Chapter 14 - Psychosis

Question 1

What are some characteristics of Schizophrenia?

Answer 1

Schizophrenia is a complex disorder characterized by a broad spectrum of cognitive and emotional dysfunctions, devastating effects, and a rare occurrence of full recovery. It encompasses many subtypes and presentations.

Question 2

early figures in diagnosing Schizophrenia

Answer 2

Emil Kraepelin created the best descriptions and categorizations, introducing the term “dementia praecox.” Eugene Bleuler introduced the term “schizophrenia,” describing it as a “split mind” with associative splitting of basic personality functions.

Question 3

clinical description of psychosis?

Answer 3

loss of contact with reality that can affect all functions of an individual.

Question 4

positive symptoms of Schizophrenia?

Answer 4

distorted reality and include hallucinations (e.g., auditory, visual) and delusions (e.g., grandeur, persecution), experienced by 60-80% and 70% of individuals with schizophrenia, respectively.

Question 5

negative symptoms of Schizophrenia?

Answer 5

deficits in normal behavior, such as avolition (lack of motivation), alogia (lack of speech), anhedonia (lack of pleasure), asociality (lack of interest in social interactions), and affective flattening (lack of emotional expression).

Question 6

disorganized symptoms of Schizophrenia?

Answer 6

disorganized speech (jumping from topic to topic) and inappropriate affect and behavior, such as catatonic immobility and waxy flexibility.

Question 7

other disorders related to psychosis?

Answer 7

Schizophreniform Disorder, Schizoaffective Disorder, and Delusional Disorder, each with distinct diagnostic criteria and prognosis.

Question 8

required for a diagnosis of Schizophrenia?

Answer 8

presence of two or more positive, negative, or disorganized symptoms, with at least one being delusions, hallucinations, or disorganized speech.

Question 9

What is Schizophreniform Disorder?

Answer 9

characterized by experiencing symptoms similar to schizophrenia but for a shorter duration, typically lasting only a few months

Question 10

Schizoaffective Disorder

Answer 10

both schizophrenia and a mood disorder, with delusions or hallucinations present for at least 2 weeks in the absence of mood symptoms.

Question 11

Delusional disorder

Answer 11

persistent beliefs contrary to reality, without other characteristics of schizophrenia. It may lead to social isolation and can persist for several years. Subtypes include erotomanic, grandiose, jealous, persecutory, and somatic delusions.

Question 12

incidence and sex differences in schizophrenia onset

Answer 12

incidence of schizophrenia is on a decline. Onset occurs typically in late adolescence or early adulthood. In terms of sex differences, onset in men diminishes with age, while the frequency for women is lower until age 36, with a more favorable outcome.

Question 13

cultural factors associated with schizophrenia?

Answer 13

label for individuals behaving outside of norms. While it is universal, the course and outcome vary. Outcomes tend to be better in less wealthy areas. There is also bias in diagnosing, with higher rates in black populations.

Question 14

genetic influences are associated with schizophrenia

Answer 14

significant role in vulnerability to schizophrenia. Family studies suggest that parental diagnosis severity impacts vulnerability, and individuals may inherit a genetic predisposition. Twin studies indicate that mutations occur in germ cells or fertilized eggs. Adoption studies show genetic vulnerability from the biological mother. Offspring of twins with schizophrenia have an increased risk, even if their parents are unaffected. Gene-environment interactions also contribute, and linkage and association studies have identified genetic risks on chromosomes 8, 6, and 22.

Question 15

What role does dopamine play in schizophrenia?

Answer 15

increased dopamine levels are associated with increased schizophrenia symptoms. Antipsychotic drugs, which are used to treat schizophrenia, typically act as dopamine antagonists. However, the role of dopamine in schizophrenia is complex and not fully understood.

Question 16

How does brain structure relate to schizophrenia?

Answer 16

deficits in their ability to perform certain tasks. Brain imaging studies have shown enlarged ventricles in proportion to age and duration of illness, indicating brain abnormalities. Additionally, the frontal lobes are typically less active in individuals with schizophrenia, and dysfunction can occur before onset, sometimes even prenatally.

Question 17

stress influence the risk of schizophrenia?

Answer 17

urban living and being born during winter associated with increased risk. Relapse is more likely to occur when stress is experienced in the previous month. Lower socioeconomic status is also linked to schizophrenia risk

Question 18

family dynamics relate to schizophrenia?

Answer 18

impact schizophrenia risk and relapse. Expressed emotion within families, particularly hostility and intrusiveness, are good predictors of relapse. Cultural variations exist in family treatment approaches for schizophrenia.

Question 19

What were some early biological interventions for schizophrenia?

Answer 19

16th century, primitive surgery, including prefrontal lobotomies, was used to remove madness. In the 1930s, seizures were induced with insulin overdose as a treatment method. Electroconvulsive therapy (ECT) was also employed.

Question 20

How do neuroleptics work in the treatment of schizophrenia?

Answer 20

help individuals with schizophrenia think more clearly and reduce hallucinations and delusions. They typically interfere with dopamine activity in the brain. Conventional antipsychotics are effective for 60-70% of individuals but can have unpleasant side effects.

Question 21

psychosocial interventions used in the treatment of schizophrenia?

Answer 21

aim to achieve insight, encourage socialization, problem-solving, and self-care. Techniques such as token economy, community support, role-play to learn social skills, and behavioral family therapy are utilized