Psychiatric Disorders II

Question 1

Which gender has: an earlier onset with schizophrenia?

Answer 1

Males

Question 2

Which gender has: poorer premorbid adjustment with schizophrenia?

Answer 2

Males

Question 3

Which gender has: less cognitive impairment with schizophrenia?

Answer 3

Females

Question 4

Which gender has: more brain structural abnormalities with schizophrenia?

Answer 4

Males

Question 5

Which gender has: a better outcomes with schizophrenia?

Answer 5

Females

Question 6

Which gender has: a later onset with schizophrenia?

Answer 6

Females

Question 7

Which gender has: more negative s/sx with schizophrenia?

Answer 7

Males

Question 8

Which gender has: symptoms that are more affect laden onset with schizophrenia?

Answer 8

Females

Question 9

Which gender has: tend not to marry with schizophrenia?

Answer 9

Males

Question 10

What percent of schizophrenics develop by age 30 in males?

Answer 10

90%

Question 11

What is the most common presentation of bipolar disorder?

Answer 11

Depression and anxiety

Question 12

True or false: there is a high comorbidity of anxiety with schizophrenia

Answer 12

True

Question 13

What are the comorbidities that are common in the schizophrenic population? (3)

Answer 13

• Anxiety
• OCD
• Panic

Question 14

True or false: Schizotypal or paranoid personalities often proceed the onset of schizophrenia

Answer 14

True

Question 15

True or false: there are high rates of substance abuse with schizophrenia

Answer 15

True (50% use tobacco)

Question 16

What is the usual age range in prison? How does this compare to the onset of schizophrenia?

Answer 16

Both young

Question 17

What percent of schizophrenics smoke?

Answer 17

50%

Question 18

What is the effect of smoking with schizophrenia?

Answer 18

Decreases hallucinations

Question 19

What is a schizoaffective disorder?

Answer 19

a mental disorder characterized by abnormal thought processes and deregulated emotions. The diagnosis is made when the patient has features of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not strictly meet diagnostic criteria for either alone

Question 20

What are the diagnostic criteria for schizoaffective disorder? What is the duration that is needed?

Answer 20

Delusions or hallucinations for 2 or more weeks in the absence of a major episode during the lifetime duration of the illness

Question 21

How do the negative s/sx with schizoaffective disorder compare to full schizophrenia

Answer 21

less severe and less persistent

Question 22

True or false: anosognosia is common, and more severe and pervasive with schizoaffective disorder than in schizophrenia

Answer 22

False–less severe and pervasive

Question 23

What is the prevalence of schizoaffective disorder? How does this compare to schizophrenia?

Answer 23

1/3 as common as schizophrenia, with a lifetime prevalence of 0.3%

Question 24

Which gender has a higher prevalence of schizoaffective disorder?

Answer 24

Females

Question 25

What is the duration of substance induced psychotic disorder?

Answer 25

s/sx that persist more than 1 month after stopping acute withdrawal or severe intoxication

Question 26

True or false: s/sx of substance induced psychotic disorder precede the onset of use

Answer 26

True

Question 27

What percent of individuals with a first episode of psychosis are reported to have substance induced psychotic disorder?

Answer 27

7-25%

Question 28

True or false: in order to diagnose substance induced psychotic disorder, the disturbances must not occur during a delirium

Answer 28

True

Question 29

What are the three major categories of medical disorders that can cause psychosis?

Answer 29

- Neurological conditions - Endocrine conditions - Metabolic conditions

Question 30

What is the prevalence of psychotic disorders 2/2 a medical condition?

Answer 30

0.21% to 0.54%

Question 31

What is the prevalence of psychotic disorders in the 65+ age group?

Answer 31

0.74%

Question 32

What is the disease that appears over 80 years old that is the usual cause for psychosis?

Answer 32

One of the major neurocognitive disorders that causes dementia

Question 33

What are the criteria for catatonia?

Answer 33

-Associated with a mental or medical condition

Question 34

What is the usual clinical picture of catatonia?

Answer 34

1. stupor 2. Cataplexy 3. Waxy flexibility 4. Mutism

Question 35

What is echolalia seen with catatonia?

Answer 35

Mimicking speech of others

Question 36

What is echopraxia seen with catatonia?

Answer 36

Mimicking others' movements

Question 37

What is stereotypy seen with catatonia?

