schizophrenia

Question 1

What is schizophrenia?

Answer 1

Schizophrenia is a severe and chronic mental disorder that affects how a person thinks, feels, and behaves. It is characterized by profound disruptions in cognition, perception, emotion, and social interactions. Symptoms typically emerge in late adolescence or early adulthood and can cause significant impairment in daily functioning.

Question 2

What are the two main types of symptoms in schizophrenia?

Answer 2

Schizophrenia symptoms are categorized into:

Positive symptoms: These involve an excess or distortion of normal functions, including hallucinations (false sensory experiences) and delusions (strong false beliefs).
Negative symptoms: These reflect a reduction or loss of normal functioning, such as avolition (lack of motivation) and speech poverty (diminished speech output). Negative symptoms often contribute to long-term disability.

Question 3

What are hallucinations?

Answer 3

Hallucinations are sensory experiences that occur in the absence of external stimuli. They can affect any of the five senses, but the most common types are:

Auditory hallucinations: Hearing voices or sounds that are not there. These voices may be critical, commanding, or conversational.
Visual hallucinations: Seeing people, shapes, or lights that do not exist.
Other types include olfactory (smell), gustatory (taste), and tactile (touch) hallucinations, though these are less common.

Question 4

What are delusions?

Answer 4

Delusions are false, firmly held beliefs that persist despite evidence to the contrary. Common types include:

Persecutory delusions: Believing one is being followed, harassed, or conspired against.
Grandiose delusions: Believing one has special powers, talents, or is an important figure (e.g., believing they are a deity or celebrity).
Delusions of control: Believing that one’s thoughts or actions are being controlled by external forces, such as aliens or government agencies.

Question 5

What is speech poverty?

Answer 5

Speech poverty, also known as alogia, is a negative symptom of schizophrenia characterized by a reduction in speech output. It may manifest as:

Reduced frequency of speech: The individual speaks less often than usual.
Impoverished content: Responses may be vague, monosyllabic, or lack detail.
Thought-blocking: Sudden interruptions in speech due to loss of train of thought.
Speech poverty is thought to reflect underlying disorganized thinking and cognitive impairment.

Question 6

What are the reliability issues in diagnosing schizophrenia?

Answer 6

Poor inter-rater reliability: Different clinicians may diagnose the same patient differently.
Lack of diagnostic consistency: Symptoms of schizophrenia overlap with other disorders, making consistent diagnosis challenging.
Subjective symptom assessment: Hallucinations and delusions rely on patient self-report, which can vary in interpretation.

Question 6

What is avolition?

Answer 6

Avolition is a negative symptom of schizophrenia involving a severe lack of motivation to initiate and sustain goal-directed activities. It can manifest as:

Neglect of personal hygiene: Failing to wash or change clothes.
Loss of interest in social activities: Withdrawal from family and friends.
Difficulty completing tasks: Struggling to maintain employment or academic work.
Avolition is linked to dysfunction in the ventral striatum, a brain region involved in motivation and reward processing.

Question 7

What is the DSM-5 diagnostic criteria for schizophrenia?

Answer 7

At least two symptoms are present for a minimum of one month, with at least one of the following being required:
Delusions
Hallucinations
Disorganized speech
Additional symptoms may include grossly disorganized or catatonic behavior and negative symptoms.
Symptoms must cause significant impairment in daily functioning (e.g., work, relationships).
Continuous disturbance must persist for at least six months.

Question 7

What is the difference between the DSM-5 and ICD-10 in diagnosing schizophrenia?

Answer 7

DSM-5: Requires at least two symptoms to be present for one month, with one being delusions, hallucinations, or disorganized speech.
ICD-10: Allows for a diagnosis based on one severe symptom (e.g., persistent hallucinations or bizarre delusions). The ICD-10 criteria are considered broader, potentially leading to higher diagnosis rates.

Question 8

What are the validity issues in diagnosing schizophrenia?

