Psychotic Disorders (4-14-14)

Question 1

3 main categories of psychosis?

Answer 1

hallucinations
delusions
manifestations of thought disorder

Question 2

emphasized negative symptoms

Answer 2

Bleuler

Question 3

emphasized positive symptoms

Answer 3

Schneider

Question 4

general prevalence of schizophrenia

Answer 4

1%

Question 5

1 schizophrenic parent –> chance in offspring?

Answer 5

12%

Question 6

2 schizophrenic parents –> chance in offspring?

Answer 6

40%

Question 7

lifetime prevalence worldwide of schizophrenia?

Answer 7

1%

Question 8

downward drift hypothesis

Answer 8

affected people move into or stay in low socioeconomic group

Question 9

social causation hypothesis

Answer 9

stresses that members of low socioeconomic groups experience contribute to their development of schizophrenia

Question 10

dopamine hypothesis

Answer 10

Over-activity or excess of dopamine system
came from 2 supporting observations:
-efficacy of dopamine receptor antagonists
-psychotomimetic effects of dopamine agonists

Question 11

relevant dopamine pathways

Answer 11

mesolimbic -> positive symptoms
mesocortical –> negative symptoms
nigrostriatal –> extra-pyramidal symptoms (EPS)
tuberoinfundibular –> prolactin secretion

Question 12

serotonin system

Answer 12

• 5HT2 antagonism –> stop psychotic symptoms

- serotonin has inhibitory relationship w/ dopamine

Question 13

neuroanatomy findings

Answer 13

none are diagnostically specific or clinically useful

• reduced brain volume
• small amygdala, hippocampus, parahippocampus
• large lateral and 3rd ventricle

Question 14

positive symptoms

Answer 14

formal thought disorder
hallucinations
bizarre behaviors
delusions**
catatonia

Question 15

negative symptoms

Answer 15

fewer spontaneous movements
speech blocking
avolition = apathy, poor grooming, anergia, anhedonia, attention deficits

Question 16

pre-morbid phase of illness

Answer 16

early on in life
problems in maturation, cognition, emotional/social life
attention deficits
magical thinking, day dreaming, can’t maintain relationshios
**none of these can predict future schizo

Question 17

prodromal phase

Answer 17

hard to diagnose
wrongfully labeled as depressed
vagueness in thinking
abnormal preoccupations
perceptual disturbances

Question 18

psychotic phase

Answer 18

positive symptoms

Question 19

convalescent phase

Answer 19

starts when symptoms stop after treatment

high risk to relapse (if stop Rx)

Question 20

stable phase

Answer 20

phateau after 2-3 yrs

chronic disease w/ relapsing nature

Question 21

criteria A to diagnose, need 2 or more in at least 1 month. Exceptions?

Answer 21

delusions
hallucinations
disorganized speech
disorganized/catatonic behavior
negative symptoms

Only need 1 if delusions= bizarre or haullicinations = voices

Question 22

good prognostic factors

Answer 22

low emotion
female
acute onset
affective symptoms
positive symptoms
married
confusion

Question 23

poor prognostic factors

Answer 23

high emotion 
male
slow onset
substance use
no affective symp.
negative symp.
never married
clear sensorium

Question 24

schizophreniform vs. brief psychotic disorder

Answer 24

schizophreniform
-1 month –> 6 months

brief psychotic

• 1 day –> 1 month
• no stressor needed

Question 25

schizoaffective disorders

Answer 25

symptoms of schizophrenia + mood disorders (depression + mania)
symptoms at least 2 weeks

Question 26

low potency neuroleptic

Answer 26

chlorpromazine (thorazine)
thioridazine
mesoridazine