Schizophrenia (2 & 3)

Question 1

What is schizophrenia?

Answer 1

chronic, debilitating illness associated with deterioration in mental function and behavior

Question 2

What is the hallmark symptom of schizophrenia?

Answer 2

psychosis

Question 3

What is psychosis?

Answer 3

Impairment in reality testing that may present as:

1- alteration in sensory perceptions (hallucinations)

2- abnormalities in thought content (delusions)

3- abnormalities in thought process organization

Question 4

What are the symptoms of psychosis?

Answer 4

1- Illusion
2- Hallucinations
3- Idea of Reference
4- Delusions
5- Loss of ego boundaries
6- Alogia
7- Echolalia
8- Thought blocking
9- Neologisms
10- Circumstantiality
11- Tangentiality
12- Loose associations

Question 5

What are illusions?

Answer 5

Misperception of real external stimuli

Question 6

What are hallucinations?

Answer 6

Sensory perceptions not generated by external stimuli

Question 7

What are ideas of reference?

Answer 7

False convictions that one is subject of attention by other people

Question 8

What are delusions?

Answer 8

False beliefs not correctable by logic or region

Question 9

What is loos of ego boundaries

Answer 9

Not knowing where one’s mind and body end and those of another begin

Question 10

What is alogia?

Answer 10

Lack of informative content in speech

Question 11

What is echolalia?

Answer 11

Repeated statements of others. associating words by their sound

Question 12

What is thought blocking?

Answer 12

Abrupt halt in the train of thrinking (often b/c of hallucinations)

Question 13

What is neogiasms?

Answer 13

Invention of new words

Question 14

What is circumstantiality?

Answer 14

In responding to a question one responds unnecessarily with voluminous information

Question 15

What is tangentiality?

Answer 15

Begins with proper response and get further and further away from the point

Question 16

What are loose associations?

Answer 16

Loss of logical meaning between words and thoughts

Question 17

What are the characteristic symptoms needed to diagnose schizophrenia?

Answer 17

2 or more for 1 month:

Delusions, hallucination, grossly disorganized or catatonic behavior, negative symtoms, disorganized speech

Question 18

What are the social/ occupational dysfunctions needed to diagnose schizophrienia?

Answer 18

One or more major areas of functioning are markedly below the level achieved prior to onset

Question 19

What is the duration of time needed to make a diagnosis of schizophrenia?

Answer 19

6 months, with at least 1 month of constant symptoms

Question 20

What are the positive symptoms of schizophrenia? (5)

Answer 20

Delusions, hallucinations, agitation, talkativeness, thought disorder

Question 21

What are the negative symptoms of schizophrenia? (6)

Answer 21

Lack of motivation, social withdrawal, flattened affect, cognitive disturbances, poor grooming, poor specch

Question 22

Why were the schizophrenia subtypes eliminated in the DSM-5?

Answer 22

B/c limited diagnostic stability, low reliability and poor validity

Question 23

What is the course of schizophrenia? (3 stages)

Answer 23

1- Prodrome

2- Psychotic/ active

3- Residual (period between psychotic breaks)

Question 24

What are some etiologic factors associated with the development of schizophrenia?

Answer 24

1- advanced paternal age

2- genetic links

3- viral infection/ exposure to drugs in development

4- 3rd trimester maternal use of diuretics

Question 25

Explain the neuro abnormality seen in the frontal lobes of people with schizophrenia?

Answer 25

Decreased glucose in the PFC –> hypofunctionality

Question 26

What happens to the ventricles in schizophrenia?

Answer 26

Lateral and 3rd ventricles are enlarged

Question 27

What changes are seen on EEG in schizophrenia?

Answer 27

Decreaesd alpha waves and increased theta and delta waves

Question 28

What are positive symptoms due to?

Answer 28

Excessive DA in mesolimbic tract

Question 29

What are negative symptoms due to?

Answer 29

hypoactivity of mesocortical DA tract

Question 30

What symptoms are seen in serotonin hyperactivity?

Answer 30

hallucinations

Question 31

What symptoms are seen in NE hyperactivity?

Answer 31

Paranoid subtype of schizophrenia

Question 32

What is the major excitatory neurotransmitter i the CNS?

Answer 32

Glutamate

Question 33

Explain the NMDA receptor hypoactivity hypothesis?

Answer 33

Mutated NMDA receptr can become inactive or underactive.

If these mutated NMDA receptors are on GABA interneurons, the GABA neurons lose their inhibitory function.

Question 34

What happens when GABA neurons lose their inhibitory function?

Answer 34

Allows for excessive firing and ultimately an increase in firing in the VTA which sends extra DA into the limbic system–> psychosis

Question 35

GLU-GABA-GLU-GAMA-DA

Answer 35

hypofunctioning–> negative symptoms

Question 36

GLU-GABA-GLU-DA

Answer 36

hyperfunctioning–> positive symptoms

Question 37

What is brief psychotic disorder?

Answer 37

1-29 days of schizophrenia symptoms

Question 38

What is schizophreniform disorder?

Answer 38

1-6 months of symptoms

Question 39

What is schizoeffective disorder?

Answer 39

Schizophrenia + mania or depression

Question 40

What is delusional disorder?

Answer 40

Delusions only

Question 41

What is shared psychotic disorder?

Answer 41

One person is delusional and a second person develops same delusion

Question 42

How is schizophrenia medicinally managed?

Answer 42

Antipsychotics–> block D2 receptors

Typical antipsychotics only block D2 receptors

Atypical antipsychotics also block 5HT2 receptos

Question 43

What are the typical antipsychotics used?

Answer 43

Haloperidol and chlorpromazine

Question 44

What are the atypical antipsychotics used?

Answer 44

‘pines and ‘dones

Question 45

Does psychotherapy work for schizophrenia?

Answer 45

Yes, fosters treatment compliance and CBT works

Question 46

What is the prognosis of an individual with schizophrenia?

Answer 46

Lifelong impairment with chronic downhill course

Negative symptoms increase with time.

Increased suicide risk