Schizophrenia Spectrum Disorders PDF

PSYCHIATRY ` PSYCHIATRY!PATHOLOGY SEC TION III 577 Schizophrenia spectrum disorders Schizophrenia Chronic illness causing profound functional Associated with altered dopaminergic activity, impairment. Symptom categories inclu...

PSYCHIATRY ` PSYCHIATRY!PATHOLOGY SEC TION III 577 Schizophrenia spectrum disorders Schizophrenia Chronic illness causing profound functional Associated with altered dopaminergic activity, impairment. Symptom categories include: "serotonergic activity, and "dendritic ƒ Positive—excessive or distorted functioning branching. Ventriculomegaly on brain (eg, hallucinations, delusions, unusual imaging. Lifetime prevalence—1.5% (males thought processes, disorganized speech, >"females). Presents earlier in males (late teens bizarre behavior) to early 20s) than in females (late 20s to early ƒ Negative—diminished functioning (eg, !at 30s). "suicide risk. or blunted affect, apathy, anhedonia, alogia, Heavy cannabis use in adolescence is associated social withdrawal) with "incidence and worsened course of ƒ Cognitive—reduced ability to understand or psychotic, mood, and anxiety disorders. make plans, diminished working memory, Treatment: atypical antipsychotics (eg, inattention risperidone) are #rst line. Diagnosis requires ! 2 of the following active Negative symptoms often persist after treatment, symptoms, including ! 1 from symptoms #1–3: despite resolution of positive symptoms. 1. Delusions 2. Hallucinations, often auditory 3. Disorganized speech 4. Disorganized or catatonic behavior 5. Negative symptoms Symptom onset ! 6 months prior to diagnosis; requires ! 1 month of active symptoms over the past 6 months. Brief psychotic disorder—! 1 positive symptom(s) lasting between 1 day and 1 month, usually stress-related. Schizophreniform disorder—! 2 symptoms lasting 1–6 months. Schizoa!ective Shares symptoms with both schizophrenia and mood disorders (MDD or bipolar disorder). To disorder differentiate from a mood disorder with psychotic features, patient must have $ 2 weeks of psychotic symptoms without a manic or depressive episode. Delusional disorder ! 1 delusion(s) lasting > 1 month, but without a mood disorder or other psychotic symptoms. Daily functioning, including socialization, may be impacted by the pathological, #xed belief but is otherwise unaffected. Can be shared by individuals in close relationships (folie à deux). Schizotypal Cluster A personality disorder that also falls on the schizophrenia spectrum. May include brief personality disorder psychotic episodes (eg, delusions) that are less frequent and severe than in schizophrenia. Manic episode Distinct period of abnormally and persistently elevated, expansive, or irritable mood and "activity or energy. Diagnosis requires marked functional impairment with $ 3 of the following for $ 1 week, or any duration if hospitalization is required (people with mania DIG FAST): ƒ Distractibility ƒ Flight of ideas—racing thoughts ƒ Impulsivity/Indiscretion—seeks pleasure ƒ  goal-directed Activity/psychomotor without regard to consequences (hedonistic) Agitation ƒ Grandiosity—in!ated self-esteem ƒ  need for Sleep ƒ Talkativeness or pressured speech