CH 13 Schizophrenia and other Psychotic Disorders

Question 1

Hallucination

Answer 1

Sensory experience that seems real to the person having it, but occurs without any external perceptual stimulus

Question 2

DSM Criteria

Schizophrenia

Answer 2

A. 2 or more present for significant time during 1-month period(at least 1 must be 1, 2, or 3)
* Delusions
* Hallucinations
* Disorganized speech
* Grossly disorganized or catatonic behavior
* Negative symptoms

B. Level of functioning in 1+ areas is markedly low

C. Continuous signs of disturbance persist for 6+ months

D-E. It’s not something else

F. If history of ASD/childhood communication disorder, schizophrenia is only diagnosed if prominent delusions or hallucinations are present

Question 3

Delusion

Answer 3

Erroneous belief that is fixed and firmly held despite clear contradictory evidence

Question 4

Disorganized speech

Answer 4

External manifestation of a disorder in thought form

Person fails to make sense

Question 5

Disorganized behavior

Answer 5

Impairment in goal-directed activity and daily functioning

Question 6

Catatonia

Answer 6

Virtual absence of all movement & speech

Catatonic stupor

Question 7

Positive symptoms vs. Negative symptoms

Answer 7

P: excess or distortion in normal behavior/experience (eg. delusions and hallucinations)

N: abscence or deficit of normal behaviors

Question 8

List Examples

Negative Symptoms

Answer 8

The absence of normal behavior:
* Alogia
* Avolition
* Anhedonia
* Flat or blunted affect

Question 9

Define

Alogia

Answer 9

Absence of speech

Question 10

Define

Avolition

Answer 10

The inibility to initiate or persist in goal directed behavior

Question 11

DSM Criteria

Schizoaffective Disorder

Answer 11

A. Uninterrupted period of illness during which there is a major mood episode concurrent with Criterion A of schizophrenia

B. Delusions or hallucinations for 2+ weeks in absence of major mood episode during lifetime duration of illness

C. Symptoms that meet criteria for major mood episode are present for the majority of the total duration of the active and residual portions of the illness

D. Disturbance is not attributable to effects of a substance or other condition

Question 12

DSM Criteria

Schizophreniform Disorder

Answer 12

A. 2+ of the following, each for a significant portion of time during 1+ month, at least 1 must be 1, 2, or 3
* Delusions
* Hallucinations
* Disorganized speech
* Grossly disorganized or catatonic behavior
* Negative symptoms

B. Episode of disorder lasts 1+ month, less than 6 months

C-D. Other disorders ruled out

Question 13

DSM Criteria

Delusional Disorder

Answer 13

A. Presence of 1+ delusion for 1+ month

B. Schizophrenia criteria A not met

C. Apart from impact of delusion(s), functioning isn’t markedly impaired

D. Mood episodes (if occured) must be brief

E. Not attributable to other disorders

Question 14

DSM Criteria

Brief Psychotic Disorder

Answer 14

A. Presence of 1+ of the following, 1 must be 1, 2, or 3
* Delusions
* Hallucinations
* Disorganized speech
* Grossly disorganized or catatonic behavior

B. Duration of an episode is at least 1 day, less than 1 month, eventual full return to premorbid levels of functioning

C. Disturbance not better explained by other conditions

Question 15

Neurotransmitters implicated in Schizophrenia

Answer 15

Dopamine & Glutamate

Question 17

Psychosis

Answer 17

Significant loss of contact with reality

Question 18

Risk factors for Schizophrenia

Answer 18

Age of father over 50, birth trauma, more severe/earlier onset in men

Question 19

List the psychotic symptoms of schizophrenia

Answer 19

Delusions, hallucinations, disorganized speech

Question 20

Command Hallucinations

Answer 20

Tell you what to do

Question 21

List examples of disorganized speech

Answer 21

Neologisms, loose associations, derailment, clanging, word salad

Question 22

Neologisms

Answer 22

Person uses words they made up (believes they are real/correct)

Question 23

Loose associations

Answer 23

Rapid jumps between topics

Question 24

Derailment

Answer 24

Jumps between topics without finishing them

Question 25

Clanging

Answer 25

Strings of rhythmic sounds or words

Question 26

Word salad

Answer 26

Speaking only in meaningless sounds or words

Question 27

Motor rigidity

Answer 27

Slow and rigid

Question 28

Waxy flexibility

Answer 28

Moldable like wax

Question 29

Catatonic stupor

Answer 29

Absence of speech and movement

Question 30

Purposeless excitement

Answer 30

Unusual excitatory movements

Question 31

Alogia

Answer 31

Absence of speech

Question 32

Differentiate between in 4 words or less

1. Schizoaffective Disorder
2. Schizophreniform Disorder
3. Delusional Disorder
4. Brief Psychotic Disorder

Answer 32

1. Schizoaffective Disorder: Schizophrenia + Mood Disorder
2. Schizophreniform Disorder: Gateway diagnosis
3. Delusional Disorder: Delusions ONLY
4. Brief Psychotic Disorder: Sudden, brief psychotic episode

Question 33

Describe

The influence of genetics on schizophrenia

Answer 33

• More common in monozygotic twins
• COMT impacts dopamine metabolism
• DISC-1
• Genome-wide association Studies
• Hundreds of genes involved

Question 34

Describe

Prenatal risks for schizophrenia

Answer 34

• Viral infection - 2nd trimester flu in mother
• Mom’s BT is -, baby’s is +
• Birth complications - hypoxia
• Early nutritional deficiency
• Maternal stress

Question 35

Describe

Structural & functional brain abnormalities associated with schizophrenia

Answer 35

• Loss of volume
• Hippocampus, amygdala, thalamus
• Enlarged ventricles
• White matter problems
• Dysconnectivity

Question 36

Define

Neuroleptic Malignant Syndrome

Answer 36

• Fatal if untreated
• High fever
• Extreme muscle rigidity
• Side effect of first-gen antipsychotics

Question 37

List examples

First-gen Antipsychotics

Answer 37

• Thorazine
• Haldol

Question 38

Define & Give an example

Extrapyramidal Side Effects

Answer 38

• Involuntary or uncontrollable movements
• Tremors
• Muscle contractions
• More common in first-gen antipsychotics
• Tardive dyskenesia - involuntary repetitive body movements, which may include grimacing, sticking out the tongue or smacking the lips