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EPPP Prep > Psychopathology: Schizophrenia Spectrum/Other Psychotic D/O > Flashcards

Psychopathology: Schizophrenia Spectrum/Other Psychotic D/O Flashcards

1
Q

Brief Psychotic Disorder Requirements

A
  • 1+ of 4 sx: delusions, hallucinations, disorganized speech**, and grossly disorganized/catatonic bx
  • 1-30 days

** = 1 of the symptoms must be one of these

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2
Q

What are delusions

A

false belief based on incorrect inference about external reality that is firmly held despite proof/evidence to the contrary

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3
Q

What are hallucinations

A

Perception-like experience with the clarity and impact of a true perception without the external stimulation of the relevant sensory organ

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4
Q

What are illusions

A

Actual stimulus is misperceived or misinterpreted

**Not to confuse with hallucination that does not have an actual stimulus

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5
Q

Schizophreniform D/O

A
  • 2+ of 5 sx: delusions, hallucinations, disorganized speech**, grossly disorganized/catatonic bx + Negative sx (avolition, alogia, anhedonia)
  • 1-6 MONTHS

** = 1 of the symptoms must be one of these

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6
Q

Schizphrenia

A
  • 2+ of 5 sx: delusions, hallucinations, disorganized speech**, grossly disorganized/catatonic bx + Negative sx (avolition, alogia, anhedonia)
  • 1+ MONTH of ACTIVE PHASE
    *6+ MONTHS of Sx

Other phases include:
Prodromal Phase=2+ characteristics in a reduced form
Residual Phase=2+ characteristics in negative symptoms only

** = 1 of the symptoms must be one of these

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7
Q

Genetic factors/Concordance rates of 1st degree relatives (Gottesman, 1991)

A

Relationship to Person with Schizophrenia
Parent =6%

Biological sibling=9%

Child of one parent with schizophrenia=13%

Dizygotic (fraternal) twin=17%

Child of two parents with schizophrenia=46%

Monozygotic (identical) twin=48%

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8
Q

Concordance rates for discordant twins (twins in which only one twin has schizophrenia)

A

Discordant MONOzygotic twins = increased risk of schizophrenia being similar for offspring of affected and non-affected twins

Discordant DIzygotic twins = risk for offspring of affected twins was SIMILAR to risk for offspring MONOzygotic twins and GREATER than risk for non-affected twins

Discordant MZ twins have significant genetic liability that can be transmitted to children even though they do not manifest it themselves

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9
Q

Dopamine hypothesis for Schizophrenia

A

Due to HIGH levels of dopamine or HIGH activity of dopamine rceptors

AMPHETAMINES increase dopamine and produce schizophrenia-like symptoms.

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10
Q

Updated Dopamine hypothesis for Schizophrenia (Kuepper, Skinbjerg & Abi-Dargham, 2012)

A

Positive sx due to Dopamine HYPER activity in the SUBcortical regions of the brain (striatal areas–basal ganglia)
Negative sx due to Dopamine HYPOactivity in CORtical regions (prefrontal cortex)

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11
Q

Brain abnormality associated with Schizophrenia

A

*Enlarged Ventricals
* HYPOFRONTALITY=lower-than normal activity in prefrontal cortex (contribute to negatie sx)
* Dysfunction of Temporal-Limbic-Frontal network causes negative symptoms
* Disinhibition in striatum (caudate nucleus, putamen, and nucleus accumbens within basal ganglia) causes positive symptoms

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12
Q

Comorbid d/o with Schizophrenia

A

Anxiety D/O
OCD
Tobacco use (70-85% aka over half meet criteria for tobacco use d/o)

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13
Q

Onset of Schizophrenia

A

1st appears between late teens and early 30ths
Peaks early- to mid-20’s for men and late-20s for women

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14
Q

Course of Schizophrenia

A

Psychotic sx decrease with age.
Negative and cognitive sx persist

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15
Q

Better prognosis for schizophrenia

A

female gender
acute & late onset of sx
comorbid mood symptoms (esp Depression)
Premoninantly positive symptoms
Precipitating factors
Family Hx of mood disorder
Good premorbid adjustment

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16
Q

Impact of Anosognosia on Schizophrenia

A

Anosognosia=lack of insight or denial of illness

Leads to non-adherence to treatmen and elevated risk for relapse

17
Q

Factors that increase risk of relapse of schizophrenia

A

Anosognosia
High Expressed Emotion (emotional response of family members to patient with criticism/hostility/emotional overinvolvement)

