Chapter 12- Schizophrenia and Psychotic Disorders

Question 1

Who gave early descriptions of schizophrenia?

Answer 1

Haslam, Pinel, and Morel

Question 2

Emil Kraeplin’s Theory of Schizophrenia

Answer 2

“Dementia Praecox”
Combined catatonia, hebephrenia, and paranoia
Differentiated from bipolar disorder with early onset and poor outcomes

Question 3

Eugen Bleuler

Answer 3

Coined term schizophrenia
Described as associative splitting of personality

Question 4

Schizophrenia Diagnostic Criteria

Answer 4

2+ Positive, negative, or disorganized symptoms
At least 1 symptom must be delusions, hallucinations, or disorganized speech
Symptoms present for over 1 month

Question 5

Schizophrenia Subtypes

Answer 5

Paranoid- Delusions of grandeur or persecution
Disorganized / Hebephrenic- Silly and Immature
Catatonic

Question 6

Positive Symptoms

Answer 6

Present in schizophrenics but not average population
Delusions and Hallucinations

Question 7

Delusions

Answer 7

Misrepresentation of Reality
Disordered thought content
Types:
Delusion of grandeur
Delusion of persecution

Question 8

Hallucinations

Answer 8

Experiencing sensory events without outside input
Any sensory modality- commonly auditory
Related to meta-cognition, intrusive thoughts, and broca’s area

Question 9

Negative Symptoms

Answer 9

Absence of normal behaviors
Examples:
Avolition, Alogia, Anhedonia, Asociality, Affective Flattening

Question 10

Avolition

Answer 10

Inability to initiate and persist in activities

Question 11

Alogia

Answer 11

Relative absence of speech
Caused by negative thought disorder

Question 12

Anhedonia

Answer 12

Lack of interest or pleasure
Indifference

Question 13

Asociality

Answer 13

Lack of interest in social interaction

Question 14

Affective Flattening

Answer 14

Lack of displayed emotions
Emotions are experienced but not displayed outwardly

Question 15

Disorganized Symptoms

Answer 15

Erratic behaviors impacting speech, motor behavior, and emotional responses
Examples- Disorganized speech, inappropriate affect, and catatonia

Question 16

Disorganized Speech

Answer 16

Talking illogically or jumping between topics
Tangents, loose associations, and derailment
Many patients lack insight

Question 17

Inappropriate affect

Answer 17

Improper emotional response to scenario

Question 18

Schizophreniform Disorder

Answer 18

Schizophrenia symptoms lasting 6 months or less
Lifetime prevalence of 0.2%
Good premorbid function

Question 19

Schizoaffective Disorder

Answer 19

Comorbidity of schizophrenia and mood disorders
Delusions and hallucinations are absent in mood symptoms

Question 20

Delusional Disorder

Answer 20

Delusions without other Schizophrenia symptoms
Subtypes-
Erotomanic, Grandiose, Jealous, Persecutory, and Somatic

Question 21

Erotomanic Delusions

Answer 21

Irrational belief of being loved

Question 22

Grandiose Delusions

Answer 22

Inflated self-worth

Question 23

Jealous Delusions

Answer 23

Belief that partner is unfaithful

Question 24

Persecutory Delusions

Answer 24

Belief that one is being mistreated in some way

Question 25

Somatic Delusions

Answer 25

Feel afflicted by physical deficit or medical condition not present in patient

Question 26

Shared psychotic Disorder

Answer 26

Development of delusions from close relationship with delusional person

Question 27

Psychotic Disorders with Direct Causes

Answer 27

Substance-Induced Psychotic Disorder
Psychotic Disorder associated with other medical condition
Ex- Tumors, Alzheimers

Question 28

Brief psychotic disorder

Answer 28

1+ Positive or disorganized symptom lasting 1 month or less in a period of extreme stress

Question 29

Attenuated Psychotic Syndrome

Answer 29

High-risk individuals that are beginning to display symptoms

Question 30

Prevalence of Schizophrenia

Answer 30

1% Lifetime prevalence
Equal among men and women
Men have earlier onset and worse outcomes

Question 31

Developmental Stages of Schizophrenia

Answer 31

Premorbid- Minor nonspecific impairments
Prodromal- Less severe abnormal symptoms (1-2 years before onset)
Onset- 2-10 years to become high risk
Critical period- 2 years post-onset
Chronic period- Lasting symptoms

Question 32

Factors influencing Schizophrenia Risk

Answer 32

Genetics, Neurobiology, and Psychosocial Factors

Question 33

Genetic Influences

Answer 33

Many genes contribute to schizophrenia vulnerability and is extremely heritable according to family studies

Question 34

Neurobiological Influences

Answer 34

Dopamine
Brain Structure
Prenatal and Perinatal Factors

Question 35

Dopamine and Schizophrenia

Answer 35

Excess dopamine in the basal ganglia and insufficient dopamine in pre-frontal cortex
Anti-psychotics block dopamine to treat symtoms

Question 36

Structural Brain Differences in Schizophrenia

Answer 36

Enlarged ventricles and brain atrophy
More significant in men
Dorsolateral pre-frontal cortex abnormalities

Question 37

Prenatal and Perinatal influences on schizophrenia

Answer 37

Fetal virus exposure
Pregnancy and Delivery Complication
Hypoxia

Question 38

Psychosocial Factors

Answer 38

Stressful LIfe Events
Family factors:
Schizophrenogenic mothers
Double-Bind communication
Expressed emotion

Question 39

Historical Biological Treatments for Schizophrenia

Answer 39

Insulin coma therapy
Psychosurgery- Frontal lobotomy
ECT

Question 40

Antipsychotic medications

Answer 40

Neuroleptics- Reduce hallucinations and delusions by interfering with the dopamine system
1st gen- Haldol and Thorazine
2nd gen- Risperidone and olanzapine
Some side effects
Non-compliance is common

Question 41

Psychosocial Schizophrenia Treatment

Answer 41

Severe cases require hospitalization
Attempt to reteach social, vocational, and independent skills
Cognitive remediation to improve cognitive function
Behavioral family therapy

Question 42

Schizophrenia Prevention

Answer 42

Treatment beginning in the prodromal stages
Identify at-risk individuals