Schizophrenia

Question 1

Epidemiology of Schizophrenia (Read-only)

Answer 1

• Prevalence M=F
• Higher incidence with comorbid conditions (i.e.HTN, DM, Cardiac, STDS, Substance abuse, smoking)
• Mortality > General populations (10% incidence of suicide)

Question 2

Etiology of Schizophrenia (Read-only)

Answer 2

• Remains unknown
• Possible fetal disturbances
• Pruning exposing lesion, excessive pruning or DEC’d number of neurons from start may explain development of Schizophrenia

Question 3

Course of Illness: Schizophrenia (Read-only)

Answer 3

• Most deterioration psychological functioning occurs within fist 5 years
• Early treatment → better long-term outcomes
• Majoritiy of patients experience at least 1 relapse

Question 4

If symptoms are additional to the patients normal presentation these are ________ symptoms, which include…

Answer 4

Positive

• Hallucinations
• Delusions (Fixed,false belief held despite negative evidence, and not consistent with cultural
• Bizarre behavior
• Paranoia
• Suspiciousness
• Disorganization

Question 5

If symptoms are take away/removed from a patient’s normal presentation, these are considered _______ symptoms which include…

Answer 5

Negative

• Avolition (decrease in the motivation to initiate and perform self-directed purposeful activities)
• Alogia (inability to speak because of mental defect, mental confusion, or aphasia)
• Affective flattening (person doesn’t have the full range of emotional expression that others do)
• Asociality (lack of motivation to engage in social interaction, or a preference for solitary activities)
• Anhedonia (inability to feel pleasure)
• Attentional impairment

Question 6

What are some cognitive symptoms observed in the clinical presentation of Schizophrenia?

Answer 6

Difficulties with

• Concentration
• Memory
• Executive functioning (set of cognitive processes that are necessary for the cognitive control of behavior: selecting and successfully monitoring behaviors that facilitate the attainment of chosen goals)
• Decision making

Question 7

What are different types of Hallucinations?

Answer 7

• Auditiory
• Visual
• Tactile (false perception of tactile sensory input that creates a hallucinatory sensation of physical contact with an imaginary object)
• Olfactory
• Gustatory

Question 8

What are different types of Delusions?

Answer 8

• Grandiose
• Persecutory (affected persons believe they are being persecuted)
• Referential
• Somatic

Question 9

What are different types of disorganization (thought disorders)?

Answer 9

• Loose associations/Derailment (spontaneous speech with marked impairments in topic maintenance)
• Tangetial (Replies to questions are off-point or totally irrelevant)
• Circumstantial (excessively indirect speech; speech is liable to be overinclusive and include irrelevant detail)
• Flight of Ideas (continuous, rapid speech that changes focus from moment to moment based on association, distractions, or plays on words)

Question 10

DSM-V Diagnostic Criteria: Schizophrenia (Read only)

Answer 10

1. 2+ of the following characteristic symptoms , each present for a significant protion of time during a 1-month period or is less successfully treated and 1 of the 2 must be*:

• Delusions*
• Hallucinations*
• Disorganized speech*
• Grossly disorganized or catatonic behavior
• Negative symptoms:
  
  • Affective flattening
  • Alogia
  • Avolition

1. For a significant portion of the time since onset of the disorder, 1 or more major areas of functioning such as work, interpersonal relations, or self-care are significantly below the level of prior to onset
2. Continuous signs of the disorder for at least 6 months. This must include at least 1 month fulfilling criterion A (unless successfully treated). This 6 months may include prodrome or residual symptoms, during this period signs may be manifested by only negative symptoms or 2 or more symptoms listed in criterion A that present in an attenuated form.
3. Schizoaffective or mood disorder with psychotic features have need excluded because either; no major depressive, manic, or mixed episodes have occurred concurrently with active phase symptoms or if mood episodes have occurred their total duration has been brief relative to duration of active and residual periods.
4. Disorder is not due to a medical disorder or substance abuse.
5. If the patient has a history autistic disorder or another pervasive developmental disorder, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month.

Question 11

What 1st Generation Antipsychotics are Phenothiazines? (6)

Answer 11

• Chloropromazine
• Thioridazine
• Mesoridazine
• Perphenazine
• Trifluoperazine
• Fluphenazine

Question 12

What 1st Generation Antipsychotics are considered Non-Phenothiazines? (4)

Answer 12

• Thiothixene
• Haloperidol
• Loxapine
• Molindone

Question 13

Which 1st Generation Antipsychotics are considered LOW potency? (3) Why?

Answer 13

• Chloropromazine (P)
• Thioridazine (P)
• Mesoidazine (P)

• LESS potent D₂ antagonism,*
• MORE Ach, alpha-antagonism, sedation*

Question 14

Which 1st Generation Antipsychotic are considered MEDIUM potency? (3) Why?

Answer 14

• Perphenazine (P)
• Loxapine (N)
• Molindone (N)

Moderate D₂ antagonism (as well as receptor sensitivity)

Question 15

Which 1st Generation Antipsychotics are considered HIGH potency? (4) Why?

Answer 15

• Fluphenazine (P)
• Haloperidol (N)
• Thiothixene (N)
• Trifluoperazine (P)

• MORE potent D₂ antagonism*
• LESS Ach, Alpha-antagonism, sedation*

Question 16

What 2nd Generation Antipsychotics are available? (6)

Answer 16

• Aripiprazole
• Clozapine
• Olanzapine
• Quetiapine
• Risperidone
• Ziprasidone