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Types of Psychotic Disorders -ANSWERS--Schizophrenia
-Schizoaffective Disorder
-Schizophreniform Disorder
-Brief Psychotic Disorder
-Delusional Disorder
-Catatonia
Schizophrenia -ANSWERS--affects between 0.25% & 0.75% of the
population in the U.S.
-one of the top 15 leading causes of disability worldwide
-at risk of premature mortality due to co-occurring medical conditions
that are often undiagnosed or undertreated
• Common comorbidities include heart and liver disease and diabetes
-increased risk for suicide
-typically symptoms begin to manifest before age 25 and persist
throughout the lifespan
-Prodromal Phase: usually develop before the first psychotic episode
,Schizophrenia Prodromal Phase -ANSWERS--usually develop before the
first psychotic episode
-over a few days to a few months and may persist for a year or more
before the onset of overt psychotic symptoms
-Symptoms that occur in the prodromal phase of the illness are typically
negative and may be overlooked due to their similarity to other
conditions, such as depression
-signs and symptoms:
• interest in abstract ideas, philosophy, and occult or religious
questions
• noticeably strange behavior, abnormal affect, unusual speech, bizarre
ideas, and odd perceptual experiences
Schizophrenia Course -ANSWERS-typically involves exacerbations and
remissions
-after the first psychotic episode, clients may recover and function
somewhat normally for a long time before relapsing
-pattern of illness during the first five years after the diagnosis generally
indicates the client's course
-Each relapse leads to further decline in client functioning
-Over time, positive symptoms tend to become less severe while
negative symptoms may increase in severity
Psychosis Screening tools -ANSWERS--Brief Psychiatric Rating Scale
(BPRS)
,-Positive and Negative Syndrome Scale (PANSS)
-Clinician-Rated Dimensions of Psychosis Symptom Severity Scale
Brief Psychiatric Rating Scale (BPRS) -ANSWERS--used to assess clients
who present with symptoms of psychosis.
-consists of 24 categories, each scored between 1-7.
-scale varies, scores may be broadly interpreted with higher numbers
indicating more severe illness
-may be used over time to evaluate treatment.
Positive and Negative Syndrome Scale (PANSS) -ANSWERS--clinician-
rated tool to identify and differentiate the presence of (+) and (-)
symptoms of psychosis
-commonly used in research settings
Clinician-Rated Dimensions of Psychosis Symptom Severity Scale -
ANSWERS--can help the provider to determine the degree of
impairment from (+), (-), and cognitive symptoms
-Each item is scored & interpreted independently
-may be used to monitor tx success & the need for additional follow-up
Schizoaffective Disorder -ANSWERS-involves symptoms of both
schizophrenia and a mood disorder, such as bipolar disorder
-associated with depression
, • often misdiagnosed as MDD
-Dx req at least 2 psychotic episodes, each lasting 2 weeks or more
• One without depressive or manic symptoms
Minh is a 19-year-old who presents to the emergency department after
a suicide attempt. She is medically stable. She states that she has
experienced auditory hallucinations for the past 3-4 weeks and "could
not take them anymore." She also complains of depressed mood, loss
of interest in activities, and feelings of hopelessness for the past few
months. Her toxicology reports on admission were negative.
Based on the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5-TR), what is the most appropriate diagnosis for Minh? include
ICD-10 code: -ANSWERS-schizoaffective disorder depressive type F25.1
Rationale: Minh presents with major depressive episode concurrent
with hallucinations. This disturbance is not attributable to a substance.
The most appropriate diagnosis for Minh is schizoaffective disorder
depressive type F25.1
Schizophreniform Disorder -ANSWERS-characterized by schizophrenia-
like symptoms that last for more than 1 month but less than 6 months
-differentiated from schizophrenia based on the length of time
symptoms have been present