Answer 8

Symptom overlap: Many schizophrenia symptoms (e.g., hallucinations, delusions) are also found in other disorders like bipolar disorder and schizoaffective disorder.
Co-morbidity: Schizophrenia frequently co-occurs with depression, anxiety, and substance abuse, making it difficult to determine if symptoms are due to schizophrenia alone.
Cultural variations: Symptoms like hallucinations may be interpreted differently in various cultures, affecting diagnostic accuracy.

Question 9

What is co-morbidity?

Answer 9

Co-morbidity occurs when a person has two or more disorders simultaneously, such as schizophrenia with:

Depression
Anxiety disorders
Substance use disorders
This complicates diagnosis and treatment, as symptoms of different conditions can overlap.

Question 9

What is symptom overlap?

Answer 9

Symptom overlap refers to the similarity of symptoms between schizophrenia and other mental disorders, making diagnosis challenging.

For example, hallucinations and delusions are present in both schizophrenia and bipolar disorder.
Disorganized speech occurs in schizophrenia but can also appear in autism spectrum disorder.
This overlap affects the validity of schizophrenia as a distinct disorder.

Question 10

What is gender bias in schizophrenia diagnosis?

Answer 10

Women are often underdiagnosed or diagnosed later than men.
Women may display fewer negative symptoms and better social functioning, which can lead to misdiagnosis or delayed treatment.
Hormonal differences (e.g., estrogen’s protective effects) might contribute to differences in symptom severity.

Question 11

What is cultural bias in schizophrenia diagnosis?

Answer 11

Some ethnic groups, particularly Black and minority ethnic (BME) populations, have higher diagnosis rates of schizophrenia.
This may be due to:
Cultural differences in symptom expression (e.g., hearing voices may be seen as spiritual rather than pathological in some cultures).
Clinician bias in interpreting symptoms.

Question 12

What are the genetic explanations of schizophrenia?

Answer 12

Schizophrenia is polygenic, meaning multiple genes contribute to its development.
Family and twin studies show a strong genetic component:
Monozygotic (MZ) twins: 48% concordance rate.
Dizygotic (DZ) twins: 17% concordance rate.

Question 12

What did Gottesman’s family study show?

Answer 12

Gottesman’s study found that the risk of developing schizophrenia increases with genetic relatedness:

MZ twins: 48% risk.
DZ twins: 17% risk.
Children with one schizophrenic parent: 13% risk.
General population: 1% risk.

Question 13

How do antipsychotic drugs support the dopamine hypothesis?

Answer 13

Typical antipsychotics (e.g., chlorpromazine) block dopamine receptors, reducing positive symptoms.
Atypical antipsychotics (e.g., clozapine) also target serotonin and dopamine, improving negative symptoms.

Question 13

What is the dopamine hypothesis?

Answer 13

Schizophrenia is associated with excess dopamine activity, especially in subcortical areas like the mesolimbic pathway.
Hyperdopaminergia (high dopamine levels) in the striatum is linked to positive symptoms (e.g., hallucinations, delusions).

Question 14

What are neural correlates?

Answer 14

. abnormal brain structures or activity patterns linked to schizophrenia symptoms.
. fMRI and PET scans have helped identify these differences.

Positive Symptoms Linked to hyperactivity in the superior temporal gyrus and anterior cingulate gyrus — areas involved in processing auditory and emotional information.

Allen et al. (2007) found lower activity in the superior temporal gyrus during hallucinations.

.Negative Symptoms Linked to reduced activity in the ventral striatum, a brain region involved in reward and motivation.

. Juckel et al. (2006) found that patients with schizophrenia had significantly lower ventral striatum activity than healthy controls, correlating with higher levels of avolition.
Structural Abnormalities:
Enlarged ventricles (fluid-filled cavities in the brain) are consistently found in schizophrenia patients, especially those with chronic symptoms.
Enlarged ventricles are linked to brain tissue loss and negative symptoms like speech poverty.
Some studies suggest that the prefrontal cortex (involved in decision-making and social behavior) shows reduced activity in patients with schizophrenia.

