Psychosis Parts I and II

Question 1

List 5 signs/symptoms of schitzophrenia

Answer 1

1. Delusions
2. Hallucinations
3. Disorganized thinking
4. Disorganized behavior
5. Negative symptoms

Question 2

Differentiate bizarre from non-bizarre delusions

Answer 2

Bizarre: clearly implausible, not understandable, and do not derive from ordinary life experiences
-“my wife is having an affair with Elvis.” “Aliens”

Non-bizarre: plausible- “My wife is having an affair” -but they know because the odometer was .1 miles longer than it should be- and a person who is delusional is 100% certain what they’re telling you is true

Question 3

What are the most common types of hallucinations?

Answer 3

1- Auditory
2- Visual
3- tactile (a distant third)

Question 4

If the only hallucinations someone has are hypnogogic or hypnopompic, should you be concerned for schitzophrenia?

Answer 4

No- not psychotic

Question 5

What is “disordered thinking” or “psychotic thinking”

Answer 5

Thought process is disorderly –> trouble thinking clearly and understanding others

Speech can be easily derailed or completely incoherent

Question 6

Describe disorganized behavior

Answer 6

Childlike agitation/silliness
Problems with goal directed behavior
Inappropriate sexual behavior
Shouting/swearing

Catatonic behavior

Question 7

Name the four negative symptoms associated with schizophrenia

Answer 7

Anhedonia (no pleasure in anything)
Alogia (no much to say)
Affective flattening (flat personality)
Avolution (no motivation to do anything)

You only have to have one of the four to have negative symptoms

Question 8

What are the schizophrenia b criteria?

Answer 8

Social/occupational dysfunction

Downward drift hypothesis (people with schizophrenia end up being poor)

Question 9

What is the time duration required from the diagnosis of schizophrenia?

Answer 9

Continuous signs for 6 months, with 1 month of criteria A symptoms (although less if treated)

…point: schizophrenia is a chronic disease

Question 10

How do you classify a psychotic episode that has been going on for less than a month?

Answer 10

Brief psychotic reaction or psychosis not otherwise specified

Question 11

What is the timing classification of schizophreniform disorder?

Answer 11

More than 1 month but less than 6th months of having symptoms

Question 12

What is the definition of schizoaffective disorder?

Answer 12

A major mood disorder (MDD or bipolar) AND schizophrenia’s A criteria are both met

BUT at some point, you have psychotic episodes WITHOUT the mood symptoms, for 2 weeks.

Not due to substances or medical illness

Question 13

Describe delusional disorder

Answer 13

Delusions, bizarre or non-bizarre, for at least 1 month

Criteria A for schizophrenia are never met

Fairly high functioning

Question 14

How can psychosis due to a substance be confused with schizophrenia?

Answer 14

Many schizophrenic are also substances abusers

Question 15

Describe the ways in which steroids can mimic schizophrenia

Answer 15

Steroids can cause psychotic episodes, depression, or mania

Question 16

Which three developmental disorders may be confused for schizophrenia initially?

Answer 16

Rhett’s syndrome, autism, asperger’s

Due to poor communication skills and flat affect/anhedonia

Question 17

What is a major distinguishing feature between personality disorders and schizophrenia?

Answer 17

There is no psychosis with the personality disorders

Question 18

Describe the “schizoid” personality disorder

Answer 18

social detachment and restricted affect

Negative symptoms of schizophrenia

Question 19

Describe the schizotypal personality disorder

Answer 19

Odd beliefs, unusual perceptual experience, odd speech, eccentric behavior

Are these delusions? Are these disorganized speech/behavior?

Question 20

What is the epidemiology of schizophrenia?

Answer 20

Prevalence -1%

Males = Females

Question 21

Describe the prodromal phase of schizophrenia

Answer 21

85% of schizophrenia will have a prodromal phase, often following the first psychotic break, that can last several months to years.

Question 22

What is the average age of onset for schizophrenia in both men and women

Answer 22

Men- 15/18-25

Women- 25-35/45 …is estrogen protective?

Question 23

What is the residual phase of schizophrenia?

Answer 23

Remission

Question 24

Does the severity of schizophrenia tend to be worse in men or women?

Answer 24

Worse in men

Maybe due to earlier onset? Maybe due to neuroprotective effect of estrogen?

Question 25

What is the suicide risk of schizophrenia?

Answer 25

20% attempt with a 6-8% completion

Question 26

Describe the progression of cognitive impairment associated with schizophrenia

Answer 26

Generally, onset is during the prodromal phase, and it worsens during an active phase

Question 27

What is the best predictor for a good prognosis in schizophrenia?

Answer 27

Good response to the first treatment

Question 28

What is a better prognosis for schizophrenia, sudden or gradual onset?

Answer 28

Sudden onset has a better prognosis

Question 29

Are schizophrenics more dangerous to society?

Answer 29

Not more so than the general population

Much greater risk of self-harm

Question 30

What is the chance you have schizophrenia if your identical twin has it?

Answer 30

50%

Question 31

What is your risk of developing schizophrenia if your parent or sibling has it?

Answer 31

10%