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schizophrenia et al. Flashcards

1
Q

What is required for the diagnosis of brief psychotic disorder?

A

Presence of one or more characteristic symptoms for at least one day but less than one month

At least one symptom must be delusions, hallucinations, or disorganized speech.

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2
Q

List the four characteristic symptoms of brief psychotic disorder.

A
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior

Disorganized speech may include derailment and tangentiality.

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3
Q

Define ‘delusion’ according to the DSM-5.

A

A false belief based on incorrect inference about external reality that is firmly held despite evidence to the contrary

This definition is found on page 819 of the DSM-5.

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4
Q

Define ‘hallucination’ as per the DSM-5.

A

A perception-like experience with the clarity and impact of a true perception but without external sensory stimulation

This definition is found on page 822 of the DSM-5.

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5
Q

True or False: Hallucinations are the same as illusions.

A

False

Illusions occur when an actual external stimulus is misperceived or misinterpreted.

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6
Q

Fill in the blank: The duration of symptoms for brief psychotic disorder must be _______.

A

at least one day but less than one month

This is a key criterion for the diagnosis.

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7
Q

What types of behavior may be classified as ‘grossly disorganized or catatonic’?

A

Behavior that is markedly disorganized or includes catatonic features

This can manifest as unusual postures, lack of movement, or excessive movement.

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8
Q

What is the duration requirement for diagnosing Schizophreniform Disorder?

A

At least one month but less than six months

This time frame differentiates Schizophreniform Disorder from other schizophrenia-related diagnoses.

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9
Q

How many characteristic symptoms are required for a Schizophreniform Disorder diagnosis?

A

At least two out of five characteristic symptoms

This requirement helps ensure a comprehensive assessment of the disorder.

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10
Q

At least one of what three symptoms must be present in Schizophreniform Disorder?

A

Delusions, hallucinations, or disorganized speech

At least one of these symptoms must be present for a diagnosis.

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11
Q

List the five characteristic symptoms of Schizophreniform Disorder.

A
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Negative symptoms (e.g., avolition, alogia, anhedonia)

These symptoms encompass a range of cognitive and behavioral issues associated with the disorder.

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12
Q

True or False: Negative symptoms include avolition, alogia, and anhedonia.

A

True

Negative symptoms refer to the reduction or absence of normal emotional responses or behaviors.

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13
Q

Fill in the blank: Schizophreniform Disorder requires the presence of at least _______ of five characteristic symptoms.

A

two

This threshold is crucial for accurate diagnosis.

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14
Q

What is required for the diagnosis of schizophrenia?

A

An active phase lasting at least one month with at least two of five characteristic symptoms

The symptoms must include at least one of delusions, hallucinations, or disorganized speech.

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15
Q

What are the five characteristic symptoms of schizophrenia?

A
  • Delusions
  • Hallucinations
  • Disorganized speech
  • Grossly disorganized or catatonic behavior
  • Negative symptoms

Negative symptoms refer to a decrease in the ability to function normally.

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16
Q

How long must there be continuous signs of schizophrenia for a diagnosis?

A

At least six months

This period may include prodromal and/or residual phases.

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17
Q

What do the prodromal and residual phases of schizophrenia consist of?

A

Two or more characteristic symptoms in an attenuated form or negative symptoms only

These phases indicate a less severe presentation of symptoms.

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18
Q

True or False: A single symptom of hallucinations is sufficient for the diagnosis of schizophrenia.

A

False

At least two characteristic symptoms are required for diagnosis.

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19
Q

Fill in the blank: The active phase of schizophrenia must last for at least _______.

A

one month

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20
Q

What type of behavior is included as a characteristic symptom of schizophrenia?

A

Grossly disorganized or catatonic behavior

This symptom reflects severe disruptions in behavior and thought processes.

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21
Q

What factors have been linked to the etiology of schizophrenia?

