Schizophrenia And Psychotic Related Diaorders

Question 1

Define Psychosis

Answer 1

The inability to diatinguish fantasy from reality
Impaired reality testing with the creation of a new reality

Question 2

Common manifestation in Schisophrenia and other psychotic related disorder dx class

Answer 2

Psychosis

Question 3

Does cannabis (weed) increase risk of developing psychotic disorders?

Answer 3

Yes

Question 4

Name disorders under Schizophrenia and other psychotic related disorders dx class in DSM 5

Answer 4

Schizophrenia
Delusional disorder
Brief psychotic disorder
Schizophreniform disorder
Schizoaffective disorder
Schizotypal personality disorder

Question 5

Name other disorders under Schizophrenia and other psychotic related disorders dx class in DSM 5

Answer 5

Substance abd medication related psychotic disorder
Pssychotic disorders due to other medical condition
Catatonic diorder due to medical cause
Unspecified catatonia
Other specified schizophrenia spectrum and other psychotic disorder
Unspecified schizophrenia spectrum and other psychotic disorder

Question 6

What is schizophrenia?

Answer 6

Mental disorder characterized by disintegration of thought processes and of emotional responsiveness
Brain disorder that affects how people think, feel and perceive

Question 7

“Schizo”

Answer 7

Fragment or split”

Question 8

“Phrenia”

Answer 8

Mind

Question 9

Schizophrenia prevalence ratio in males to females

Answer 9

1:1 (0.3-0.7)

Question 10

Schizophrenia mean age of onset in females

Answer 10

21-30 yrs

Question 11

Schizophrenia mean age of onset in males

Answer 11

18-25 yrs

Question 12

What are the 3 phases of Schizophrenia

Answer 12

1. Prodormal
2. Acute
3. Residual

Question 13

Describe prodormal phase of Schizophrenia

Answer 13

Lasts weeks,months or even years
Sx - loss of interest in usual persuit
- pull away from family
- easily confused
- trouble concentrating
- lethargy
- apathetic
- prefer spending time alone

Question 14

Describe the Acute phase of Schizophrenia

Answer 14

Sx - acute psychotic episode
- negative and positive sx of Schizophrenia
- positive sx > than negative sx

Question 15

Describe the residual phase of Schizophrenia

Answer 15

Sx similar to those in prodormal phase
- reduced positive sx
- negative sx persist
- Improved cognitive functioning
-patient is aware of their strange beliefs

Question 16

Etiology of Schizophrenia

Answer 16

Genetic
Neurochemistry
Neuroanatomy
Neuroendocrinology
Neuropsychilogy
Enviromental

Question 17

Genetic cause of Schizophrenia

Answer 17

Dysbindin (Chrm 6p), neurogulin(8p) and G72 (13q) are found to be susceptible

Question 18

Chances of schizophrenia when sibling has it

Answer 18

10%

Question 19

Chances of Schizophrenia when one parent has it

Answer 19

5%

Question 20

Chances of Schizophrenia in monozygotic twin when the other twin has it (concordance)

Answer 20

46%

Question 21

Chances of Schizophrenia in dizygotic twin when the other twin has it (concordance)

Answer 21

14%

Question 22

Neurochemistry cause of Schizophrenia (dopamine hypothesis)

Answer 22

Excessive activity in mesolimbic dopamine pathway precipitates positive sx of psychosis

Decreased dopamine in the frontal cortex may mediate negative and cognitive sx of Schizophrenia

Question 23

Neuroanatomy causes of Schizophrenia

Answer 23

Enlarged lateral ventricles
Smaller brain volume
Cortical atrophy (brain shrinking)
Widening of third ventricle
Smaller hippocampus

Question 24

Neuroendocrine causes of Schizophrenia

Answer 24

Abnormal growth hormone
Abnormal cortisol
Abnormal prolactin

Question 25

Neuropsychological cause of Schizophrenia

Answer 25

Global defects in attention, language and memory Suggesting disrupted connectivity of neural pathways

Question 26

Environmental causes of Schizophrenia

Answer 26

Drug use Cannabis increases chances of getting Schizophrenia Geographical variance Winter season of birth (suggesting perinatal/prenatal exposure of child to certain microorganisms Obstetrics complications

Question 27

What are the clinical features of Schizophrenia

Answer 27

**Positive sx** - hallucinations - delusions **Negative sx** - avolition (lack of motivation) - alogia (poverty of speech) - flattened affect - anhedonia (inability to experience pleasurable activities) - Asociality (lacking capacity for social interactions) **Cognitive sx** - disorganized dimension - thought disorder (thought form and content) - disorganized behaviour (catatonic behaviour) **Other sx** - lack insight - memory problems - attention problems - disturbances in sleep and sexual interest

Question 28

Schneider's first rank sx of Schizophrenia

Answer 28

- Delusional perception - 3rd person auditory hallucinations (2 voices speaking in patients head) - Thought interference - Passivity phenomenon

Question 29

What are the different typea of Schizophrenia

Answer 29

1. Paranoid type 2. Disorganized type 3. Catatonic type 4. Undifferent type 5. Residual type 6. Post schizophrenic depression 7. Simple schizophrenia

Question 30

The DSM 5 dx criteria of Schizophrenia

Question 31

Specifiers - severity of Schizophrenia

Answer 31

Eaxh sx may be rated for uts current severity in the last 7 days on a 5 point scale 0 - not present 1 - present 2 - present but mild 3 - present and moderate 4 - present and severe

Question 32

How do you manage Schizophrenia

Answer 32

** Biological tx** Acute tx - Antipsychotics - 1st Line (1st generation Antipsychotics *Haloperidol*) ( 2nd generation Antipsychotics *Risperidone and Olanzapine*) - 2nd Line (*Clozapine*) **Maintanance Therapy** - Initial episode - treat for 1 - 2 years because there is high risk of relapse - Multiple episodes - treat for 5 years **Adjunctive** - Mood stabilizers for aggression / impulsiveness- *lithium, valproate and carbamazepine* - Anxiolytics *Benzodiazepines* with or w/o ECT - Antidepressants - for depression - Electroconvulsive Therapy (ECT) - for concurrent depression and catatonic sx

Question 33

Schizophrenia psychological intervention

Answer 33

CBT Supportive therapy - group or family Assertive Community Treatment - help with medication adherence - basic living skills - social support - job placement and resources - social skills training - vocational rehabilitation - disability benefits -appropriate housing