Chapter 15 - Schizophrenia

Question 1

define schizophrenia

Answer 1

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. It is characterized by a combination of symptoms including hallucinations (seeing or hearing things that aren’t there), delusions (false beliefs not based on reality), disorganized thinking and speech, reduced expression of emotions, and difficulty concentrating. These symptoms often impair daily functioning and can be distressing for the individual experiencing them.

Schizophrenia typically emerges in late adolescence or early adulthood, although it can develop at any age. The exact cause of schizophrenia is not fully understood, but it is believed to involve a combination of genetic, brain chemistry, and environmental factors. Treatment usually involves a combination of antipsychotic medications, psychotherapy, and support services to help manage symptoms and improve quality of life. Early intervention and ongoing support are crucial for managing the condition effectively.

Question 2

simply put schizophrenia is

Answer 2

devastating brain disease affecting thinking, language, emotions, social behavior, and reality perception

Question 3

at what age does the usual onset of schizophrenia start

Answer 3

s/s generally appear i late adolescence or early adulthood, although they may occur in middle or late adult life

early onset schizophrenia is when s/s appear before age 18

Question 4

the lifetime prevalence of schizo is about ____% of the general population

Answer 4

1%

Question 5

comorbidities schizo

Answer 5

substance abuse
anxiety
depression
cognitive impairments

Question 6

schizo causes disturbances in

Answer 6

thought processes
perception
affect

Question 7

phases of schizo:

phase 1 - the premorbid phase

Answer 7

s/s occur before there is clear evidence of illness and may include distinctive personality traits or behaviors.
noted; very shy, withdrawn, no friends, antisocial

Question 8

phase 2: the prodromal phase

Answer 8

more clearly manifested signs of developing illness of schizo.
onset of frank psychotic symptoms, ranges from 2 to 5 years
the person begins to show signs of significant deterioration in function.
depressive symptoms, social w/d, cognitive impairment, OCD.

Question 9

phase 3: active psychotic phase

Answer 9

acute episodes in which s/s more pronounced.
psychotic symptoms are prominent

Question 10

Phase 4: residual phase

Answer 10

schizo is characterized by periods of remission and exacerbation.
symptoms of the acute stage are either absent r no longer prominent.

positive symptoms (dellusions, hallucionations) are often alleviated but negative symptoms may remain

flat affect and role impairment are common

Question 11

DSM-V criteria for schizo
includes 2 or more of each for a significant portion of time during a 1 month period

1. delusions
   2.hallucinations
2. disorganized speech
3. catatonic behavior
4. negative symptoms

Question 12

what is the prognosis for schizo

Answer 12

difficult to predict and are highly variable.

a more positive outcome comes from:
good premorbid functioning
later age at onset
female
abrupt onset of symp w/ obvious predicting factor
rapid treatment of symptoms
absence of brain abnormalities
normal neurological functioning
and no family hx of schizo

Question 13

predisposing factors:

genetic
biochemical

Answer 13

increased risk with parent w/ schizo

biochemical r/t pathogenic role of “chemical imbalance” as an explanation of insanity

Question 14

the dopamine hypothesis

Answer 14

this theory suggests that schizo may be caused by an excess of dopamine-dependent neuronal activity in the brain

Question 15

a number of neurotransmitters have been implicated in the etiology of schizophrenia

can you name a few?

Answer 15

acetylcholine,dopamine, serotonin, norepinephrine, glutamate, and GABA

Question 16

physiological factors:

A number of physical factors of possible etiological significance have been identified. However their specific actions are unclear

viral infection:
data indicates a high incidence of shcizo after prenatal exposure to

Answer 16

influenza

Question 17

Anatomical abnormalities:

structural brain abnormalities have been observed in individuals with schizo - _________enlargemnt is the most consistent finding; however some reductions in ___________matter are also reported

Answer 17

ventricular enlargement, gray matter

Question 18

long term studies of patients with schizo have noted brain volume _______, particularly in the temporal and preventricular areas

Answer 18

reduction

Question 19

name some 2nd generation antipychotics

Answer 19

clozpine, quetiapine, ariprizole, risperidone,

Question 20

psychological predisposing factors

Answer 20

childhood trauma, particullary multiple ones, are associated with development of schizo

