🧠Psych Lecture 3-Schizophrenia and Personality Disorders Flashcards

Psychiatry

How much shorter is the life expectancy in schizophrenia?

20% shorter than the general population.

What is the minimum duration of symptoms required for schizophrenia diagnosis?

At least 6 months.

Name 3 positive symptoms of schizophrenia.

Delusions, auditory hallucinations, disorganized speech.

What are some negative or functional symptoms of schizophrenia?

1. Social withdrawal

2. deterioration in personal care

3. absorption in inner thoughts

What is the most common psychotic disorder?

Schizophrenia.

Stats:

1) What percentage of the general population is affected by schizophrenia?

2) What percentage of long-term psychiatric hospitalizations are due to schizophrenia?

3) What percentage of people with schizophrenia are nicotine dependent?

1) 1%

2) 50%

3) 90%

What is a major cause of higher mortality in schizophrenia?

Suicide, accidents, and natural causes.

What are some etiologies for schizophrenia?

1) Genetic

2) Infections—> prenatal expoure to influenza

3) Dopamine hypothesis—>  Excessive dopaminergic activity

Whats the treatment for schizophrenia? (first-line). What are the SEs?

1st episode psychosis: MRI/CT;

Rule out thyroid/adrenal/pituitary disorders, toxins, drugs

FIRST LINE: 2nd gen antipsychotics (risperidone, olanzapine, ziprasidone, clozapine for refractory cases)± Benzo

SEs: weight gain, sedation, anticholinergic, EPS, tardive dyskinesia, ↑ prolactin, QT prolongation

What is Schizoaffective Disorder?

• Definition: A mix of schizophrenia symptoms (delusions, hallucinations, disorganized speech) and a mood disorder (depression, mania, or hypomania). Key point: Mood disorder is prominent and co-exists with psychosis.

what is the prognosis. like for schizoaffective disorder?

better than schizophrenia because psychosis is temporary

What is the treatment for Schizoaffective disorder?

Bipolar type: mood stabilizer if( lithium, carbamazepine)

If depressive type: SSRIs

Schizo sx: antipsychotics 

What is Schizophreniform Disorder?

• Definition: Looks like schizo, but the duration is shorter ( ≥1 month but <6 months)

• Outcomes:

  • May progress to schizophrenia if symptoms persist >6 months OR completely remit.

💡 Think: Forming schizophrenia → “in-between” stage.

What is the treatment for schizophreniform?

Treatment: Hospitalization + antipsychotics for 3–6 months

What is Delusional Disorder?

• Definition: Persistent delusions for ≥1 month, but no hallucinations (except maybe mild tactile/olfactory).

• Functioning: Generally preserved, except in areas affected by delusions.

  • Subtypes: Jealous (e.g., convinced partner is unfaithful); Persecutory (believing one is being conspired against); Somatic (false belief about body/health, e.g., infestation, odor)

Treatment: Antipsychotics + psychotherapy.

Short Review:

👉 In short:

• Schizoaffective = Schizo + mood disorder (better prognosis).

• Schizophreniform = Schizo-like, short duration (1–6 months).

• Delusional disorder = Only delusions ≥1 month, no hallucinations, otherwise intact functioning.

Whats the main treatment for personality disorders?

therapy

What are the cluster A personality disorders👽? Name them, describe and give treament. 

1. Paranoid Personality Disorder 🤨- Suspicious and mistrustful of others; interprets their motives as harmful.

• Treatment: 🧠 Psychotherapy (to build trust) & 💊 Antianxiety medications or low-dose antipsychotics

2. Schizoid Personality Disorder: Detached, prefers isolation, and shows limited emotional expression.

• Treatment: 👥 Group therapy (to build social skills) &💊 Antipsychotics or antidepressants (for flat affect or depression)

3. Schizotypal Personality Disorder 🔮🦉Eccentric behavior, magical thinking, odd speech, and social anxiety.

• Treatment: 🧠 Psychotherapy (social training and reality testing) &💊 Antipsychotics (for perceptual distortions)

Describe Cluster B personality disorders (*4) Name them, describe and give treament. 

1. Antisocial Personality Disorder 😈
Disregard for others, manipulative, impulsive.
Must be ≥18 years old.
Often preceded by Conduct Disorder in childhood.

