Psych set 4
Terms
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- Positive symptoms of schizophrenia
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Delusions
Hallucinations
Disorganized speech and behavior
Poor Attention - Negative symptoms of schizophrenia
-
Flat affect
Alogia (no speech)
Avolition (apathy)
Anhedonia (loss of interest) - Good prognostic factors for schizophrenia
-
Good premorbid functioning
Late onset
Obvious precipitating factors
Married/good support system
Family history of mood d/o
Positive symptoms - Time period for psychotic disorders
-
< 1 month = brief/acute psychotic d/o
1-6 months = schizophreniform
> 6 months = schizophrenia - Age of onset for schizophrenia
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men: 15-25 years
women 25-35 years - Risk of suicide in schizophrenia
- 10%
- Risk of suicide for men and women in general
- Women have more attempts at suicide, but men have more success due to more aggressive attempts.
- Treatment of schizophrenia
- antipsychotic medications with psychotherapy
- Prevalence of schizophrenia in the world
- 1%
- Season in which most schizophrenic pts are born (in the U.S.)
- winter (not know why)
-
Risk of schizophrenia for the following:
parent of schizo child
sibling
child of 1 schizo parent
child of 2 schizo parents
MZ twins, DZ twins -
parent: 6%
sibling: 10%
1 parent: 16%
2 parents: 46%
MZ twins: 46%
DZ twins: 14% - Result of brain imaging in schizophrenia
- dilated lateral and 3rd ventricles
- Neurotransmitter involved in schizophrenia
- dopamine (hyperactivity)
- Major risk factors for suicide
-
#1 risk = prior suicide attempts
age > 45 (greatest risk > 65)
alcohol/substance abuse
hx of rage or violence
depression
recent loss or separation
single/widowed/divorced - Does asking a patient about suicide make it more likely for them to comitt suicide?
- NO
- Pt develops amnesia and travels to a different place, assuming a new identity
- Dissociative fugue/psyhogenic fugue
- D/o most associated with childhood sexual abuse
- Dissociative identity disorder (aka multiple personality d/o)
- Pt worries about everything at the same time. Symptoms are not as dramatic as in panic disorder, but pts are just severe worriers.
- Generalized anxiety d/o
- Are homosexuality and homosexual experimentation normal?
- Yes, at any age.
- Daytime sleepiness, decr REM latency (go into REM as soon as they fall asleep), cataplexy
- Narcolepsy
- Treatment of narcolepsy
-
modafinil (non-amphetamine stimulant)
or, amphetamines - First line treatment of generalized anxiety d/o
-
Buspirone (atypical antidepressant)
or SSRI
(both are nonaddictive, nonsedating) - Second line treatment of generalized anxiety d/o
- Benzodiazepine (addictive, sedating)
- Pts have recurrent thoughts or impulses and recurrent behaviors that cause marked dysfunction
- Obsessive-compulsive d/o
- Age of onset of OCD
- late adolescence or early adulthood
- Treatment of OCD
-
Clomipramine (TCA) or Fluvoxamine (SSRI)
with cognitive-behavioral therapy - Pt presents with fear of dying, chest pain, palpitations, tachypnea, diaphoresis
- Panic d/o
- S/S in Panic d/o vs Social phobia
- S/S of panic attacks occur "out of the blue" while s/s of social phobia occur due to a trigger (social setting)
- Fear of social settings due to the risk of a panic attack
- Agoraphobia
- Treatment of Panic d/o
-
acute: benzodiazepine (alprazolam)
chronic: SSRI - Recurrent nightmares and flashbacks of a traumatic event and depression
- Posttraumatic stress disorder (PTSD)
- Drug treatment of PTSD
- SSRI
- Repitition compulsion
- Repetitive behavior by a patient to reduce the axiety associated with PTSD. This is NOT OCD.
- Treatment of specific phobias
- Behavioral therapy (desensitization)
- Treatment of social phobia
-
Beta blocker
SSRI - Complaints involving symptoms of multiple organ systems with negative test results
- Somatization d/o
- Sudden loss of voluntary motor or sensory function following a stressor
- Conversion d/o
- La belle indifference
-
"the beautiful indifference"
associated with conversion d/o
pt is not worried about their deficit - Preoccupation with fear of having a specific disease despite medical reassurance
- Hypochondriasis
- Preoccupation with imagined physical defects
- Body dysmorphic d/o
- Difference between somatoform, facticious, and malingering d/o
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Somatoform: s/s are not intentional
Facticious: s/s are intentional, but no secondary gain
Malingering: s/s are intentional for purpose of secondary gain