Question 15

What are the evaluation points of the genetic explanation?

Answer 15

✔️ Research Support:

Gottesman’s family study shows a 48% concordance rate in MZ twins compared to 17% in DZ twins, supporting the role of genetics.
Tienari et al. (2004) found higher schizophrenia rates in adopted children with schizophrenic biological parents compared to controls.
❌ Nature vs. Nurture:

High concordance rates in MZ twins could be due to shared environments, not just genetics.
Adoption studies show that children with a genetic risk are more likely to develop schizophrenia only in dysfunctional environments, suggesting gene-environment interaction.

Question 16

How does family dysfunction contribute to schizophrenia?

Answer 16

Family dysfunction refers to abnormal family communication and relationships that may trigger or worsen schizophrenia.

Double Bind Theory (Bateson et al., 1956): Children receive contradictory messages from parents (e.g., “I love you” said in a cold tone), making them feel trapped and leading to disorganized thinking.
Expressed Emotion (EE): High levels of criticism, hostility, and emotional over-involvement in families increase the risk of relapse.

Question 16

What are the evaluation points of the dopamine hypothesis?

Answer 16

✔️ Evidence from Drug Studies:

Antipsychotic drugs (e.g., Chlorpromazine) that reduce dopamine activity alleviate positive symptoms like hallucinations.
Amphetamines (which increase dopamine levels) can produce schizophrenia-like symptoms in healthy people.
❌ Oversimplification:

Dopamine alone cannot explain all symptoms — negative symptoms like avolition are more likely linked to low dopamine in certain areas or glutamate dysfunction.
Newer research highlights the role of multiple neurotransmitters like glutamate and serotonin.

Question 17

What is Expressed Emotion (EE)?

Answer 17

Expressed Emotion is a communication style within families characterized by:

Criticism: Negative comments about the patient’s behavior.
Hostility: Aggressive attitudes towards the patient.
Emotional Over-Involvement: Overprotective or excessively concerned behavior.
Higher levels of EE are linked to higher relapse rates (Brown, 1972).

Question 17

What are the evaluation points of family dysfunction?

Answer 17

✔️ Supporting Research:

Brown (1972) found that patients returning to high EE families had 58% relapse rates, compared to 10% in low EE families.
Tienari et al. (2004) showed that adopted children with a genetic risk were more likely to develop schizophrenia in dysfunctional families.
❌ Cause or Effect?

Family dysfunction could be a consequence of the patient’s symptoms rather than a cause.
Many patients without family dysfunction still develop schizophrenia, suggesting biological factors play a greater role.

Question 18

What is Metarepresentation?

Answer 18

Metarepresentation is the ability to reflect on one's own thoughts and the intentions of others. Deficits in metarepresentation cause patients to struggle with identifying their own thoughts as self-generated, which may lead to auditory hallucinations.

Question 18

What is the cognitive explanation of schizophrenia?

Answer 18

The cognitive explanation focuses on how faulty information processing contributes to symptoms. Schizophrenic patients may have problems with attention, memory, and perception. Two key types of cognitive dysfunction: Metarepresentation Deficits: Inability to reflect on one’s own thoughts, leading to hallucinations (e.g., thinking inner speech is coming from an external source). Central Control Deficits: Inability to suppress automatic responses, linked to disorganized speech (e.g., word salad).

Question 19

What is Central Control?

Answer 19

Central control is the ability to suppress automatic responses and focus on a goal. Deficits in central control are linked to disorganized speech, as patients struggle to suppress automatic word associations during conversations.

Question 20

What are the evaluation points of the cognitive explanation?

