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91 Cards in this Set
- Front
- Back
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How long does the person need to have the symptoms to diagnose schizophrenia?
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6 months
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How is Schizophrenia different from other psychiatric problems?
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- 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 |
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What are the risk factors?
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men get Dz younger 15-25
women 25-35 |
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What is the worst prognosis?
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the younger the patient gets a Dz the worst pronosis
so men have a worst prognosis |
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What is the neurotransmitter unbalance of schizophrenia?
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Increase levels of DOPA
Also serotonins (New drugs work on both) |
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How do patients develop Schizophernia? Theories?
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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 |
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ANother theroy is High EE family? Expressed Emotions
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A family that has high emotions (Italians?)
family very critical, intrusive, emotional |
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WHat is important about High EE family and relapse?
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Chances are very high that you will relapse and return to hospital
you go back to the same environment |
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Viral Theory for Schizophrenia?
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They belive that viruses infect patients when they are born since lots of patients are born in winter and early spring
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Downward Drift or Social Causation theory?
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Schizophrenia in low-socioeconomic status (low SES)
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Social Causation Theory?
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Different stress levels
- low SES with high stress |
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Prevalence vs. genetics?
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Monozygotic (47%)increase
Dizygotic 12% |
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What is schizophrenia percentage in the general population?
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1%
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One parent w/ schizophernia what is the chance?
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12%
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Two schizophrenic parents??
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40%
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Monozygotic Twins?
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47%
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Dizygotic Twins?
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12%
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First-degree relative w/ schizophrenia?
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12%
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Second-degree relative w/ schizophrenia?
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5-6% chance
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What percentage was the chance for bipolar disorder? two parents having bipolar
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50-75%
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Symptoms of Schizophrenia?
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Auditory Hallucinations (2/3's)
Visual Hallucinations Bad voices You are evil, terrible kill yourself |
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Command voice hallucinations?
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Tell you to do things
most patients hears voice and don't pay attention to it but there are some that do |
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What is a delusion?
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false belief
mostly bizarre not believable (makes no sense in what they believe) |
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What is catatonia?
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not moving
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What are negative symptoms?
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flat affect
social withdrawal cognitive defects |
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Are Schizophrenics functional?
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No, usually loos jobs
Withdrawal |
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What is a saccadic eye movement?
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Irregularity of eye movements
REM like trade mark (Pathognomonic) |
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What is another characteristic of schizopchrenic behavior?
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Scanning behavior
Hypervigilance (Paranoid) |
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What is a common finding in a CT scan of the head?
Or MRI |
Lateral and Third Ventricular Enlargement
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What other patients have ventricular enlargement?
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Alzheimer patients have it
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What is associated with ventricular enlargment?
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the larger the enlargement
the greater the negative symptoms worst prognosis |
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What do you find in a PET scan?
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hypoactivity of frontal lobes
no areas of pickup no red/yellow black areas (frontal) |
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What is the frontal lobe responsible for?
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- personality
- abstract thinking - higher order func - ability to change |
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What kind of answers do you get in abstract thinking?
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what does a rolling stone gathers no moss
it is rolling so nothing sticks |
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How is schizophrenia correlate w/ IQ?
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low IQ
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Schizophrenia associated w/ problems in neuropsychological tests?
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problems in frontal lobe
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What psychological tests are worst in Schizophrenia?
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Personality test
Projective tests are worst since they will give bizarre answers Ink blot |
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Tx of Schizophrenia?
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Antipsychotics
typical newer atypicals |
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What is the first line tx of schizophrenia?
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Atypical Drugs
since less side effects (better compliance) |
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What is special abouth the atypical drugs?
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both positive and negative symptoms
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What symptoms do the typical antipsychotics cover?
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Only positive symptoms
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What is the theory of therapy?
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the sicker the patient the less intrusive the therapy
the sicker the patient the more intrusive therapy |
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What is the most intrusive therapy?
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Psychoanalisis
therapist sits behind you patient says whatever is on their mind free association |
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What is supportive psychotherapy?
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how is your job
the sickest patient since you want to gain their trust |
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What is differential diagnosis for Schizophrenia?
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Rule out organic
Drugs (psychostimulants cocaine/amphetamine) Looks paranoid/scanning the room |
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What is the first test?
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Urine test
Cocaine stays in body for 3-4 days |
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What does hallucinogens produce?
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LSD
Alcohol withdrawal |
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What other medical condition is associated with bizarre disorders, hallucinations in the brain?
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Temporal Lobe Epilepsy/Seizures
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What other psychiatric disorders are part of the differential?