A

Genetic factors, neurotransmitter abnormalities, brain abnormalities

Genetic factors include familial studies showing concordance rates; neurotransmitter abnormalities involve dopamine, glutamate, and serotonin; brain abnormalities include enlarged ventricles and hypofrontality.

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22
Q

What does the term concordance rate refer to in the context of schizophrenia?

A

The likelihood that two people with shared genes will develop the same disorder

Higher genetic similarity correlates with higher concordance rates.

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23
Q

What are the reported concordance rates for schizophrenia in first-degree relatives according to Gottesman (1991)?

A

Rates are frequently cited but not specified in this content

Subsequent studies on twin concordance rates vary, with monozygotic twins showing .40 to .50 and dizygotic twins showing .15 to .17.

24
Q

Which neurotransmitter is primarily associated with the original dopamine hypothesis of schizophrenia?

A

Dopamine

The hypothesis suggests that high levels or hyperactivity of dopamine receptors contribute to schizophrenia.

25
Q

What evidence supports the original dopamine hypothesis?

A

Amphetamines increase dopamine activity and produce schizophrenia-like symptoms; drugs that decrease dopamine activity reduce symptoms

This suggests a direct link between dopamine levels and schizophrenia symptoms.

26
Q

What does the revised dopamine hypothesis predict about positive and negative symptoms of schizophrenia?

A

Positive symptoms are due to dopamine hyperactivity in subcortical regions; negative symptoms are due to dopamine hypoactivity in cortical regions

Specifically, positive symptoms are linked to striatal areas and negative symptoms to the prefrontal cortex.

27
Q

What brain abnormalities are associated with schizophrenia?

A

Enlarged ventricles, hypofrontality

Hypofrontality refers to lower-than-normal activity in the prefrontal cortex, contributing to negative and cognitive symptoms.

28
Q

What model of schizophrenia is consistent with the revised dopamine hypothesis?

A

Dysfunction in the temporal-limbic-frontal network

This model explains negative symptoms and disinhibition in subcortical areas, leading to increased dopamine release in the striatum.

29
Q

Fill in the blank: According to the original dopamine hypothesis, schizophrenia results from high levels of _______.

A

Dopamine

30
Q

True or False: The concordance rates for schizophrenia in monozygotic twins are consistently reported as .15 to .17.

A

False

The rates for monozygotic twins are reported to range from about .40 to .50.

31
Q

What are the three neurotransmitters linked to schizophrenia?

A
  • Dopamine
  • Glutamate
  • Serotonin
32
Q

What are common comorbid conditions associated with schizophrenia?

A

Anxiety disorders, obsessive-compulsive disorder, tobacco use disorder

About 70 to 85% of individuals with schizophrenia are tobacco users, and over half meet the criteria for tobacco use disorder according to the DSM-5-TR.

33
Q

At what age do psychotic symptoms of schizophrenia typically first appear?

A

Late teens to early 30s, with peak onset in early- to mid-20s for males and late-20s for females

Symptoms often decrease with age, while negative and cognitive symptoms may persist.

34
Q

What factors are associated with a better prognosis for schizophrenia?

A

Female gender, acute and late onset of symptoms, comorbid mood symptoms, predominantly positive symptoms, precipitating factors, family history of mood disorder, good premorbid adjustment

Positive symptoms refer to the presence of abnormal behaviors, while negative symptoms refer to the absence of normal behaviors.

35
Q

What is anosognosia?

A

A lack of insight into or awareness of one’s disorder

It is associated with non-adherence to treatment and an elevated risk for relapse.

36
Q

How does expressed emotion impact patients with schizophrenia?

A

High expressed emotion is associated with increased risk for relapse

Expressed emotion includes high criticism, hostility, and emotional overinvolvement from family members.

37
Q

What variations have been identified in the onset, course, and prognosis of schizophrenia across countries?

