule out organic

Drugs (psychostimulants cocaine/amphetamine)

Looks paranoid/scanning the room
What is the first test?
Urine test

Cocaine stays in body for 3-4 days
What does hallucinogens produce?

Alcohol withdrawal
What other medical condition is associated with bizarre disorders, hallucinations in the brain?
Temporal Lobe Epilepsy/Seizures
What other psychiatric disorders are part of the differential?

What other disorders are involved?

Factitious Disorder (physical and psychological symptoms)
How long do mood disorders last in schizophrenia?

so different
What are some medical causes of schizophrenia like?
- HIV (psychotic)
- Steroids (rage)
- tumors
- CVAs
What personality disorder is involved in the differential?
- Schizotypal
- Schizoid (short live psychotic episodes)
- Borderline (short live psychotic episodes)
they go back to normal though

functioning patients in society
Types of Schizophrenia?
- Paranoid
- Disorganized type
- Catatonic Type
- Undifferentiated type
- Residual
What is the MC type of Schizophrenia?
Paranoid Type

Later in Life (so better prognosis)
What is characteristic of Disorganized type?
Bizarre behavior

dressed inappropiate
making faces
making animal noises
masturbating in public
What is the prognosis of disorganized type?
they have the worst prognosis since they get it a young age

<25 y.o.
What is the hallmark of Residual type?
Negative symptoms

flat affect, anhedonia, attention deficit, isolation

they don't hear voices (but they use to probably)
What is the theme in Paranoid Schizophrenia?
What is the theme catatonic type?

excitation or not moving
What is the theme of disorganized type of schizophrenia?

everything is weird/bizarre
What is the theme of Residual type?
No hallucinations/delutions

Negative Symptoms
What is the theme for Undifferentiated type?
not clear
What is the schizophreniform disorder?
duration of symtpoms is 3 months

hallucination (auditory)
delusions (bizarre)
disorganized speech

negative symptoms

Duration needs to be less than 6 months
What is the pronosis of schizophreniform disorder?
Better than schizophrenia since the duration is less
What is a risk factor of schizophreniform disorder?
What is the tx? How long is the Tx
3-6 months
What is schizoaffective disorder?
Waste paperbasquet patient
Mood symptoms
Psychotic Symptoms
can differentiate patient

pure garabage
both mood disorder and schizophrenia

major depression, mania
What is better major depression or schizophrenia?
better is to have major depression

better prognosis
Major Depression vs. Schizoaffective Dz?
Major depression has a better prognosis

all mood
Schizoaffective vs. schizophrenia?
Schizoaffective is better prognosis

since has mood disorder
Family history of Mood Disorder vs. Psychotic Disorders?
Hx of Mood Disorder has a better prognosis on the patient
Tx for Schizoaffective Dz?
Tx w/ Schizo part w/ antipsychotic and Antidepressant

First Antipsychotic since worse symptoms treated first

If you start w/ mood tx then you worsen the psychosis
Delusional disorder?
Scenario is possible
Delusions are believable

- like wife trying to kill patient
Delusion Disorder patients characteristic?

no impairment of level of fx

thoughts are logical and coherent
Delusional vs. Schizophrenia?
Non-bizarre dilusion 1 month

schizophernics not working
not functioning
What are the types of delusional disorders?
What are erotomanic delusional disorder?
Pat. believe that a famous person is in love with them

- brad pitt
- Billy Jean think Michael Jackson made the song for her

MC type of Delusional Disorder?
Persecutory Delusional Disorder
MC type of schizophrenia?
What are the risk factors for delusional disorder?
- onset about 40 years
Prognosis better

- women (MC)
- recent immigration
Which part of the brain is affected in delusional disorder?
- limbic system
- basal ganglia
What is the Tx of Delusional Patient?
Not really Tx

unless stalker

Delusions very hard to treat
Try to give individual psychotherapy
get the pat. trust
Confront the delusion
What is brief psychotic disorder?
Disorganized speech

very similar to schizophrenia
What is responding to internal stimuli?
Turn their head as if to listen to someone
How long does the brief psychotic disorder?
Symptoms last 1 day but <30 days
If symtoms last for more than 6 weeks?
If psychotic symptoms last for 7 months or more?
What are the risk factors of breif psychotic sx?
Accident and hear voices
Pat in a fire and then he hear voices
Tx for Brief Psychotic Disorder?

1st line antipsychotics

also treat with
Haloperidol vs. Risperidone?
Always choose Risperidone

Less Side Effects