Schizophrenia

Question 1

Who classified the symptoms of schizophrenia based on the physical etiology, termed dementia praecox (course of delusions, hallucinations, and bazzare motor problems) which separated it from depression?

Answer 1

Emil Kraepelin (1856-1926)

Question 2

Who indicated that emotions, perceptions, and cognitions split off from the others in schizophrenia?

Answer 2

Eugene Bleuler (1857-1939)

Question 3

What were the 4 A’s that Bleuler used for schizophrenia?

Answer 3

Associations (loosened)
Affect (excited or withdrawn)
Ambivalence
Autism (living in an internal/unrealistic world)

Question 4

Who characterized 1st and 2nd rank symptoms for schizophrenia, where you only need 1 1st rank for a Dx and 2nd rank were a little more vague for a Dx?

Answer 4

Kurt Schneider (1887-1967)

Question 5

In the 1966 adoptive study, the 47 adoptees that had schizophrenia had what parental relation?

Answer 5

All schizophrenic children had schizophrenic mothers

Question 6

Generally what is the correlation between the consinguinity and the incidence of schizophrenia?

Answer 6

Closer consanguinity = higher rates of schizophrenia.

MZ twins is 47%, where population is 1%

Question 7

What was the drug that a surgeon designed to reduce the anxiety of pre-op patients?

Answer 7

Chlorpromazine (thorazine)

Question 8

Chlorpromazine was then found that, in high doses, it acts on what receptors in the brain to chill out highly agitated and aggressive schizophrenic pts?

Answer 8

D2 receptors

Question 9

Name the dopaminergic pathway:

Increased D will cause hallucinations and delusions, ↓ D will decrease the Sx.

Answer 9

Mesolimbic pathway

VTA –> limbic

Question 10

Name the dopaminergic pathwau:

malfunction causes disordered thinking, like the negative Sx of schizophrenia.

Answer 10

Mesocortical pathway

VTA –> frontal lobe

Question 11

Name the dopaminergic pathway:

↓ D causes muscular dyscontrol and trembling, and an ↑ D will cause extrapyramidal SE (tardive dyskinesia)

Answer 11

Nigrostriatal pathway

substrantia nigra –> striatum

Question 12

Name the dopaminergic pathway:

blocking D causes ↑ PRL –> boob milk and sexual dysfunction

Answer 12

Tubuloinfundibular pathway

arcuate nucleus –> median emisence

Question 13

What other NT in the brain (other than D) is throught to cause either + or - symptoms of schizophrenia when it’s in excess?

Answer 13

Serotonin

Question 14

This is the condition where there is fixed and persistent delusions > 1 month, where there is no change in functioning.

Answer 14

Delusional disorder

note, the DSMIV says it’s nonbizarre delusions, but the DSM5 says they can be bizarre lol

Question 15

What is the form of delusional disorder characterized by the central theme is that another person is in love with u?

Answer 15

Erotomanic type

Question 16

What is the form of delusional disorder characterized by thinking u have some great talent or made some important discovery?

Answer 16

Grandiose type

Question 17

What is the form of delusional disorder characterized by thinking your spouse in unfaithful?

Answer 17

Jealous type

Question 18

What is the form of delusional disorder characterized by thinking ur consipired against or being harassed?

Answer 18

Persecutory type

Question 19

What is the form of delusional disorder characterized by problems with body functions or sensations?

Answer 19

Somatic type

Question 20

This is the condition where there is a sudden onset of delusions, hallucinations, disorganized speech, or disorganized/catatonic behavior LESS THAN 1 MONTH.

Answer 20

Brief psychotic disorder

Question 21

This is the conditon where there is delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, or negative Sx from 1-6 months.

Answer 21

Schizophreniform disorder

Question 22

What are “negative Sx” that we keep talking about?

Answer 22

Flat affect, social withdrawal, lack of motivation, lack of speech or thought.

Question 23

This is the condition characterized by delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms GREATER THAN 6 MONTHS.

Answer 23

Schizophrenia

Question 24

In essence, how long to these conditons last?

Brief psychotic disorder
Schizophreniform disorder
Schizophrenia

Answer 24

Brief psychotic disorder: < 1mo
Schizophreniform disorder: 1-6mo
Schizophrenia: > 6 months

Question 25

What must we rule out of schizophrenia to not fall to make a Dx of schizoaffective disorder?

Answer 25

Mood Sx

Question 26

What defines “positive Sx” which may be seen in schizophrenia?

Answer 26

delusions or hallucinations

overactivity of the D2 receptors

Question 27

This is the condition where there is an uninterrupted period of illness where there is a major MOOD episode (major depressive or manic) concurrent with the delusions/hallucinations/disorganized speech/catatonia/negative Sx of schizophrenia?

Answer 27

Schizoaffective disorder

Question 28

How long must the Sx last in schizoaffective disorder to be diagnostic?

Answer 28

> 2 weeks

Question 29

What is the subtype of schizoaffective disorder where there is manic episode and possible major depressive episodes?

Answer 29

Bipolar type

Question 30

What is the subtype of schizoaffective disorder where there is only major depressive episodes?

Answer 30

Depressive type

Question 31

5 or more of the following Sx describe what condition?

Stupor, catalepsy, waxy flexability, mutism, negativism, posturing, mannerism, stereotypy, agitation, grimacing, echolalia, and echopraxia

Answer 31

Catatonia

Question 32

What is the LIFE THREATENING condition with antipsychotic medications due to abrupt withdrawal of D antagonists?

Answer 32

Neuroleptic Malignant Syndrome (NMS)

Question 33

What are the PNS impairments seen with antipsychotics?

Answer 33

anti-DUMBELLSS

Question 34

This is the condition where there is involuntary choreoathetoid movements of the face, trunk, or extremtities that typically occurs subsequent to prolonged exposure to D receptor blocking agents.

Answer 34

Tardive dyskinesia

Question 35

This is the syndome caused by 2nd gen atypical antipsychotics, and the pts has 3 or more of the following risk factors:

abdominal obesity, high TGs, low HDL, HTN, elevated fasting glucose.

Answer 35

Metabolic syndrome

Question 36

What are the 2 main reasons for higher relapse rates?

Answer 36

Discontinuation of the medication (usually due to SE)
Substance abuse (interfering with drug action)

Question 37

True or False: Schizophrenics have the same rate of suicide as the general population.

Answer 37

FALSE

Suicide rates are higher in schizophrenics than the general population.