A

Patients in non-Western developing countries experience more acute onset, shorter course, and higher rate of remission compared to those in Western industrialized countries

Research indicates cultural factors may influence these outcomes.

38
Q

What is the ‘immigrant paradox’ in relation to schizophrenia?

A

Newly arrived immigrants have better health outcomes than more acculturated immigrants or US-born natives of the same ethnicity

This paradox applies to schizophrenia, alcohol use disorder, and other psychiatric disorders.

39
Q

What is the treatment approach for schizophrenia?

A

Multimodal, including psychosocial interventions, antipsychotic drugs, and adjunctive medications.

This approach addresses the diverse needs of patients with schizophrenia.

40
Q

Name three evidence-based psychosocial interventions for schizophrenia.

A
  • Cognitive-behavior therapy for psychosis (CBTp)
  • Cognitive remediation
  • Acceptance and commitment therapy

These interventions aim to improve mental health outcomes for patients.

41
Q

What are the two categories of antipsychotic drugs?

A
  • First-generation antipsychotics (FGAs)
  • Second-generation antipsychotics (SGAs)

These categories differ in their mechanisms and side effects.

42
Q

What factors should be considered when choosing an antipsychotic drug?

A
  • Drug benefits and side effects
  • Potential interactions with other medications
  • Patient preferences and past responses
  • Health conditions

This comprehensive evaluation helps tailor treatment to the individual.

43
Q

Which SGA is considered the most effective for treatment-resistant schizophrenia?

A

Clozapine

Clozapine is particularly effective for patients who do not respond to other antipsychotics.

44
Q

Define treatment-resistant schizophrenia according to the American Psychiatric Association.

A

Symptoms show no response or partial/suboptimal response to two antipsychotic trials of at least 6 weeks each at adequate dosages.

This definition emphasizes the challenges in treating certain patients.

45
Q

True or False: Medication non-adherence is rarely a problem for patients with schizophrenia.

A

False

Non-adherence is common and can affect treatment outcomes.

46
Q

How can family involvement impact medication adherence in schizophrenia patients?

A

Increases adherence and decreases relapse risk.

Support systems play a crucial role in the treatment process.

47
Q

What is NAVIGATE?

A

A team-based program for individuals experiencing their first episode of psychosis.

NAVIGATE includes family education, resiliency training, supported employment, and individualized medication treatment.

48
Q

What does individualized resiliency training focus on?

A

Teaches skills to manage illness, process triggers and effects, and improve psychological well-being.

This training is based on CBTp and aims to empower patients.

49
Q

What is the primary requirement for diagnosing schizoaffective disorder?

A

Concurrent symptoms of schizophrenia and a major depressive or manic episode for most of the duration of the illness

Delusions or hallucinations must be present for two or more weeks without mood symptoms.

50
Q

What duration of delusions is required for a diagnosis of delusional disorder?

A

At least one month

The person’s overall functioning should not be markedly impaired except for any direct effects of the delusion.

51
Q

Name one subtype of delusional disorder.

A

Subtypes include:
* Erotomanic
* Grandiose
* Jealous
* Persecutory
* Somatic

Each subtype is characterized by specific types of delusions.

52
Q

True or False: In delusional disorder, the person’s overall functioning is markedly impaired.

A

False

The person’s overall functioning is not markedly impaired except for any direct effects of the delusion.

53
Q

Fill in the blank: The person with an erotomanic delusion believes that another person is _______.

A

[in love with him/her]

This subtype involves the belief that someone, often of higher status, loves the individual.

54
Q

What is a grandiose delusion?

A

The belief that one has great but unrecognized talent or insight

Individuals may think they have special powers or abilities.

55
Q

Define persecutory delusion.

A

The belief that one is being conspired against, spied on, poisoned, or maliciously maligned

This is one of the most common types of delusions.

56
Q

What type of delusion involves bodily functions or sensations?

A

Somatic delusion

These delusions focus on the individual’s body, often involving false beliefs about physical health.

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