Treatment:
🧠 Psychotherapy
💊 SSRIs, lithium, or antipsychotics

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2. Borderline Personality Disorder ⚡️💔
Unstable relationships, self-image issues, impulsivity, self-harm, fear of abandonment, and chronic feelings of emptiness.
More common in females.

Treatment:
🧩 Behavioral therapy (DBT)
💊 Antipsychotics, antidepressants, benzodiazepines, or lithium

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3. Histrionic Personality Disorder 🎭💃
Dramatic, attention-seeking, seductive, and shallow emotions.Unable to maintain deep long-lasting relationship. *careful with transference

Treatment:
🧠 Psychotherapy
💊 Antidepressants or anxiolytics (for mood or anxiety symptoms)

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4. Narcissistic Personality Disorder 👑🪞
Grandiosity, exploitive, fragile self-esteem, lack of empathy, and sensitivity to criticism.

Treatment:
🧠 Psychotherapy (often difficult to treat)

What are the Cluster C Personality Disorders – “Worried, Anxious, Fearful” 😰 (*3) Name them, describe and give treament. 

1. Avoidant Personality Disorder 😔

• Wants friends but fears rejection and criticism.

• Feels inadequate and avoids social interaction despite desire for closeness.

Treatment:

• 🧠 Psychotherapy (build confidence, challenge negative beliefs)

• 💊 SSRIs or beta-blockers (for social anxiety)

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2. Dependent Personality Disorder 🤝

• Clingy, indecisive, and fears abandonment.

• Difficulty making decisions without reassurance.

• High risk for depression and anxiety.

Treatment:

• 🧠 Psychotherapy (focus on independence and assertiveness)

• 💊 Antidepressants or anxiolytics

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3. Obsessive-Compulsive Personality Disorder (OCPD) 📏🧩*different from OCD

• Ego-syntonic (behaviors seen as appropriate by the person).

• Perfectionistic, inflexible, and preoccupied with orderliness and control.

Treatment:

• 🧠 Psychotherapy (address rigidity and perfectionism)

• 💊 SSRIs (for anxiety or obsessive traits)

What are the four main treatment categories for Personality Disorders?

1. Social: Day hospitals, halfway houses, self-help communities. 🏡

2. Behavioral: Operant conditioning, aversive conditioning. ⚙

3. Psychological: Group therapy, individual therapy. 💬

4. Medical: Antidepressants, antipsychotics. 💊

What are Somatic Symptom Disorders?

Disorders with abnormal physical symptoms that cause distress or impairment, not fully explained by medical conditions.

Who is most affected?

More common in females with low education, low socioeconomic status, or history of abuse/chronic illness.

What are common comorbidities?

Depressive and anxiety disorders.

What conditions are encompassed under Somatic Symptom Disorders?

1. Conversion disorder

2. Hypochondriasis

3. Somatization disorder

4. Pain disorder

5. Body dysmorphic disorder

DSM-5 criteria for Somatic Symptom Disorder?

• ≥1 somatic symptom causing distress or psychosocial impairment for >6 months.

• Excessive thoughts, feelings, or behaviors about symptoms (e.g., worry, anxiety, or excessive time focused on symptoms)

What is the treatment for Somatic Symptom Disorder?

• 🧠 Group psychotherapy

• ⏰ Frequent scheduled appointments to reassure the patient

• 💊 Pharmacotherapy for anxiety or depression

What is Conversion Disorder?

Q:what does “conversion” mean?

The mind converts psychological stress into a physical symptom.

Neurologic symptoms (e.g., paralysis, blindness, aphonia, or psychogenic seizures) that appear as a manifestation of psychological conflict or stress in place of anxiety or panic attack. 

What is a common example?

Psychogenic seizure occurring instead of a panic attack.

What defines Somatization Disorder?

Multiple physical symptoms (pain, weakness, SOB) causing significant distress and excessive health worries.

🔍 How does Somatization differ from Somatic Symptom Disorder?

Somatization involves many symptoms, not just one main complaint.

⚠ What defines Factitious Disorder?

Intentional production of symptoms to assume the sick role (no external reward) to trick clinicians

👩‍⚕ What are the subtypes of Factitious Disorder?

• Factitious Disorder imposed on self

• Factitious Disorder by proxy (caregiver induces illness in another)

How does Factitious Disorder differ from Malingering?

• Factitious: motivation = 🧠 psychological (wants to be seen as sick)

• Malingering: motivation = 💰 external gain (money, drugs, avoiding work)