Lecture 3 'Schizophrenia'

Question 1

Eugene Bleuler (1911) described four core disturbances of people with schizophrenia, what are they?

Answer 1

1. Affect
2. Ambivalence
3. Association
4. Preference for fantasy over reality

Question 2

The prevalence for schizophrenia in the population is _____%?

Peak age of onset for
Males = ________
Females = _______

Answer 2

1%

Males = 15-25 years
Females = 25-35 years

Question 3

Males are ____% more likely to develop schizophrenia than females

Answer 3

30-40%

Question 4

What is the most expensive of all mental disorders in terms of direct treatment costs, loss of productivity and public assistance costs?

Answer 4

Schizophrenia

Question 5

What are the characteristic symptoms of schizophrenia of which at least one must be met for diagnosis?

Answer 5

Delusions
Hallucinations
Disorganised speech (frequent derailment or incohorerence)

Question 6

What are the two exclusionary criteria for schizophrenia?

Answer 6

Symptoms cannot be better explained by 1) schizoaffective or mood disorder or) substance use / medical condition

Question 7

What are the two types of disturbances in thought as characteristic of schizophrenia?

Answer 7

Disturbances in CONTENT of thought (delusions)

Disturbances in FORM of thought (loosening of associations)

Question 8

List five examples of loosening of associations in schizophrenia?

Answer 8

Neologism - random words
Preservation - repeat same idea
Word salad - not making sense
Circumstantiality - going off topic 
Tangentiality - never get back to finishing point

Question 9

What are the characteristics of schizophrenia?

Answer 9

Disturbances in content of thought (delusions)
Disturbances in form of thought (loosening associations)
Disturbances in perception (hallucinations)
Disturbances in affect
Disturbances in psychomotor behaviour
Positive symptoms
Negative symptoms

Question 10

What are examples of positive symptoms of schizophrenia?

Answer 10

Delusions
Hallucinations
Loose associations
Disorganised behaviour

Question 11

What are some examples of negative symptoms of schizophrenia?

Answer 11

Flat affect
Apathy
Social withdrawal
Poor attention

Question 12

Hat is the difference between type 1 and type 2 schizophrenia?

Answer 12

Type 1= sudden onset, normal intellect, no brain damage, no negative symptoms, good drug response

Type 2= slower onset, intellectual deterioration, brain abnormality, prominent negative symptoms, poor drug response

Question 13

What are the three phases of schizophrenia?

Answer 13

Prodromal phase
Active phase
Residual phase

Question 14

What are good outcome predictors for schizophrenia?

Answer 14

• good pre morbid adjustment
• no family history
• sudden onset
• precipitating stress
• good response to medication
• later age of onset
• positive symptoms
• female gender

Question 15

What are poor outcome predictors of schizophrenia?

Answer 15

• poor pre morbid adjustment
• family history
• slow onset
• early age of onset
• negative symptoms
• no precipitating stress
• male gender

Question 16

Schizophreniform disorder is characterised by what?

Answer 16

Duration: at least one month but less than six months

Question 17

Schizoaffective disorder is characterised by what?

Answer 17

Prominent episode of mood disturbance concurrent with Criterion A for schizophrenia

Question 18

Family studies of schizophrenia indicate ____% concordance rates of monozygotic twins, what does this mean?

Answer 18

~50% (48%)

Indicates genetics likely plays a large role in the aetiology of the disorder

Question 19

Biochemical hypothesis of schizophrenia aetiology suggests symptoms are caused by too much what?

Answer 19

Dopamine, this is a problem because drugs to treat schizophrenia can treat other disorders as well

Question 20

What are the structural brain differences and group averages of schizophrenia patients?

Answer 20

Enlarged brain ventricles, decreased frontal / temporaral / whole brain volume

Question 21

What are Neurodevelopment theories of schizophrenia aetiology

Answer 21

> Fetal neurodevelopment = obstetric complications + maternal infection (winter causes more maternal sickness) + maternal stress (acute)

Question 22

What are the four major limitations of the biological view of the aetiology of schizophrenia?

Answer 22

1. biological abnormalities correlational
2. difficult to determine if abnormality is related to disease process or to treatment
3. pathology identified in one area of the brain does not mean primary area of pathology has been identified
4. a single pathological process in the brain can cause a wide range of phenomena in different individuals

Question 23

Psychosocial factors of schizophrenia focus on what?

Answer 23

Reciprocal transaction between patient and their family

Question 24

Explain the Darcis – stress model of schizophrenia?

Answer 24

Predisposition of factors (diathesis) mixed with stresses and lead to schizophrenia

Question 25

What are the treatment options for schizophrenia?

Answer 25

Psychosocial Interventions:
> cognitive behaviour therapy
> broad rehab therapy
> family interventions 
> social skills training

Somatic treatments
> anti psychotics

Multifaceted approach
> community approach
> effective community care