405exam2

-disorganization of personality
-deterioration of social functioning
-loss of contact w/reality

-transactional
>genetic predisposition
>biochemical dysfunction
>physiological factors
>psychosocial stress

-pharmacotherapy
-pychosocial care
>living/social skills training
>rehab
>family therapy

suicide
- 10% die
-ideations: 40-55%
attempts: 20-50%

-one of leading causes of disability among young adults
-huge economic burden to society
-Most studied mental illness.
-Suicide is the primary cause of death.

late adolescence/ early adulthood
- often occur earlier in men

1. Premorbid
2. Prodromal
3. Schizophrenia
4. Residual

Marked by a period of normal functioning although events can occur that contribute to the development of the subsequent illness.
Precursors:1). etilogical ie fam h/x or 2) behavioral/personality ie shy, withdrawn

-family h/x
-perinatal.obstetric complications
-neurobehavioral deficits

-shy, withdrawn (female)
-poor peer relationships
-poor in school
-antisocial behavior (male)

-average length btwn 2-5 yrs
-functional impairment & nonspecific symptoms are experienced
-positive symptoms such as perceptual abnormalities, ideas of reference and paranoia develop late in the prodromal phase and herald the onset of psychosis.
-pharmacologic intervention is not recommended at this stage given the uncertain risk-benefit ratio.

-disturbed sleep, anxiety, irritability, depressed mood, poor concentration, fatigue, poor role functioning, social withdrawal
-average length of prodromal phase is 2 to 5 years
-Positive symptoms such as perceptual abnormalities, ideas of reference and paranoia develop late in the prodromal phase and herald the onset of psychosis.

perceptual abnormalities, ideas of reference, suspiciousness

early recognition of symptoms: *therapeutic > to i.d. probs
*cognitive therapy>minimize functional impairment
*family intervention> for coping
*involve schools>reduce failure
NO PHARMACOLOGICAL t/x

1.Characteristic Symptoms
2.Social/Occupational Dysfuntion
3.Duration
4.Schizoaffective/Mood Disorder exclusion
5. Substance/general medical exclusion
6.R/t Pervasive Dvlpmt Disorder (1month of delusions or hallucinations PRESENT)

>6 months-continuous signs
AND
>1 month of criterion one (active-phase symptoms)

follows active phase, acute S &S are absent, negative s&s may be present: flat affect, role impairment

better if:
-later age onset
-female
-abrupt onset vs gradual
-no brain abnormalities or family h/x of schiz
- better if there is a family h/x of mood d/o instead

"chemical disturbance" in brain

schizophrenia may be caused by EXCESS of dopamine-dependent neuronal activity in brain

haloperidol and chlorpromazine

Amphetimines

No

Yes

hallucinations, delusions

apathy, poverty of ideas, loss of drive

prenatal exposure to influenza contributes to a
high incidence of schizophrenia

Ventricular enlargement->>premorbid functioning, negative symptoms; sulci enlargement, cerebral atrophy

disarray of cells, possibly r/t to 2nd trimester flu

epilepsy, huntingtons,birth trauma, head injury, etoh abuse, lupus, myxedema, parkinsonism, Wilson's disease

1. Factors of: living in poverty-congested housing, accomodations, inadequate nutrtion; few resources contribute
2. "downward drift hypothesis"- schizophrenia causes poverty of individual

doesn't cause, but may contribute to severity and length of psychotic episodes

onset of S&s before 25 yrs; "hebephrenic"; silliness, giggling, flat affect; neglected personal appearance, extreme social impairment

abnormality in motor behavior: stupor or excitement

waxy flexibility; mutism, negativism

extreme psychomotor agitation; often require physical and medical control because they are often violent towards others and may injure themselves or collapse from complete exhaustion. frenzied, purposeless, incoherent verbalizations: more rare now b/c antipsychotic meds

s&s late20s/30s; prognosis promising

can't be classified; but clearly psychotic, w/ bizarre behavior and hallucinations

-p/t has chronic form
--stage that follows acute episode
-s&s: social isolation, eccentric behavior.; poor grooming; apathy, inappropraite affect. disorganized thought

depression/mania/ grandiosity/hyperactivity/ bizarre delusions

To use wrongfully or in a harmful way. Improper conduct that may result in injury

Compulsive of chronic requirement. Need so so strong as to generate distress

physical or mental state exhiliration, emotional frenzy, lethargy and stupor

-genetics
-biochemical aspects: morphine-like substance in brain formed by amines+ alcohol metabolism ex:tetrahydropapaveroline, salsolinol
-psychodynamic: punitive superego & fixation @ oral stage; self-medication
-personality
-etc...

physical or mental state exhiliration, emotional frenzy, lethargy and stupor

-genetics
-biochemical aspects: morphine-like substance in brain formed by amines+ alcohol metabolism ex:tetrahydropapaveroline, salsolinol
-psychodynamic: punitive superego & fixation @ oral stage; self-medication
-personality
-etc...

amines+ alcohol metabolism ex:tetrahydropapaveroline, salsolinol

dependence and abuse

intoxication. withdrawal, delirium, dementia, amnesia, mood d.o, anxiety d/o, sexual d/o, sleep d/o

18 to 24 yrs

-fluid/electrilyte
-hypoxia
-anoxia
-diabetic prob

Cholinisterase Inhibitors (mild to moderate)

-obesity
-hyperactivity in children
-narcolepsy

extensively used to treat pulmonary edema