Schizo

Question 1

CATATONIA

Answer 1

• Negativism
• CATATONIC EXCITEMENT: purposeless and excessive motor activity without obvious cause
  
  • repeated stereotyped movements, staring, grimacing, mutism and echoing of speech
• can occur in bipolar, depressive and medical conditions

Question 2

avolution

Answer 2

decrease in motivated slef initiated purposeful activities

Question 3

alogia

Answer 3

diminished speech output

Question 4

anhedonia

Answer 4

decrease ability to experience pleasure from positive stimuli or degradation in the collection of pleasure previously experienced

Question 5

asociality

Answer 5

lack of interest in social interactions

Question 6

Schizotypal disorder

Answer 6

• pervasive pattern of social and interpersonal deficits marked by discomfort or inability to have close relationships as well as COGNITIVE and PERCEPTUAL DISTORTIONS and ECCENTRICITES of behavior
  
  • ideas of reference
  • ODD BELIEFS or MAGICAL THINKING
  • unusual perceptual experiences including BODILY ILLUSIONS
  • ODD THINKING OF SPEECH
  • SUSPICIOUS or paranoid ideation
• MORE PREVALENT IN MALES

Question 7

DELUSIONAL DISORDER

Answer 7

• PRESENCE OF ONE OR MORE DELUSIONS WITH A DURATION OF 1 MONTH OR LONGER
  
  • hallucinations are NOT PROMINENT and related to delusions
• Functioning is NOT markedly impaired and behaior is NOT obviously bizarre
• MANY TYPES (persecutory is most common)
  
  • jealous type is more common in males than females

Question 8

Specified types of DELUSIONAL DISORDERS

Answer 8

• Erotomanic = another person is in love with the individual
• Grandiose = conviction of having some great talent or insight or having made some important discovery
• Jealous = is that the spouse or lover is unfaithful
• persecutory = belief that one is being consipired against, cheated, spied on, followed, poisoned, drugged, maligned, harassed, or long term goals are obstructed
• somatic = involved bodily functions or sensations
• mixed = no one theme is prominent

Question 9

Brief psychotic disorder

Answer 9

• DURATION IS AT LEAST 1 DAY but not more than 1 months with eventual return to premorbid functioning
  
  • delusions
  • hallucinations
  • disorganized speech
  • grossly disorganized or catatonic behavior
• assocaited with emotional turmoil, INCREASE RISK OF SUICIDALITY in the acute episode

Question 10

Schizophremiform disorder

Answer 10

• 2 or more of the following PRESENT FOR A SIGNIFICANT TIME DURING a 1 MONTH PERIOD. (atleast 1 months but LESS THAN 6 MONTHS)
  
  • DELUSIONS
  • HALLUCINATION
  • DISORGANIZED SPEECH
  • grossly disorganized or catatonic behaior
  • negative symptoms (dimisnished emotional expression or avolittion)
• 1/3 recover in 6 months and the OTHERS PROGRESS TO SCHIZOPHRENIA or schizoaffective disorder

Question 11

SCHIZOPHRENIA

Answer 11

• 2 or more of the following PRESENT FOR A SIGNIFICANT TIME DURING A 1 month period (continuous signs of distrubance persist for AT LEAST 6 MONTHS with 1 month of active symptoms)
  
  • delusions
  • hallucinations
  • disorganized speech
  • grossly disorganized or catatonic behaior
  • negative symtpoms (diminished emotional expression)
    *

Question 12

Associated features supporting the diagnosist of SCHIZOPHRENIA

Answer 12

• lack of insight into their illness (anosognosia) and this is a symtpom not a coping strategy, similar to lack of awareness of enurological deficits following brain damage and this PREDICTS NON-ADHERENCE TO TX AND POORER OUTCOMES

Question 13

Males - schizophrenia

Answer 13

• early onset
• poorer premorbid adjustment
• lower educational achievement
• more brain structural abnormalities
• more negative signs and symptoms
• more cognitive impairment
• poorer outcomes
• 90% develop before age 30
• often do not marry, limited social contacts

Question 14

Female = schizophrenia

Answer 14

• later onset, lower icnedence
• less brain structural abnormalities
• less cognitive impairment
• better outcomes
• 25% develop before age 30
• symtpoms more affect laden
• more psychotic symptoms and symptoms worsen later in life
• greater tendency for lat onset cases after the age of 40

Question 15

schizoaffective disorder

Answer 15

• DELUSIONS OR HALLUCINATIONS for 2 or more weeks in the absence of a major mood episode during the lifetime duration of the illness
  
  • UNINTERRUPTED period of ilness during which there is a major mood episode

Question 16

dopamine model of schizo

Answer 16

increased mesolimbic dopaminergic acitivity (psychosis) medaited by reciprocal prefrontal dopaminergic hypoactivity (negative symtpoms)

Question 17

Glutamate model of schizo

Answer 17

• glutamate NMDA antagonists, like PCP and ketamine, produce psychotic, negative and cogntive symptoms in normal and psychotic relapse in schizophrenic patients

Question 18

Histopathological changes

Answer 18

• Decreased volume of hippocampus, thalamus, temproal and prefrontal cortex
• decreased total gray matter volume
• cyto-architectural abnormalities

Question 19

Neuroimaging changes

Answer 19

• lateral and third ventricle are enlarged
• bilateral, volume reduction
• if present at time of diagnosis this may progress to poor outcome patient
• larger ventricles in affected discordant monozygotic twins

Question 20

Functiona brain imaging

Answer 20

• hypofrontally at rest in chronic patients may correlate with negative symptoms
• consistent failure to activate prefrontal cortex during performance of cognitive task (deficit syndrome)
• temporal lobe activity increased at baseline-impaired activation in response to memory risk