Schizophrenia I: Overview Flashcards
Is the popular-science notion, that Schizophrenia is a “split personality disorder” accurate?
No. Schizophrenia is a severe mental disorder, that manifests itself in early adulthood. It is cross-culturally stable regarding its frequency, symptomatology and course.
Summarize the key points of Emil Kraeplins concept of schizophrenia.
Emil Kraeplin conceptualized schizophrenia as “dementia praecox”.
The core feature of dementia praecox is the rapid cognitive decline in late teens and early adulthood.
Kraeplinian dichotomy: The big two endogenous psychosis can be separated into two classes: manic-depressive psychosis (today bipolar disorder) and dementia praecox (today schizophrenia)
Summarize the key points of Eugen Beulers concept of schizophrenia.
Eugen Beuler was the first to coin the word “Schizophrenia” as a disorder of dissociation.
According to him, there were underlying biological processes to schizophrenia, whereas dementia (cognitive decline) is only a secondary symptom.
He split schizophrenia symptoms into different categories: perception, personality, cognitive and memory.
The core feature of his theory is the negative symptoms.
Summarize Kurt Schneiders’s concept of schizophrenia
Kurt Schneider did groundlaying work in the categorization of schizophrenia for the DSM and ICD10.
He included symptoms as the following:
Passivity experience
Auditory illusions
Insertion, Withdrawal and broadcasting of thoughts
delusional perception.
Pyschosis as core feature.
Who were the three importantt figures in the history of schizophrenia research & treatments? What where the core features of their theories?
Emil Kraeplin: cognitive decline
Eugen Beuler: negative symptoms
Kurt Schneider : Psychosis
According to the DSM, what are the (core) features of Schizophrenia? How can these symptoms be classified into broader categories? And what are the necessary conditions, that allow for a diagnosis (diagnostic rules)?
The core features are:
- Hallucination
- Delusion
- Disorganized speech
- Disorganized behavior
- Negative symptoms (e.g. flat affect, avolition, alogia)
Symptoms can be organized into positive (hallucination, delusion), cognitive (disorganized speech and behavior) and negative (c.f. above) symptoms.
At least two symptoms of wich one hast to be a core feature (features 1-3) must be present for 1 month. Attenuated features must be present for 6 months.
What phases are there in the natural progression of Schizophrenia? What symptoms are they comprised of?
Premorbid phase (motor, social cognitive dysfunctions)
Prodromal (first brief attenuated positive symptoms)
Psychotic phase (mostly florid positive symptoms)
Stabel phase (mostly negative symptoms)
How are the distribution patients with Schizophrenia (symptoms) normally propagated through the medical system. Name only the three main stations.
65% no diagnosis, 30% high risk. Of those with high risk 29% psychosis, rest other diseases of wich 7% are cured.
What is understood under the concept of dimensional diagnostics in schizophrenia?
Instead of a categorial approach (symptom present or either not present), all symptoms are on a dimensional plane. Rating symptoms according to their severity results in a certain pattern, that can be associated with a certain diagnosis.
Is Schizophrenia the only disorder of the psychotic spectrum? Does it overlap (genetically and in its symptomology with other diseases)? And can other causes mimic the illness?
No, there are other pyschiatric conditions in the psychotic spectrum: psychotic disorder, schizophreniform disorder, schizoaffective disorder or delusional disorder.
Schizophrenia overlaps with affective psychosis and neurocognitve/affective disorders genetically and in their symptomatology.
Injuries to the head or drug abuse (e.g. ampthetamine, cocain, ketamin or phenylcylidinde, PCP) can mimic schizophrenia
Describe the epidemiology of Schizophrenia, what is the prevalence and incidence?
Prevalence less than 0.5%, incidence 1/10.000 per year.
about 1million germans, 50 Charité employees and 1 medical student per semester are affected.
What are the three main (non-genetic) risk factors for Schizophrenia developement?
Sex differences (men have more intense, and prolonged negative symptoms, and women have a later and bimodal onset)
Perinatal and early childhood (in utero infections, birth complications, maternal infections during pregnancy and high age of father are indicated)
Enviromental factors (infections with toxoplasmose gondii, high emotion expressing families, larges cities, migration status)
What other diseases (apart from Schizophrenia) is Toxoplasmose gondii related to?
psychomotor dysfunction, depression, bipolar disorder, addiction and suicide