Answer 20

✔️ Explains Specific Symptoms: Cognitive explanations account for positive symptoms like hallucinations and negative symptoms like speech poverty. ❌ Descriptive, Not Causal: Cognitive dysfunction explains how symptoms occur, but not what causes schizophrenia in the first place. It may be the result of biological abnormalities rather than the root cause.

Question 20

What is the main biological treatment for schizophrenia?

Answer 20

The primary biological treatment is antipsychotic drugs, which work by altering the action of neurotransmitters in the brain to reduce symptoms.

Question 21

What are Atypical Antipsychotics?

Answer 21

Atypical antipsychotics are newer drugs (e.g., Clozapine and Risperidone) developed in the 1990s. They target both dopamine and serotonin systems. Clozapine is effective for treatment-resistant patients but can cause agranulocytosis (a life-threatening blood disorder).

Question 22

What are Typical Antipsychotics?

Answer 22

Typical antipsychotics are first-generation drugs (e.g., Chlorpromazine) developed in the 1950s. They work by blocking dopamine receptors (D2 receptors), reducing positive symptoms like hallucinations. Side effects include tardive dyskinesia and sedation.

Question 23

What are the side effects of Atypical Antipsychotics?

Answer 23

Weight gain. Agranulocytosis (with Clozapine). Lower risk of tardive dyskinesia compared to typical antipsychotics

Question 23

What are the evaluation points of drug treatments?

Answer 23

✔️ Effective for Positive Symptoms: Antipsychotics are highly effective at reducing hallucinations and delusions. ❌ Less Effective for Negative Symptoms: Drugs do not significantly improve avolition or speech poverty. ❌ Ethical Issues: Patients may not be able to give informed consent if they lack insight into their condition.

Question 24

What is CBT for Schizophrenia?

Answer 24

Cognitive Behavioural Therapy (CBT) helps patients: Identify and challenge irrational beliefs. Develop coping strategies to manage symptoms.

Question 25

What are the side effects of Typical Antipsychotics?

Answer 25

Tardive Dyskinesia: Involuntary facial movements (affects 30% of patients). Sedation: Feeling drowsy or sluggish. Weight gain.

Question 26

What is Family Therapy?

Answer 26

Family therapy aims to: Improve family communication. Reduce expressed emotion. Lower relapse rates.

Question 26

What are the evaluation points of CBT?

Answer 26

✔️ Effective for Reducing Symptom Severity: Jauhar et al. (2014) found that CBT significantly reduces positive symptoms. ❌ Not a Cure: CBT helps patients cope with symptoms but does not eliminate them.

Question 27

What is Token Economy?

Answer 27

A behavioural therapy used in hospitals where patients receive tokens for desirable behaviours (e.g., personal hygiene or social interaction), which can be exchanged for reward

Question 28

What is the Interactionist Approach to Schizophrenia?

Answer 28

The Interactionist Approach combines biological and psychological explanations. The Diathesis-Stress Model suggests schizophrenia is caused by a combination of genetic vulnerability (diathesis) and environmental stressors (e.g., trauma or drug use).

Question 29

What is the diathesis-stress model of schizophrenia?

Answer 29

The Diathesis-Stress Model suggests that schizophrenia is caused by an interaction between genetic vulnerability (diathesis) and environmental stressors. Old View: The diathesis was thought to be purely genetic. Modern View: Diathesis includes psychological trauma, such as childhood abuse, which can alter brain development and increase vulnerability. Environmental stressors can include family dysfunction, substance abuse, or major life events.

Question 29

What research supports the diathesis-stress model

Answer 29

✔ Tienari et al. (2004) – Finnish Adoption Study: Studied 19,000 Finnish adoptees. Found that children with a genetic predisposition (schizophrenic biological mother) were more likely to develop schizophrenia if raised in dysfunctional families.

Question 29

What is a strength of the diathesis-stress model?

Answer 29

✔ Comprehensive Explanation: Unlike purely biological or psychological explanations, it accounts for both nature and nurture. Can explain why some people with a genetic risk never develop schizophrenia – they may not experience enough environmental stress.