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Personality
Schizoaffective |
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What other disorders are involved?
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Malingering
Factitious Disorder (physical and psychological symptoms) |
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How long do mood disorders last in schizophrenia?
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brief/short
so different |
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What are some medical causes of schizophrenia like?
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- HIV (psychotic)
- Steroids (rage) - tumors - CVAs |
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What personality disorder is involved in the differential?
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- Schizotypal
- Schizoid (short live psychotic episodes) - Borderline (short live psychotic episodes) they go back to normal though functioning patients in society |
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Types of Schizophrenia?
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- Paranoid
- Disorganized type - Catatonic Type - Undifferentiated type - Residual |
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What is the MC type of Schizophrenia?
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Paranoid Type
Later in Life (so better prognosis) |
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What is characteristic of Disorganized type?
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Bizarre behavior
dressed inappropiate making faces laughing making animal noises masturbating in public |
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What is the prognosis of disorganized type?
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they have the worst prognosis since they get it a young age
<25 y.o. |
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What is the hallmark of Residual type?
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Negative symptoms
flat affect, anhedonia, attention deficit, isolation they don't hear voices (but they use to probably) |
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What is the theme in Paranoid Schizophrenia?
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Persecution
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What is the theme catatonic type?
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psychomotor
excitation or not moving |
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What is the theme of disorganized type of schizophrenia?
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Weird
everything is weird/bizarre look/talk/behave |
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What is the theme of Residual type?
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No hallucinations/delutions
Homeless Negative Symptoms |
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What is the theme for Undifferentiated type?
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not clear
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What is the schizophreniform disorder?
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duration of symtpoms is 3 months
hallucination (auditory) delusions (bizarre) disorganized speech negative symptoms Duration needs to be less than 6 months |
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What is the pronosis of schizophreniform disorder?
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Better than schizophrenia since the duration is less
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What is a risk factor of schizophreniform disorder?
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Suicide
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What is the tx? How long is the Tx
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Antipsychotics
3-6 months |
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What is schizoaffective disorder?
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Waste paperbasquet patient
Mood symptoms Psychotic Symptoms can differentiate patient pure garabage both mood disorder and schizophrenia major depression, mania |
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What is better major depression or schizophrenia?
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better is to have major depression
better prognosis |
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Major Depression vs. Schizoaffective Dz?
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Major depression has a better prognosis
all mood |
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Schizoaffective vs. schizophrenia?
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Schizoaffective is better prognosis
since has mood disorder |
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Family history of Mood Disorder vs. Psychotic Disorders?
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Hx of Mood Disorder has a better prognosis on the patient
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Tx for Schizoaffective Dz?
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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 |
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Delusional disorder?
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Scenario is possible
Delusions are believable - like wife trying to kill patient |
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Delusion Disorder patients characteristic?
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Reliable
no impairment of level of fx thoughts are logical and coherent |
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Delusional vs. Schizophrenia?
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Non-bizarre dilusion 1 month
schizophernics not working not functioning |
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What are the types of delusional disorders?
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erotomanic
jeleaous grandiose somatic mixed |
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What are erotomanic delusional disorder?
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Pat. believe that a famous person is in love with them
- brad pitt - Billy Jean think Michael Jackson made the song for her Stalker |
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MC type of Delusional Disorder?
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Persecutory Delusional Disorder
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MC type of schizophrenia?
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Paranoid
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What are the risk factors for delusional disorder?
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- onset about 40 years
Prognosis better - women (MC) - recent immigration |
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Which part of the brain is affected in delusional disorder?
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- limbic system
or - basal ganglia |
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What is the Tx of Delusional Patient?
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Not really Tx
unless stalker antipsychotics Delusions very hard to treat Try to give individual psychotherapy get the pat. trust Confront the delusion |
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What is brief psychotic disorder?
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hallucination
delusion Disorganized speech very similar to schizophrenia |
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What is responding to internal stimuli?
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Turn their head as if to listen to someone
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How long does the brief psychotic disorder?
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Symptoms last 1 day but <30 days
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If symtoms last for more than 6 weeks?
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Schizophreniform
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If psychotic symptoms last for 7 months or more?
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Schizophrenia
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What are the risk factors of breif psychotic sx?
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Low SES
Accident and hear voices Pat in a fire and then he hear voices |
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Tx for Brief Psychotic Disorder?
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Hospitalized
1st line antipsychotics also treat with |
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Haloperidol vs. Risperidone?
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Always choose Risperidone
Less Side Effects |
