Psychosis and Schizophrenia

Question 1

Normal Psychotic experiences

Answer 1

Transient Hallucinations (visual and tactile)
Hypnogogic (false perception while falling off to sleep)
Hypnopomic (false perception upon awakening)
Loosening of associations and illogical thinking decrease considerably after age 6 or 7.

Question 2

Psychosis

Answer 2

loss of contact with reality

Question 3

Hallucination

Answer 3

false perception

Question 4

Deluson

Answer 4

false belief

Question 5

Illusion

Answer 5

misinterpretation of a real phenomenon or occurence

Question 6

Catatonia

Answer 6

motor immobility and behavioral abnormality manifested by stupor; can include extreme loss of motor skills and purposeless hyperactivity.

Question 7

Most common causes of Psychosis in Children

Answer 7

Mood and anxiety

Question 8

Epidemiology

Answer 8

1 in 10,000 children
Rare before age 13, but incidence steadily increases during adolescence
Peak onset is aged 15-30 years
Youngest childhood diagnosis is 3 years
2:1 Male to Female in children ( males
1% of population

Question 9

The 4 As of Schizophrenia

Answer 9

Affective Blunting
Loosening of Associations (cognitive disorganization)
Autism
Ambivalence (indecisiveness)

Question 10

Positive Symptoms (occurring in mind and still active)

Answer 10

Auditory hallucinations
Thought insertions
Thought Broadcasting
Thought withdrawal
Believing in external force to be acting upon one's body
Ideas of referencing

Question 11

Negative symptoms (withdrawal into oneself)

Answer 11

Avolition
Associality
Diminished Emotional Expression
Alogia
Anhedonia

Question 12

Schizoaffective Disorder vs. schizophrenia vs. psychotic mood disorders

Answer 12

a. Schizoaffective—uninterrupted period of psychosis with intervals of depression or not have mania. MIXED OR EITHER
b. Schizophrenia- depressed periodically and sometimes psychotic.
c. Depression: stay depressed for a long time

Question 13

Neuroimaging studies and gray matter changes in adolescent schizophrenia

Answer 13

MRI brain scans show abnormally enlarged ventricles and decreased brain volume. The children lose 4-5 times more gray matter as do normal teens do (from back to front–visuospatial and associative thinking to sensorimotor and visual function)

Reduced cell size and total neurons in BG
Reduced amygdala, hippocampus, and parahippcampal volume.

Reduced prefrontal activity, thalamic abnormalities and reduction in size of cerebral vermis.

Question 14

Prognostic indications for Schizphrenia

Answer 14

Good: Acute onset, short duration of illness, lack of prior psychiatric history, presence of affective symptoms, confusion, or mood symptoms; good premorbid adjustment; steady work history; marriage; older age onset; female.

Bad: insidious onset, long duration of illness, psychiatric history, poor insight, OC symptoms, history of violence, premorbid personality disorder, poor work history, celibacy, young age at onset, family history

Question 15

Differential diagnosis of schizophrenia

Answer 15

Schizophrenia and schizoaffective Disorder
BP Disorder
Depression
PDD
Anxiety
PTSD
SUDS
Medication Induced