Review Part 1

What is psychosis?

it is altered cognition, altered perception and or impaired ability to determine what is or is not real

What is delusional disorder?

it is false thoughts or beliefs that have lasted 1 month or longer

What is brief psychotic disorder?

it is the sudden onset of at least one of the following

• delusions

• hallucinations

• disorganized speech

• disorganized; catatonic behavior

What is schizophreniform disorder?

it ferrules like those of schizophrenia except the symptoms have lasted less than 6 months

What is schizoaffective disorder?

it is major depressive, manic, or mixed episode concurrent with symptoms that meet criteria for schizophrenia

What is substance induced psychotic disorder due to another medical condition?

it is illicit drugs, alcohol, medications, or toxins that can induce hallucinations and or delusions

• they can also be caused by a medical condition like delirium, neurological, hepatic or renal disease.

What is the usual onset age of schizophrenia?

the onset is usually between 15-25 years of age

What gender is schizophrenia most common in?

it is more common in males in urban areas

What is the epidemiology of childhood onset schizophrenia?

1-40000

What are the comorbidities of schizophrenia?

• substance abuse
  - 60% use nicotine

• anxiety, depression, and suicide attempt
  - 20%

• physical health and illness

• polydipsia
  - 20%

What are the DSM criteria for schizophrenia?

• two or more of the following for a significant portion of time in 1 month
  - delusions
  - hallucinations
  - gross disorganization or catatonia
  - negative symptoms (diminished emotional expression or avolition)
  - functional impairment of some kind

• continuous disturbance for at least 6 months

What are the 4 phases of schizophrenia?

• prodromal

• acute

• stabilization

• maintenance or residual 

What is the prodromal phase of schizophrenia?

it is before acute symptoms occur, mild changes

What is the acute phase of schizophrenia?

it is exacerbation or symptoms to many and disabling

What is the stabilization phase of schizophrenia?

• symptoms are diminishing

• movement toward previous level of functioning

What is the maintenance or residual phase of schizophrenia?

it is when a new baseline is established, with positive symptoms

What are the positive symptoms during the prodromal phase of schizophrenia?

they are symptoms that should not be present like hallucinations and delusions

What are the negative symptoms during the prodromal phase of schizophrenia?

it is qualities that should be present like anhedonia, social discomfort, or lack of goal directed behavior

What are the cognitive symptoms during the prodromal phase of schizophrenia?

they are impairment in memory, attention, thinking, impaired executive functioning

What are the affective symptoms during the prodromal phase of schizophrenia?

they are symptoms involving emotions and expressions

What are the 4 positive symptoms of schizophrenia?

• alterations in reality testing

• delusions

• alterations in speech

• concrete thinking

What is reality testing?

it is the automatic and unconscious process by which we determine what is real and what is not real

• this is a positive symptom and altered in schizophrenia

What are delusions?

they are false beliefs that are held despite a lack of evidence

What are the 10 alterations in speech?

• associative looseness

• clang association

• neologisms

• echolalia

• circumstantiality

• tangentiality

• cognitive retardation

• pressured speech

• flight of ideas

• symbolic speech

What is associative looseness?

it is haphazard and illogical thinking where concentration is poor and thoughts are only loosely connected

• for example: "My friend talks about french fries but how can you trust the french"

• word salad is the most extreme form "agents want strength on a boat reigning supreme" which is just a jumble of words that is meaningless to the listener

What is clang association?

it is meaningless rhyming or words based on the sound

• "on the track.....have a big mac.... or click, clack, clutch, close"

What are neologisms?

it is made up words, words that have meaning only to the patient nut a different or nonexistent meaning for others

• "his mannerologies are poor"

What is echolalia?

it is pathological repetition of another's words

What is circumstantiality?

it is including unnecessary and often tedious details in conversation but eventually reaching the point

What is tangentiality?

it is wandering off topic or going off on tangents and never reaching the point

What is cognitive retardation?

it is generalized slowing of thinking, which is represented by delays in responding to questions or difficulty finishing thoughts

What is pressured speech?

it is urgent or intense speech; resists allowing comments from others

What is flight of ideas?

it is moving rapidly from one thought to the next, often making it difficult for others to follow the conversation

What is symbolic speech?

it is using words based on what they symbolize, not what they mean (demons are sticking needles in me) when in reality the patient is feeling pain from the needle