Question 30

What is a limitation of the diathesis-stress model?

Answer 30

❌ Difficulty Establishing Cause and Effect: It is hard to determine whether stressors (e.g., family dysfunction) cause schizophrenia or are a result of early symptoms. Not all individuals with genetic vulnerability develop schizophrenia, even in high-stress environments, suggesting other protective factors might be involved.

Question 30

What are the cognitive deficits linked to schizophrenia?

Answer 30

Cognitive deficits refer to faulty thinking processes that contribute to schizophrenia symptoms: Metarepresentation: Inability to reflect on one’s own thoughts, leading to hallucinations (e.g., hearing voices and believing they are external). Central Control: Inability to suppress automatic responses, leading to disorganised speech (e.g., thought disorder, word salad).

Question 31

What research supports cognitive deficits in schizophrenia?

Answer 31

✔ Stirling et al. (2006) – The Stroop Test: Compared schizophrenic patients to a control group. Patients took twice as long to complete the Stroop Test (a task requiring the suppression of automatic responses). Supports the idea that schizophrenia involves deficits in central control.

Question 32

What is the dopamine hypothesis (revised version)?

Answer 32

both high and low dopamine activity contribute to schizophrenia: Excess dopamine in subcortical areas → Causes positive symptoms (e.g., hallucinations, delusions). Low dopamine in the prefrontal cortex → Causes negative symptoms (e.g., avolition, speech poverty). This explains why some symptoms are not improved by dopamine-blocking drugs, as other areas of the brain may have dopamine deficits.

Question 32

What is the supporting research for the revised dopamine hypothesis?

Answer 32

✔ Patel et al. (2010) – PET Scan Study: Found lower dopamine levels in the prefrontal cortex of schizophrenic patients. Supports the idea that negative symptoms are linked to dopamine underactivity, not overactivity.

Question 33

How do neural correlates link to schizophrenia symptoms?

Answer 33

✔ Brain activity and symptoms: Lower activity in the ventral striatum → Linked to avolition (lack of motivation). Higher activity in the superior temporal gyrus → Linked to hallucinations. Brain scans show that different areas of the brain are affected, depending on the symptom type.

Question 33

What is the double bind theory?

Answer 33

The double bind theory (Bateson et al., 1956) suggests that schizophrenia is linked to contradictory messages from parents. A child receives conflicting verbal and non-verbal cues (e.g., a mother saying "I love you" while acting distant). This confusion leads to difficulties in understanding reality, increasing the risk of schizophrenia.

Question 33

What is the evaluation of neural correlates?

Answer 33

✔ Scientific Methods: Brain imaging techniques (fMRI, PET scans) provide objective and reliable evidence. ❌ Correlation ≠ Causation: Abnormal brain activity may not be the cause of schizophrenia – it could be a consequence of the disorder.

Question 34

What is the supporting research for the double bind theory?

Answer 34

✔ Bateson et al. (1956): Found that schizophrenic patients often reported confusing and contradictory communication patterns in their childhood. Suggests that family communication issues may contribute to schizophrenia.

Question 34

What is the evaluation of the double bind theory?

Answer 34

✔ Explains Family Influence: Provides a psychological explanation for why family dysfunction may contribute to schizophrenia. ❌ Lack of Direct Evidence: Hard to scientifically test whether double bind communication directly causes schizophrenia. Some patients develop schizophrenia without a dysfunctional family background, suggesting other factors are involved.

Question 35

. What is the role of Expressed Emotion (EE) in schizophrenia?

Answer 35

Expressed Emotion (EE) refers to high levels of emotional negativity in family communication: Criticism → Negative comments about the patient’s behavior. Hostility → Aggressive attitudes toward the patient. Emotional Over-Involvement → Overprotective, controlling behaviors. High EE is linked to higher relapse rates in schizophrenia patients.

Question 36

What supporting research is there for EE?