Question 21

sociocultural predisposing factors

Answer 21

greater numbers of patients with schizo come from a lower socioeconomic class

Question 22

what is the downward drift hypothesis

Answer 22

suggests that because of the characteristic symptoms of the diorder, person has difficulty maintaining gainful employement and “drift down” to lower socioeco level

Question 23

what is catatonia

Answer 23

significant motor disturbance that may range from stupor to excessive motor activity and agitation

Question 24

what is delusional disorder

Answer 24

presence of delusions that have been experienced for at least 1 month.
hallucinations if present at all are not prominent and behavior is not bizarre

a persistent false psychotic belief regarding the self or persons or objects outside the self that is maintained despite indisputable evidence to the contrary

Question 25

brief psychotic disorder

Answer 25

sudden onset of psychotic symptoms that may or may not have been preceded by a severe psychosocial stressor
lasts at least 1 day but less than 1 month
there is an eventual full return to the pemorbid level of functioning

Question 26

schizophreniform disorder

Answer 26

identical to schizophrenia with the exception that the duration, including prodromal, active, and residual phases, is at least 1 month but less than 6 months

the diagnosis is changed to schizophrenia if the clinical picture persists beyond 6 months

Question 27

schizoaffective disorder

Answer 27

manifested by s/s of schizophrenia, along with a strong element of symptomatology associated with mood disorders (depression or mania)

Question 28

general medical conditions that may vause psychotic symptoms

Answer 28

CNS trauma, meningitis, migraines, renal disease, vitamin deficiency

Question 29

what is the definition of a positive symptom r/t schizophrenia

Answer 29

Positive Symptoms:

Positive symptoms involve the presence of abnormal experiences or behaviors that are not typically seen in healthy individuals.
These symptoms add something to a person’s mental state or behavior that is not usually present.
Examples include hallucinations (seeing, hearing, or feeling things that are not real), delusions (false beliefs that are not based on reality), disorganized thinking, and abnormal motor behaviors.
Positive symptoms are often more responsive to treatment with antipsychotic medications.

hallucinations, delusions

Question 30

what is a negative symptom r/t schizophrenia

Answer 30

Negative Symptoms:

Negative symptoms involve the absence or reduction of normal experiences or behaviors that are typically present in healthy individuals.
These symptoms represent a loss or reduction in normal functioning or behavior.
Examples include flat affect (reduced emotional expression), avolition (lack of motivation or interest in activities), alogia (reduced speech output), anhedonia (inability to experience pleasure), and social withdrawal.
Negative symptoms are often more difficult to treat and may persist even with treatment.

flat affect, social withdrawal, lack of motivaiton

Question 31

Disturbances in thought content:
delusions are fixed false beliefs that are irrational and that the individual maintains is true despite evidence to the contrary

what is persecutory delusions

Answer 31

most common, individual believes they are being persecuted or malevolently treated in some way.

“the fbi has bugged my room!”

these also may be called paranoid delusions

“i wont eat this food its poisoned!”

Question 32

grandiose delusions

Answer 32

exaggerated feeling of importance, power, knowledge, or identiy

“i am jesus christ!”

Question 33

delusions of reference

Answer 33

events within the environment are referred by the psychotic person to himself

“someone is trying to get a message to me through teh magazine articles - i have to break the code!”

Question 34

delusions of control or influence

Answer 34

the individual believes they have control over certain objects or persons have control of them or vice versa

“its raining because im sad”

Question 35

somatic delusions

Answer 35

false idea of functioning of their body

“the doctor says im not pregnant but i know that i am”

Question 36

nihilistic delusion

Answer 36

believes that self, others, or the world doesnt exist

Question 37

eromanic delusions

Answer 37

false belie that someone ususally of a higher status is in love with them

Question 38

disturbance in thought processes manifested in speech:

loose associations

Answer 38

speech in which ideas shift from one topic to the next with no relation

“Im late for the bus. my cat is orange. im hungry”

Question 39

neologisms

Answer 39

person invents new words that are meaningless to others but have meaning to the individual

Question 40

clang associations

Answer 40

choice of words goverened by sound. “ its cold, im bold, that is sold”

Question 41

circumstantiality

Answer 41

delays in reaching the point of communication because of unneccary pointless details

Question 42

what is avolition

Answer 42

inability to initiate goal directed activity

Question 43

anosognosia

Answer 43

the lack of awareness of there being any illness or disorder even when symptoms appear obvious to others

Question 44

anhedonia

Answer 44

inability to experience pleasure

Question 45

waxy flexibility