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Emil Kraepelin used this term for the "condition" of schizophrenia in 1800s |
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Eugen Bleuler coined the term in 1911 |
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not associated with multiple personalities; symptoms are positive and negative |
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risk of 1st degree relative w/ schizophrenia |
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risk for children with 2 parents with schizophrenia |
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avolition, affective flattening, alogia |
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delusions, hallucinations, disorganized speech, tactile symptoms (touch) |
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risk of 1st degree relative w/ schizophrenia |
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risk for children with 2 parents with schizophrenia |
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avolition, affective flattening, alogia |
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delusions, hallucinations, disorganized speech, tactile symptoms (touch) |
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prominent delusions or hallucinations |
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disorganized speech, behavior, and/or inappropriate affect |
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motoric changes, extreme negativism and/or echolalia/echopraxia |
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criteria not met by other subtypes |
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prominent positive symptoms absent, continuing negative symptoms |
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delusions, hallucinations, disorganized speech, psychomotor agitation |
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affective flattening, alogia (don't talk much), avolition (don't move much), poverty of speech, anhedonia (don't feel pleasure) |
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attention, memory, executive functioning |
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hyperactivity in limbic system leading to positive symptoms; hypofunctioning in prefrontal cortex leading to negative symptoms |
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Glutamate dyfunction correlates with increased psychiatric symptoms |
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leads to cognitive symptoms |
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acetylcholine hypoactivity (nicotinic receptors) |
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reduce threat to self and others; reduce acute symptoms; improve role functioning; minimize adverse effects |
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minimize/prevent treatment relapse; treatment adherence; optimize dose for maximizing response and minimizing adverse effects |
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improve function and quality of life; optimize dose and minimize adverse reactions; continue treatment adherence |
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antagonism of dopamine D-2 receptors |
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first generation antipsychotics |
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First generation antipsychotics |
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primarily effective for positive symptoms; notable for association with motor symptoms and secondary negative symptoms |
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Chlorpromazine, Fluphenazine, Haloperidol, Loxapine, Molindine, Perpheazine, Pimozide, Thioridazine, Thiothexine, Trifluperazine |
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First Generation Antipsychotics |
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involuntary tonic contraction of skeletal muscles (adverse effect) |
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rigidity, tremors, bradykinesia (adverse effect) |
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subjective inner restlessness: fidgeting, pacing (adverse effect) |
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stereotypical involuntary movements (e.g., sucking and lip smacking) (adverse effect) |
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treatment of acute dystonia |
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treatment of pseudo-parkinsoniam |
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beta-blockers, benzodiazepines |
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treatment of tardive dyskinesia |
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focus on preventions; may use clozapine |
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onset of pseudo-parkinsonism |
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onset of tardive dyskinesia |
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high risk for acute dystonia |
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high risk of pseudo-parkinsonism |
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high risk of tardive dyskinesia |
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older females; history of mood disorders |
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has high sedative effects, moderate hypotensive effects |
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life threatening disease: muscular rigidity, hyperthermia, change in mental status, autonomic dysfunction |
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Neuroleptic Malignant Syndrome (NMS) |
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Treat with hydration and cooling blankets; bromocriptine and/or dantrolene may be useful |
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from dopamine blockade in hypothalamus; may result in gynecomastia, amenorrhea, and sexual dysfunction |
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secondary negative symptoms |
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reduced initiative, interest in environment, emotion or affect |
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allergic-maculopapular rash, localize or general urticaria; photosensitivity reaction |
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other antipsychotic adverse events |
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cardiac, lowering seizure threshold, hepatic function |
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antagonism of D2, D1 and Serotonin receptors; effective for positive and negative symptoms |
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Clozapine, Risperidone, Olanzapine, Quetiapine, Ziprazidone, Aripiprazole, Paliperidone, Ilopendone, Asenapine, Lurasidone |
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Second Generations Antipsychotics |
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