18
Q

Cultural differences in onset, course, and prognosis of Schizophrenia

A

non-Western developing countries=acute onset, shorter course, and higher rate of remission

19
Q

Immigrant Paradox

A

Newly arrived immigrants have better health outcomes than much more acculturated immigrants with longer US residence/US born natives of the same ethnicity

Applies to schizophrenia and ETOH use d/o among other psychiatric d/o

20
Q

Treatment of Schizophrenia

A

Psychosocial interventions, antipsychotic drug, and adjunctive medications to treat comorbid disorders

21
Q

Psychosocial treatments for Shizophrenia

A

CBT for psychosis (CBTp)
Cognitive remediation for schizphrenia
ACT
Assertive Community Treatment
Family psychoeducation
Illness self-management training
Social skills training
Supported employment services

22
Q

Factors to consider for medication treatment for Schizophrenia

A

Drug’s likely benefits and side effects
Potential interactions w/other drugs
Health conditions that might be affected by the drug’s side effects

23
Q

Best med for treatment-resistant schizophrenia

A

2nd Generation Antipsychotic Clozapine

24
Q

Multicomponent Early Interventions for individuals at high risk or early stages of Schizophrenia

A

NAVIGATE (exp 1st eps of psychosis) = family education, individual reiliency training, supported employment/education, and individualized medication treatment

Individualized resiliency training (based on CPTp) = teaches patients the skills they need to manage their illness

25
Q

Sx of SchizoAFFECTIVE d/o

A

Concurrent schizophrenia +
Major Depressive or Manic episode for most of the duration of illness

Presence of delusions/hallucinations for 2+ weeks w/out mood symptoms

26
Q

Sx of Delusional d/o

A
  • 1+ delusions for a duration of at least 1 month
  • Overall functioning has NOT been markedly impaired except for direct effects of delusion
27
Q

Erotomanic Subtype of Delusional d/o

A

Person believes that another person is in love with him/her

28
Q

Grandiose Subtype of Delusional d/o

A

Person believes he/she has great but unrecognized talent or insight

29
Q

Jealous Subtype of Delusional d/o

A

Person believes his/her spouse/partner is unfaithful

30
Q

Persecutory Subtype of Delusional d/o

A

Person believes he/she is being conspired against, spied on, poisoned, or maliciously maligned

31
Q

Somatic Subtype of Delusional d/o

A

Person’s delusion involves bodily functions or sensations

32
Q

A poor prognosis for people with schizophrenia is least associated with which of the following?

A. female gender

B. anosognosia

C. early age of onset

D. predominantly negative symptoms

A

A. female gender

Answers B, C, and D are related to poor prognosis of schizophrenia

33
Q

A person who abuses an amphetamine or other ________-enhancing drug may develop symptoms similar to those associated with schizophrenia.

A. ACh

B. dopamine

C. serotonin

D. GABA

A

B. dopamine

A person who abuses an amphetamine or other ________-enhancing drug may develop symptoms similar to those associated with schizophrenia.

A. ACh

B. dopamine

C. serotonin

D. GABA

34
Q

As reported by I. I. Gottesman (1991), the concordance rate for schizophrenia is about ___% for monozygotic twins and ____% for dizygotic twins.

A. 50; 30

B. 50; 25

C. 48; 24

D. 48; 17

A

D. 48; 17

35
Q

A person whose biological mother and father have both received a diagnosis of schizophrenia is about _____ times more likely to receive the same diagnosis as a person whose only biological relative with schizophrenia is his or her non-twin sibling.

A. 50

B. 16

C. 5

D. 2

A

C. 5

you need to know that the risk for receiving a diagnosis of schizophrenia is about 46% for a person whose biological mother and father have received the diagnosis, while the risk is about 9% for a person whose biological non-twin sibling is the only relative who has received the diagnosis. Forty-six divided by 9 is 5.1, which means that a person whose biological mother and father have received the diagnosis of schizophrenia is about 5 times more likely to receive the diagnosis than a person whose only relative with schizophrenia is a biological non-twin sibling

36
Q

Which of the following is considered the most effective antipsychotic drug for treatment-resistant schizophrenia?

A. haloperidol

B. chlorpromazine

C. clozapine

D. risperidone

A

C. clozapine

EPPP Prep (3 decks)

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