MH Exam 3 Study Guide 1
Week 5: Ch 24, 30, 31
Ch 24: Schizophrenia - split mind HIGH YIELD 15-20 QUESTIONS
Active recall games -
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● Schizophrenia is a type of psychosis
● Psychosis - disorganization of personality, deterioration in social/occupational fx, loss of
contact/distortion of reality
○ Evidence of hallucinations & delusional thinking
○ Disturbance in thought process, perception & affect
■ Goal - reorient & bring patient back to reality
● Concern - risk for suicide***
● Schizophrenia Risk factors
○ Smoking
○ Genetics - not solely responsible for causing the dz
○ Biochemical - insufficient dopamine
○ Physiological - viral infx, anatomical abn
○ Sociocultural - poverty & stress linked to schizo
○ Psychological - per researchers, schizo is a brain disorder
○ Psychosocial stress - stress → relapse
○ Theoretical - onset is triggered by internal/external environment
● 4 phases of Schizophrenia
○ Premorbid - identify at-risk pts to prevent transition to illness
■ Shy & withdrawn
■ Poor peer relationships/school performance
■ Antisocial behavior - pt doesn’t care or have respect for others, can hurt others w/o
remorse
○ Prodromal - pt undergoes behavioral/cognitive changes (50% have depressive s/s)
■ Significant deterioration in fx
■ Social withdrawal
■ OCD behavior
■ Cognitive impairment
○ Active psychotic - can occur w/ or w/o prodromal phase
■ Psychotic s/s are prominent
■ Delusions, hallucinations, disorgan. speech & behavior
■ Dec level of fx in work, personal relationships, self-care
○ Residual - can occur w/ or w/o active psychotic phase
■ Absent or decreased s/s
■ 2 categories of s/s
● Positive - the presence of abnormal s/s
○ Delusions, hallucinations, disorganized speech, magical thinking
● Negative - the absence of normal s/s
○ Flat affect, apathy, withdrawal, impaired role fx, avolition (lack of
motivation), alogia (lack of communication)
○ Regression, posturing, pacing/rocking, abn eye movements
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MH Exam 3 Study Guide 2
● Prognosis - return to full premorbid function is uncommon
○ Positive prognosis factors
■ Good premorbid fx
■ Later age at onset
■ Female
■ Abrupt onset precipitated by a stressful event
■ Associated w/ mood disturbance
■ The brief duration of active phase s/s
■ Minimal residual s/s
■ Absence of brain abnormalities
■ Normal neuro function
■ Family hx of mood disorder - depression, bipolar
■ No family hx of schizo
● If schizophrenia is a family disorder → poor prognosis
● Schizophrenia spectrum & psychotic disorders
○ Delusional disorder - onset at least 1 month
■ Existence of prominent, non-bizarre delusions
■ Erotomanic - ex. A celebrity is in love with me
■ Grandiose - ex. Pt has an appt at the white house
■ Jealous - ex. The belief that partner is cheating
■ Persecutory - ex. There’s a police car that’s out to get me
■ Somatic - ex. Focused on physical s/s
■ Mixed - more than 1 of the types mentioned above
○ Brief psychotic disorder - onset <1 month
■ Sudden onset
■ May or may not be preceded by severe psychosocial stress
○ Schizophreniform disorder - onset at least 1 month to <6 months
■ Same s/s as regular Schizophrenia
■ Social/occupational dysfunction
○ Schizoaffective disorder
■ Schizophrenia & mood disorder (mania/depression) combo
○ Catatonic disorder
■ Lack of movement/communication d/t another medical condition
■ Does not meet criteria for dx
■ DKA, hepatic encephalopathy, hypo/hyperthyroidism, hypercalcemia, vit B12 deficiency,
epilepsy, tumors, head trauma, encephalitis
○ Substance-induced psychotic disorder
■ Hallucinations & delusions associated w/ intoxication or withdrawal
■ Psychotic s/s are more severe than expected
○ Psychotic disorder d/t another medical condition
■ Hallucinations & delusions d/t a general medical condition
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MH Exam 3 Study Guide 3
● Disturbances in thought process - assoc. w/ speech
○ Loose association - shifting from one idea to another unrelated idea
○ Neologisms - made-up words that have meaning only to the patient
○ Clang association - a random group of words that rhyme
○ Word salad - a random group of words
○ Circumstantiality - delay in reaching the point due to unnecessary tedious details
○ Tangentiality - inability to get to the point due to the introduction of many new topics
○ Perseveration - persistent repetition of the same word in response to different questions
○ Echolalia - persistent repetition of the same word spoken by another person
● Disturbances in perception - hallucination involving the 5 senses [Show Less]