Early Onset Schizophrenia

Question 1

Hallmark of the disorder

Answer 1

psychotic symptoms

Question 2

Diagnostic Criteria

Answer 2

McDonnell & McClennen (2006)

Two or more significant for a month:

1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganized or catatonic behavior
5. negative symptoms (e.i affective flattening, alogia, or avolition).

If hallucination and delusions are bad then one might suffice.

Must have impairment for at least 6 months. Excludes schizoaffective and mood disorders with psychotic features.

Question 3

Subtypes

Answer 3

1. paranoid - hallucinations/persecutoary delusions
2. disorganized (hebephrenic) - disorganized thought or behavior
3. catatonic - unresponsive to environment
4. undifferentiated - not other types
5. residual - no longer manifest hallucinations, disorganized speech…but show negative symptoms

Question 4

Developmental Issues

Answer 4

Child more likely to experience more hallucinations, thought disorder, and negative symptoms..LESS delusions (Pavuluri, Herbener, & Sweeny, 2004).

Question 5

Course of illness

Answer 5

Schizophrenia is a phasic disorder with a great deal of individual variability

Question 6

Negative vs. Positive Symptoms

Answer 6

Positive (added)

• hallucinations (sensory experiences)
• delusions (fixed false cognitive beliefs)
• disorganized speech (frequent derailment or incoherence)

Negative symptoms - lost or taken away (deficits)

• flat affect
• avolition (difficulty with motivation)
• alogia (poverty of speech content)
• anehdonia

Question 7

Premorbid impairments

Answer 7

premorbid difficulties include

• bizarre preoccupations
• unusual behaviors
• social withdrawal and isolation
• deteriorating self care
• academic, speech, and language problems
• language delays

helps differentiate between EOS and BPD

Question 8

Genetic Factors

Answer 8

5-20 times higher if first degree relatives have it

concordance rate MZ twins = 40-60% but DZ twins it is 5-15% (Cardno & Gottesman, 2000)

Question 9

Environmental Factors

Answer 9

Disruptions in prenatal brain development
developmental disturbances in childhood
maternal starvation
environmental factors interact with biological risk factors to mediate the timing of onset, course, and severity of the disorder (psychsocial stressors).

Question 10

Brain Anomalies

Answer 10

Neurodevelopmental disorder

ventricular enlargement and decreased hippocampal volume
decrease in gray matter and frontal lobe, temporal lobe, parietal lobe and thalamas.
deficits in white matter in the frontal lobe

Question 11

Dopamine

Answer 11

Overactivation of D2 receptors

Question 12

Prevalence

Answer 12

1% in general population…less than 1% in children

predominantly male…typically during adolescence

Question 13

Phases of Schizophrenia

Answer 13

1. Premorbid functioning…
2. Prodromal phase…significant decline from baseline functioning.
3. Acute Phase…increase in positive symptoms
4. recovery phase…remission of psychosis..
5. residual phase…no positive symptoms…somewhat impaired negatie symptoms.

Question 14

Assessment

Answer 14

Family history
base rates
cultural considerations (belief system)
drug use

Question 15

Executive dysfunction in Schizophrenia

Answer 15

no inhibition
no affect
inattnetion

antipsychotic medication –> dopamine agonists improve executive functioning