Answer 36

✔ Brown (1972) – Family Study: Found that schizophrenia patients in high EE families had a relapse rate of 58%, compared to 10% in low EE families. Suggests that EE plays a role in worsening symptoms rather than causing schizophrenia.

Question 36

What is the evaluation of EE?

Answer 36

✔ Practical Applications: Family therapy reduces EE and improves patient outcomes. ❌ Only Explains Relapse: EE explains why schizophrenia relapses, but not what causes it in the first place.

Question 37

How do atypical antipsychotics work?

Answer 37

Atypical antipsychotics block both dopamine and serotonin receptors, helping to treat: Positive symptoms (e.g., hallucinations). Negative symptoms (e.g., avolition). Clozapine also reduces anxiety and improves cognitive function.

Question 37

What research supports atypical antipsychotics?

Answer 37

✔ Meltzer et al. (2012) – Effectiveness Study: Found that Clozapine was more effective than typical antipsychotics in 30-50% of treatment-resistant cases. Suggests that serotonin and dopamine interactions are important in schizophrenia treatment.

Question 37

What is the evaluation of atypical antipsychotics?

Answer 37

✔ Fewer Side Effects: Lower risk of tardive dyskinesia compared to typical antipsychotics. ❌ Risk of Agranulocytosis: Clozapine can cause agranulocytosis, a potentially fatal blood disorder. Requires regular blood monitoring for patients.

Question 38

What is the supporting research for CBT?

Answer 38

✔️ Tarrier et al. (2000): Compared patients receiving CBT + medication to those receiving medication alone. The CBT group showed fewer symptoms and greater improvement in coping strategies. Suggests that CBT is more effective than medication alone in symptom reduction.

Question 38

What are the ethical issues with antipsychotic drugs?

Answer 38

❌ Severe Side Effects: Long-term use can cause weight gain, tremors, and metabolic disorders. ❌ Lack of Informed Consent: Some patients lack insight into their condition, making it difficult to obtain valid consent for treatment.

Question 38

What is CBT for schizophrenia?

Answer 38

Cognitive Behavioural Therapy (CBT) is a psychological treatment that helps patients: Identify and challenge irrational beliefs (e.g., delusions like persecution). Develop alternative explanations for hallucinations or delusions. Use coping strategies such as relaxation techniques or thought distraction. Focus on improving self-awareness and reducing the distress caused by symptoms. CBT does not eliminate symptoms but helps patients manage their impact.

Question 39

What is the evaluation of CBT?

Answer 39

✔️ Effective in Reducing Symptoms: Research shows CBT reduces symptom severity, especially for positive symptoms like delusions. Helps patients develop coping mechanisms to live more independently. ❌ Does Not Prevent Relapse: CBT helps manage symptoms but does not address the biological causes of schizophrenia. High relapse rates if not combined with medication.

Question 40

What is family therapy?

Answer 40

Family therapy aims to: Improve communication and interaction between family members. Reduce levels of Expressed Emotion (EE) (e.g., criticism, hostility). Increase family understanding of schizophrenia to create a supportive environment. Encourage problem-solving skills and better medication compliance. It typically involves 10-20 sessions over several months.

Question 41

What research supports family therapy?

Answer 41

✔️ Pharoah et al. (2010) – Meta-Analysis: Reviewed multiple studies on family therapy. Found that family therapy significantly reduced relapse rates and improved medication compliance. Supports the idea that family therapy creates a more supportive environment for patients.

Question 42

What is the token economy system?

Answer 42

Token Economy is a form of behavioural therapy used in psychiatric hospitals. Patients are rewarded with tokens for positive behaviours (e.g., personal hygiene, social interaction). Tokens can be exchanged for privileges (e.g., extra TV time, snacks). Based on operant conditioning – reinforcing desirable behaviours to improve daily functioning.

Question 42

What is the evaluation of family therapy?

