Schizophrenia

Question 1

List two screening questions for schizophrenia.

Answer 1

1. Have you ever had trouble with your thinking?

2. Have you ever felt like people were watching or following you, or that they wanted to hurt you?

Question 2

Both illusions and hallucinations are disorders of perception. What is the difference between them?

Answer 2

Illusions are misperceptions of external sensory stimuli, while hallucinations are false sensory perceptions in the absence of external stimuli.

Question 3

What is one theory of why hallucinations may be occurring?

Answer 3

The efferent copy hypothesis; breakdown of monitoring of internal speech

Question 4

What are the 4 categories of positive symptoms?

Answer 4

1. Disorders of perception
2. Disorders of thought content
3. Disorders of form of thought
4. Disorders of behavior

Question 5

What is a disorder of thought content, and what is one theory as to what causes it?

Answer 5

They are delusions, fixed false beliefs that are held firmly despite contrary evidence. Misplaced salience is believed to underlie delusions

Question 6

What do disorders of form of thought manifest as?

Answer 6

Loose associations, neologism (coining of new terms) and word salad

Question 7

What are 4 negative symptoms?

Answer 7

1. amotivation
2. alogia (poverty of speech)
3. affective blunting
4. asociality

Question 8

What is the diagnostic criteria for schizophrenia?

Answer 8

(A) Must have two of the symptoms for a significant part of a month period, and at least one of them must be a positive symptom (1-3)
1. delusions 2. hallucinations 3. disorganized speech 4. disorganized or catatonic behavior 5. negative symptoms
(B) failure to achieve expected level of functioning
(C) Continued signs of disturbance for 6 months
(D) none or minimal mood disorders
(E) not attributable to substance abuse or other medical condition

Question 9

What are some associated factors with schizophrenia in epidemiological studies?

Answer 9

Slight male preponderance

• commin low SES
• geography (globally and living in a city)
• late winter births
• psychosocial stress
• immigrant status
• marital status
• birth complications

Question 10

Which circuits are believed to have increased dopamine in schizophrenia?

Answer 10

Mesolimbic dopamine structures

Question 11

What dopamine receptors are present in the PFC? In the mesolimbic area?

Answer 11

D1 in the PFC, D2 in the mesolimbic region

Question 12

What are the 5 stages during the early course of schizophrenia?

Answer 12

1. Premorbid
2. Prodromal
3. Psychotic (florid phase)
4. Convalescent
5. Stable

Question 13

What percentage of patients recover sufficiently to lead normal lives? What % have moderate symptoms? % of permanent impairment?

Answer 13

30-40% = normal recovery
20-30% = moderate symptoms
20-30 % = permanent impairment

Question 14

What are factors that predict good outcome?

Answer 14

• Acute onset
• Short duration
• female
• Good premorbid functioning
• no brain abnormalities
• low expressed emotion
• low cognitive symptoms
• Absent substance use

Question 15

What are factors that predict poor outcome?

Answer 15

• Insidious onset (not acute)
• chronic duration
• male
• poor premorbid functioning
• brain abnormalities present
• high expressed emotion
• high negative/cognitive symptoms
• substance use present

Question 16

What two neurotransmitters are impacted by atypical antipsychotics?

Answer 16

Both BLOCK dopamine and serotonin

Question 17

What percentage of schizophrenia patients attempt suicide? What is the risk of death from completed suicide?

Answer 17

20% attempt suicide. Risk of death from suicide is 10%