Ch 15 Schizophrenia

Question 1

What is the biggest problem in treating schizophrenia?

Answer 1

Relapse

Clients won’t stay on meds due to side effects

Question 2

4 risk factors for schizophrenia

Answer 2

genetic predisposition
biochemical influence
phsyiological factors
psychological factors

Question 3

Biochemical risk factor for schizophrenia

Answer 3

there is an excessive amount of dopamine

Question 4

Physiological risk factors for schizophrenia

Answer 4

Viral infections (usually in utero)
anatomical abnormalities

Question 5

Psycho-social risk factors for schizophrenia

Answer 5

poverty/stress can intensify or speed up onset of schizophrenia

Question 6

Positive symptoms of schizophrenia

Answer 6

anything that adds to their behavior
hallucinations
delusions
alteration is speech
bizarre behavior

Question 7

Negative sx of schizophrenia

Answer 7

flat affect
alogia (sparse speech)
anhedonia (inability to have fun)
avolition (no motivation)
anergia (no energy)

Question 8

Cognitive sx of schizophrenia

Answer 8

disordered thinking
inability to make decisions
poor problem solving ability
difficulty concentrating 
memory deficits (hippocampus is affected)

Question 9

Sx treated by traditional/typical antipsychotics

Answer 9

positive sx only

Question 10

Sx treated by atypical antipsychotics

Answer 10

positive and negative sx

also treat cognitive sx and help a person’s thinking become more ordered

Question 11

Reason to switch from typical to atypical med

Answer 11

EPS

Question 12

First line of treatment for NMS

Answer 12

dantrium

Question 13

Age of onset of schizophrenia

Answer 13

earlier in men (around 20) than women (around 30)

possibly due to women’s hormones

Question 14

4 phases of schizophrenia

Answer 14

premorbid
prodromal
active
residual

Question 15

signs seen in premorbid phase of schizophrenia

Answer 15

Social maladjustment
Antagonistic thoughts and behavior
Shy and withdrawn
Poor peer relationships
Doing poorly in school
Antisocial behavior

Question 16

Phase II: Prodromal phase

Answer 16

can last weeks to years

Deterioration in functioning

Question 17

Symptoms seen in the prodromal phase

Answer 17

sleep disturbance, anxiety, irritability
depressed mood, poor concentration fatigue
Abnormalities in perception

Question 18

Active phase of Schizophrenia

Answer 18

delusions
hallucinations
impaired functioning

Question 19

Residual phase

Answer 19

sx similar to prodromal phase (depression, anxiety, sleep disturbance, irritability)
also flat affect

Question 20

Schizophrenia prognosis

Answer 20

a return to premorbid functioning is not common

Question 21

Factors associated with a good prognosis **

Answer 21

good premorbid function
later age of onset
female
abrupt onset
brief active phase
no structural brain abnormalities
no family hx of schizophrenia
family hx of mood disorder/associated mood disturbance

Question 22

Downward drift hypothesis

Answer 22

poor social conditions are seen as a consequence of rather than a cause of schizophrenia

Question 23

Delusional disorder

Answer 23

has the existance of prominent, non-bizarre delusions

Question 24

Types of delusional disorders

Answer 24

Erotomanic (thinks people are in love with them)
Grandiose (thinks they are god)
Jealous type
Persecutory type
Somatic (they overplay physical sx)

Question 25

Brief psychotic disorder

Answer 25

sudden onset of sx
may be preceded by stress
last < 1 month
return to normal functioning

Question 26

The Catatonic Features Specifier

Answer 26

may be associated with other psychotic disorders, such as brief psychotic disorder, schizophreniform disorder, schizophrenia, schizoaffective disorder, and substance-induced psychotic disorder

Question 27

Catatonic disorder sx

Answer 27

Stupor and muscle rigidity or excessive, purposeless motor activity
Waxy flexibility, negativism, echolalia, echopraxia (copying how someone else moves)

Question 28

Schizophreniform Disorder

Answer 28

Same symptoms as schizophrenia with the exception that the duration of the disorder has been at least 1 month but less than 6 months

Question 29

Schizoaffective Disorder

Answer 29

Schizophrenic symptoms accompanied by a strong element of symptomatology associated with the mood disorders, either mania or depression
They are usually highly suicidal

Question 30

Category of medications to treat positive sx

Answer 30

traditional/typical antipsychotics

Question 31

Individual psychotherapy as tx for schizophrenia

Answer 31

long term therapeutic approach

difficult because clients have problems with interpersonal functioning

Question 32

Group therapy as tx for schizophrenia

Answer 32

some success when used long term

Question 33

behavior therapy as tx for schizophrenia

Answer 33

not a good option

inability to generalize to the community after discharge

Question 34

skills therapy training as tx for schizophrenia

Answer 34

aimed at improving relationship development

use of role play to teach appropriate behavior

Question 35

Social treatments

Answer 35

milieu therapy (best combined with psychopharmacology)
Family therapy

Question 36

Program of Assertive Community Treatment (PACT)

Answer 36

case management using a team approach for comprehensive, community-based psychiatric treatment, rehabilitation, and support