Schizophrenia

Question 1

What is Schizophrenia?

Answer 1

A severe mental illness where contact with reality and insight are impaired, an example of psychosis.

Question 2

What is the classification of a mental disorder?

Answer 2

The process of organising symptoms into categories based on which symptoms cluster together in sufferers.

Question 3

What are positive symptoms of schizophrenia?

Answer 3

Atypical symptoms experienced in addition to normal experiences. They include hallucinations and delusions.

Question 4

What are hallucinations?

Answer 4

A positive symptom of schizophrenia. They are sensory experiences of stimuli that have either no basis in reality or are distorted perceptions of things that are there.

Question 5

What are delusions?

Answer 5

A positive symptom of schizophrenia. They involve beliefs that have no basis in reality, for example, that the sufferer is someone else or that they are victim of a conspiracy.

Question 6

What is a negative symptom of schizophrenia?

Answer 6

Atypical experiences that represent the loss of a usual experience such as clear thinking or ‘normal’ levels of motivation.

Question 7

What is speech poverty?

Answer 7

A negative symptom of schizophrenia. It involves reduced frequency and quality of speech.

Question 8

What is avolition?

Answer 8

A negative symptom of Schizophrenia. It involves loss of motivation to carry out tasks and results in lowered activity levels.

Question 9

What is co-morbidity?

Answer 9

The occurrence of two illnesses or conditions e.g a person has both schizophrenia and a personality disorder. Where two conditions are frequently diagnosed together it calls into question the validity of classifying the two disorders separately.

Question 10

What is symptom overlap?

Answer 10

Occurs when two or more conditions share symptoms. Where conditions share many symptoms this calls into question the validity of classifying the two disorders separately.

Question 11

What percentage of the world population suffer from schizophrenia?

Answer 11

About 1%.

Question 12

Which gender is schizophrenia more common in?

Answer 12

Men.

Question 13

According to the DSM-5 system, what must be present for a diagnosis?

Answer 13

Positive symptoms - delusions, hallucinations or speech disorganisation.

Question 14

According to the ICD-10 what must be present for a diagnosis?

Answer 14

Two or more negative symptoms.

Question 15

What is the sub category of schizophrenia, paranoid schizophrenia?

Answer 15

Characterised by hallucinations and delusions but relatively few other symptoms.

Question 16

What is the sub category of schizophrenia, hebephrenic schizophrenia?

Answer 16

Involves primarily negative symptoms.

Question 17

What is the defining characteristic of the sub category of schizophrenia, catatonic schizophrenia?

Answer 17

Disturbance to movement, leaving the sufferer immobile or alternatively overactive.

Question 18

What is are examples of hallucinations?

Answer 18

Voices heard either talking to or commenting on the sufferer, often criticising them.
Seeing people or animals that aren’t there.

Question 19

What are examples of delusions?

Answer 19

Believing they’re are an important historical, political or religious figure such as Jesus or Napoleon.
Being persecuted or having superpowers.

Question 20

What can some delusions lead to?

Answer 20

Aggression.

Question 21

What did Andreason (1982) identify?

Answer 21

Three identifying signs of avolition; poor hygiene and grooming, lack of persistence in work or education and lack of energy.

Question 22

What’s an important measure of reliability?

Answer 22

Inter-rater reliability.

Question 23

Elie Cheniaux et al (2009). Reliability.

Answer 23

Two psychiatrists independently diagnose 100 patients using both DSM and ICD criteria. Inter-rater reliability was poor as one psychiatrist diagnosed 26 with schizophrenia (according to DSM)and 44 (according to ICD) while the other diagnosed 13 (according to DSM) and 24 (according to ICD). Weakness of diagnosis as poor reliability.

Question 24

What’s the standard way of testing the validity of a diagnosis?

Answer 24

Criterion validity.

Question 25

What is criterion validity?

Answer 25

Testing whether different assessment systems arrive at the same diagnosis for the same person.

Question 26

Cheniaux et al (2009). Validity.

Answer 26

Schizophrenia is more likely to be diagnosed under ICD than DSM. This suggests that schizophrenia is either over diagnosed in ICD or under diagnosed in DSM.

Question 27

Buckley et al (2009). Co-morbidity.

Answer 27

50% of patients with schizophrenia also had a diagnosis of depression, 47% had a diagnosis of substance abuse, 29% had a diagnosis of PTSD and 23% had a diagnosis of OCD.

Question 28

Julia Longenecker et al (2010). Gender bias in diagnosis.

Answer 28

Since that 1980’s men have been diagnosed with schizophrenia more than women although prior to this, there appears to have been no difference. This may be because men are more genetically vulnerable to developing schizophrenia than women.

Question 29

Cotton et al (2009). Gender bias in diagnosis.

Answer 29

It appears that female patients typically function better than men, being more likely to work and have good family relationships. This high functioning may explain why women have not been diagnosed with schizophrenia when men have similar symptoms might’ve been.

Question 30

What is dopamine?

Answer 30

A neurotransmitter that generally has an excitatory effect and is associated with the sensation of pleasure.

Question 31

How is dopamine connected to schizophrenia?

Answer 31

Unusually high levels are associated with schizophrenia and unusually low levels are associated with Parkinson’s disease.

Question 32

What are neural correlates?

Answer 32

Patterns of structure or activity in the brain that occur in conjunction with an experience and may be implicated in the origins of that experience.

Question 33

Is schizophrenia hereditary?

Answer 33

It has been noted for many years that schizophrenia runs in families.

Question 34

How much of our genes are shared with an identical twin?

Answer 34

100%

Question 35

How much of our genes are shared with a parent or sibling?

Answer 35

50%

Question 36

Irving Gottesman (1991) large scale family study.

Answer 36

As genetic similarity increases so does the probability of sharing schizophrenia.
Identical twins - 48% probability
Fraternal twins - 13% probability
Parents - 6% probability

Question 37

What are candidate genes?

Answer 37

Individual genes that are believed to be associated with risk of inheritance.

Question 38

Are candidate genes a cause for schizophrenia?

Answer 38

A number of genes each appear to confer with a small increase risk of schizophrenia which could mean that schizophrenia is polygenic because it requires a number of factors to work in combination.

Question 39

What have different studies identified about candidate genes?

Answer 39

That schizophrenia appears to be aetiologically heterogeneous (different combinations of factors can lead to the condition).

Question 40

Stephen Ripke et al (2014).

Answer 40

Combined all previous data from genome-wide studies of schizophrenia. The genetic make up of 37,000 patients was compared to that of 113,000 controls. 108 separate genetic variations were associated with increased risk of schizophrenia.