Answer 42

✔️ Reduces Relapse Rates: Evidence shows family therapy reduces hospital readmission rates and improves quality of life. ❌ Requires Family Cooperation: Not all families are willing or able to engage in therapy. Success depends on the family's willingness to change their behaviour.

Question 43

What is the evaluation of token economy?

Answer 43

✔️ Improves Daily Functioning: Helps patients adopt better self-care habits and become more independent. ❌ Ethical Issues: Treating patients like children may be seen as degrading. Those with more severe symptoms may struggle to earn tokens, leading to discrimination

Question 44

. What supporting research is there for token economy?

Answer 44

✔️ Ayllon & Azrin (1968): Introduced token economy in a psychiatric hospital. Found that self-care behaviours (e.g., brushing teeth) significantly improved among patients. Demonstrates that token economy can increase independent functioning.

Question 45

What is the interactionist treatment approach?

Answer 45

The interactionist approach combines: Biological treatments (antipsychotic drugs) Psychological therapies (CBT, family therapy, or token economy) Based on the Diathesis-Stress Model, which suggests that both genetic vulnerability and environmental factors contribute to schizophrenia.

Question 46

What supporting research is there for interactionist treatments?

Answer 46

✔️ Tarrier et al. (2004): Patients receiving combined treatments (medication + CBT) showed greater symptom reduction than those receiving medication alone. Suggests that interactionist treatments are more effective in the long-term management of schizophrenia.

Question 46

What is the evaluation of the interactionist approach?

Answer 46

✔️ Holistic Treatment: Treats both biological and psychological symptoms. Reduces relapse rates compared to medication alone. ❌ Expensive and Time-Consuming: Psychological therapies require trained therapists and long treatment periods, which can be costly.

Question 47

What are the ethical issues in schizophrenia research?

Answer 47

Informed Consent: Patients may lack mental capacity to fully understand research procedures. Deception in Placebo Trials: Patients may be given placebos without being aware, denying them effective treatment.

Question 47

What is the overall effectiveness of schizophrenia treatments?

Answer 47

Drug Treatments → Most effective for positive symptoms (e.g., hallucinations). CBT → Helps patients cope with delusions and reduce symptom distress. Family Therapy → Reduces relapse rates by improving family communication. Token Economy → Improves daily functioning in hospital settings. The Interactionist Approach is the most effective as it combines biological and psychological treatments.

Question 48

How does schizophrenia affect social functioning?

Answer 48

Poor social relationships and isolation. High rates of unemployment (up to 80% of patients). Difficulties in maintaining friendships or romantic relationships. Increased risk of homelessness and substance abuse.

Question 49

What is the genetic concordance rate in identical twins?

Answer 49

✔️ Gottesman (1991): Concordance rate for monozygotic (MZ) twins: 48% Concordance rate for dizygotic (DZ) twins: 17% Shows a strong genetic influence, but the fact that MZ twins are not 100% suggests environmental factors also play a role.

Question 50

What is the role of glutamate in schizophrenia?

Answer 50

Recent research suggests that low glutamate activity is linked to: Cognitive deficits Negative symptoms (e.g., avolition) Glutamate plays a key role in the prefrontal cortex and may explain why some patients do not respond to dopamine-based treatments.

Question 51

What is the evaluation of glutamate explanations?

Answer 51

✔️ Explains Cognitive Symptoms: Provides an explanation for negative symptoms, which dopamine theories cannot fully explain. ❌ Less Research than Dopamine Hypothesis: The dopamine hypothesis remains the dominant theory, with more supporting evidence.

Question 52

What is the relapse rate for patients on medication alone?

Answer 52

Approximately 40% of patients relapse within one year if they rely on medication alone.

Question 53

What is the most effective approach to treating schizophrenia?

Answer 53

The Interactionist Approach is considered the most effective because it: Combines biological and psychological treatments. Reduces symptom severity and relapse rates. Treats both positive and negative symptoms.