Answer 37

Repetitive, abnormal frequent non-goals directed movement

Question 38

What is the negativism form of catatonia?

Answer 38

Opposition or no response to external stimuli

Question 39

What is the mannerism form of catatonia

Answer 39

Odd, circumstantial caricature of normal actions

Question 40

What percent of inpatients with schizophrenia have catatonia?

Answer 40

35%

Question 41

In order to call catatonia medical, what must be true?

Answer 41

Must be directly related to the medical condition

Question 42

The majority of cases of catatonia are related to what disorders?

Answer 42

Bipolar or MDD

Question 43

Before catatonia can be used as a specifier in a neurodevelopmental disorder, what must be true?

Answer 43

Medical conditions must be ruled out

Question 44

The risk of schizophrenia increases with the age of the mother or father?

Answer 44

Father

Question 45

What is the dopamine model of psychosis?

Answer 45

Increased mesolimbic dopaminergic activity mediated by reciprocal prefrontal dopaminergic hypoactivity

Question 46

What is the glutamate model?

Answer 46

Glutamate NMDA antagonists like PCP produce psychotic, negative and cognitive symptoms in normal and psychotic relapse in schizos

Question 47

What is the viral hypothesis of schizophrenia?

Answer 47

Associated with prenatal infx with flu / rubella

Question 48

What is the diathesis and stress model of schizophrenia?

Answer 48

The patient has inherited vulnerability to schizophrenia that may be manifested by neuropsychological deficits

Question 49

What are the histopathological changes that occur with psychosis (what 4 areas of the brain are smaller)?

Answer 49

Decreased volume of: - hippocampus - thalamus - temporal - prefrontal cortex

Question 50

True or false: there is a decrease in total gray matter volume with schizophrenia

Answer 50

True

Question 51

What happens to the ventricles with schizophrenia?

Answer 51

Lateral and third ventricles are enlarged

Question 52

Hypofrontality at rest in chronic patients correlates with what type of symptoms?

Answer 52

Negative symptoms

Question 53

What happens to the prefrontal cortex during performance of cognitive tasks with schizophrenia?

Answer 53

Failure to activate

Question 54

What may happen to the cognitive deficits that present at the time of diagnosis with schizophrenia?

Answer 54

May progress

Question 55

What are the three major components of treatment for acute psychotic disorders?

Answer 55

- Containment - Avoid medication side effects - Educate and support family

Question 56

What is the homicide rate of psychotic disorders (relative and total incidence)?

Answer 56

Increased 10x but still less than 1% of the population

Question 57

What is the only risk factor for violence within the context of the delusional system?

Answer 57

Auditory command hallucinations

Question 58

True or false: as a group, schizophrenics are more frequently victimized than other individuals

Answer 58

True

Question 59

What is the suicide rate of psychotics? When is the risk highest?

Answer 59

10-15% | Within the first 5 years of illness

Question 60

What percent of schizophrenics die by suicide?

Answer 60

5-6%

Question 61

What is the relative rate of violence with schizophrenia? What happens with treatment?

Answer 61

Higher rates of arrest which decreases with appropriate treatment

Question 62

What is stupor catatonia?

Answer 62

Not relating to the environment

Question 63

What is cataplexy form of catatonia?

Answer 63

Passive induction of posture against gravity

Question 64

What is the waxy flexibility form of catatonia?

Answer 64

Slight ven resistance to positioning

Question 65

What are the criteria for "other specified schizophrenia spectrum and psychotic disorders"?

Answer 65

Does not meet full criteria for one of the disorders listed, but still has symptoms and significant social, occupational, or other functional deficits

Question 66

What is unspecified schizophrenia spectrum and psychotic disorder?

Answer 66

When the clinician chooses not to specify why the criteria are not met like presentations where there is insufficient information

Question 67

Are D1 and D2 receptors increased or decreased in the striatum of patients with schizophrenia?

Answer 67

Increased (maybe)

Question 68

What is the basis for the nicotinic theory of schizophrenia?

Answer 68

nicotine normalizes auditory evoked potential gating deficit in schizophrenic pts

Question 69

What is the basis for the glutamate theory of schizophrenia?

Answer 69

Altered receptor densities and subunit compensation in hippocampus and prefrontal cortex