7.5.1 Psychosis and Shizophrenia

Question 1

Describe the Prevalence and Peak Age of Onset in patients with Schizophrenia?

Answer 1

Prevalence - 1% lifetime prevalence in the United States; 1:1 ration men/women

Peak Age of Onset:

Men: 15-25 years of age

Women: 25-35 years of age

Question 2

Describe the difference between disturbance in process and disturbance in form in regards to Schizophrenia.

Answer 2

Question 3

What is the difference between thought broadcasting, insertion, and withdrawl?

Answer 3

Broadcasting - Belief that one’s thoughts can be perceived by others

Insertion - Belief that one’s thoughts are not their own but are inserted into their head elsewhere

Withdrawl - Thought are being removed from their head

Question 4

What are Schizophreniform and Schizoaffective disorder?

Answer 4

Question 5

Is there a genetic component associated with Schizophrenia?

Answer 5

Yes

Question 6

What are the emotional disturbances associated with Schizophrenia?

Answer 6

Blunting or flattening of Affect - patients seem to be emotionally detached or distant. Expressions of feelings are limited both in terms of vocal intonation and facial movement

Inappropriate Affect - Emotions that are expressed inappropriate to the situation or content of thought

Hostile Affect

Question 7

What is Delusional and Brief Psychotic disorder?

Answer 7

Question 8

Why is duration important in making a diagnosis of schizophrenia?

Answer 8

Question 9

What is behavioral disturbances associated with Schizophrenia?

Answer 9

Bizarre Behavior

Catatonic Behavior

Question 10

What is the DSM-V diagnostic criteria for schizophrenia?

Answer 10

Two or more of the following, each present for a significant portion of time. One of the follow needs to be 1-3.

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms (diminished emotional expression)

Question 11

Patients with Schizophrenia are more likely to?

Answer 11

Die of an accident and 80% of patients also have significant concurrent medical illness

Question 12

Schizophrenia has multiple subtypes of disturbance in thought contents. One of which is delusions, what is that?

Answer 12

Delusions are a flase belief based on incorrect perception of reality

• Paranoid or persecutory
• Grandiose
• Somatic

Question 13

Why is suicide important to monitor in schizophrenic patients?

Answer 13

About 50% of patients will attempt suicide at least once

10-15% die of suicide

Question 14

How can Schizophrenia be related to Social/Occupational Dysfunction?

Answer 14

Question 15

What has to be excluded in a diagnosis of Schizophrenia?

Answer 15

Question 16

Schizophrenia has multiple subtypes of disturbance in thought contents. One of which is ideas of Reference, what is that?

Answer 16

Events in the environment that the patient believes to have special meaning to them

Question 17

Schizophrenia is thought to be considered a formal thought disorder, what does that mean?

Answer 17

A process affecting the relationship and associations among the words used to express thought

Question 18

What is the difference between an illusion and hallucination?

Answer 18

Illusion - A false interpretation of a real perception

Hallucination - Experiences of perception in the absence of corresponding external stimuli (most commonly auditory)

Question 19

How does substance abuse relate to Schizophrenic patients?

Answer 19

75% of Schizophrenic patients smoke compared to less than 50% of other psychiatric patients

30-50% are dependent on alcohol

15-25% cannabis abuse

5-10% cocaine abuse

Question 20

What is the Neuropathology associated with Schizophrenia?

Answer 20

Patients with Schizophrenia are higher levels of Dopamine/Norepinephrine