What Is Schizophrenia? - ANSWER -- -An uninterrupted period of illness during which,
Disorder characterized by psychotic symptoms at some time, there is a Major Depressive, Manic,
which are usually persistent (>6 mos.) or at least or Mixed Episode *concurrent with symptoms that
recurrent meet Criterion A for Schizophrenia*
-significant impairment in functioning
Schizophreniform Disorder - ANSWER --
-major cause of inpatient care episodes Meets most criteria for schizophrenia but episode
lasts *less than 6 months*
What isn't Schizophrenia? - ANSWER -- -Impaired social & occupational functioning are
"split personality" *not* required
-major source of violence, danger to others Note: If symptoms persist beyond a six month
period, the diagnosis is changed to schizophrenia
DSM IV Diagnostic Criteria (Schizophrenia) -
ANSWER -*A*. Characteristic symptoms: Catatonic Schizophrenia - ANSWER -
*2 or more of the following*, each *present for a Catatonic—dominant symptoms relate to
significant portion of time* during a 1 month decreased or increased motor activity
period:
• Delusions
• Hallucinations Waxy Flexibility - ANSWER --A
• Disorganized speech psychomotor *symptom of catatonic
• Grossly disorganized or catatonic behavior schizophrenia*
• Negative symptoms
-Leads to a decreased response to stimuli and a
-*Only one* of these symptoms is required *if* *tendency to remain in an immobile posture*.
delusions are bizarre or hallucinations consist of
a voice keeping a running commentary
Disorganized Schizophrenia - ANSWER -
*B*. Sufficient to *cause social/occupational Disorganized—speech and behavior are
dysfunction* disorganized; flat or inappropriate affect
*C*. Duration: Continuous signs of disturbance
for at least *6 months* which may include a Paranoid Schizophrenia - ANSWER -
prodromal period or residual period Paranoid—delusions are especially prominent;
paranoid ideation; auditory hallucinations
*D*. Exclusion of schizoaffective and mood
disorders, substance-induced psychosis, or
psychosis due to a medical condition
Residual Schizophrenia - ANSWER -
Residual—has history of schizophrenia, *but* no
longer meets criteria; typically, mostly negative
Schizoaffective Disorder - ANSWER -- symptoms remain
Thought disorder *+* Mood disorder
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, Schizophrenia Test Questions and Answers Rated A
*Brief/reactive psychosis*—acute onset of
Undifferentiated Schizophrenia - apparent schizophrenia, brief duration.
ANSWER -Undifferentiated: Criteria for
sub-types *not* met *Shared psychosis* (Folie a Deux)—SO's
"acquire" schizophrenic-like features.
Most common type of schizophrenia - Schizotypal and schizoid personality disorders
ANSWER --Paranoid
Why Assessment and Detection Is So Important
MEDICAL DISORDERS THAT MAY in Schizophrenia - ANSWER --Many major
MASQUERADE AS MENTAL DISORDERS - mental illnesses tend to begin in childhood
ANSWER --One must always rule out
physical causes for what might appear to be -Childhood MI's usually go undetected and
mental illness; this is esp. true if the onset is untreated for 7-9 years (there may be a
acute (over hours or days) and/or there is no prodromal phase where "soft" or early signs are
prior history of mental illness. present but unrecognized)
-Head Injury -Earlier recognition leads to earlier treatment
-Low sodium (hyponatremia)
-Liver disease -Earlier treatment is believed to limit the amount
-Pancreatitis of neurological damage that accrues, improving
-Acute Intermittent Porphyria Infection (mimics the long-term prognosis
it).
-Heavy Metal Poisoning (Mercury in tuna) -Early treatment reduces maladaptive coping and
-Hyperthyroidism —mimics mania, anxiety, provides for interventions to reduce
lability; look for increased pulse, tremor, developmental deficits that otherwise tend to
sweating, weight loss, visual disturbances. occur
-Digitalis toxicity may present with unusually well-
formed visual hallucinations of "small people". -Staff may mislabel symptoms as resistance or
-Anticholinergic toxicity Many OTC and other negative, volitional (chosen) behavior and
psychotropic meds have ACh activity. respond non-therapeutically
-Other drug reactions (bath salts)
-Drug abuse/intoxication .
Positive symptoms - ANSWER -An
abnormality or excess in normal functioning or
Related Diagnoses or "Rule outs" - the presence of abnormal functioning, typically
ANSWER -*Delusional disorder*— including:
prominent delusions, usually *non-bizarre*, -hallucinations
without other features of psychosis (look normal, -delusions
speak normally, & behave normally). -thought disorder
-disorganized and sometimes bizarre speech,
*Capgras Syndrome*—belief that others have and behavior
been replaced with imposters; or may be unable
to recognize self in mirror.
Persons with positive symptoms... -
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