Schizophrenia & Paranoid Disorders

Question 1

Schizophrenia and Paranoid group of disorders are characterized by a disturbance of _________, accompanied by disturbances in psychomotor activity, affect, perception and behavior.

Answer 1

Thinking.

Question 2

Dementia Praecox or Démence Précoce are disused terms for which disease? Why is it named so and whom was it given by?

Answer 2

It is a disused name for Schizophrenia meaning a “premature dementia” or “precocious madness”.
Demence Precoce was used by French Psychiatrist Benedict Morel in “Traité des maladies mentales” (1860) whereas Dementia Praecox was used by German psychiatrist Emil Kraepelin.

Question 3

Hebephrenia is a major subtype of which disorder? Etymology + Characteristic (esp wrt personality). Give examples.

Answer 3

It’s a subtype of schizophrenia.
“adolescent insanity,” from Greek Goddess of Youth Hēbē “youth” + phrene “mind”.
The onset is early and the prognosis is bad. It is characterized by prominent disorganized beh./thinking and negative symptoms. There is severe deterioration of personality.
Person isn’t able to maintain hygiene, there’s inappropriate social interaction and odd behavior.

Question 4

“Katatonia” was first described by? Give the 12 symptoms of catatonia.

Answer 4

Term was given by Kahlbaum.
The DSM­5 criteria include the presence of three symptoms from the following list of twelve:
1). STUPOR (decreased response to external stimuli, hypoactive behavior)
2). CATALEPSY (the passive adoption of a posture)
3). WAXY FLEXIBILITY (slight resistance to being moved)
4). MUTISM (verbally unresponsive, refusal to speak)
5). NEGATIVISM (doesn’t react to something happening around them or actively resists what’s happening around them for no rational reason)
6). POSTURING (purposely maintaining a position for long periods of time)
7). MANNERISMS (person acts out motions or movements that could be normal but does them in an unusual or exaggerated way)
8). STEREOTYPY (repetitive movements that don’t seem to have a purpose. They can include finger-play and patting/rubbing one’s body)
9). AGITATION (person acts upset or irritable. It only counts as a symptom of catatonia if it happens and it isn’t a response to something around the person having it.)
10). GRIMACING (holding the same facial expression, usually with stiff or tense facial muscles. Sometimes, it can take the form of smiling in inappropriate contexts)
11). ECHOLALIA (person echoes sounds that someone else makes)
12). ECHOPRAXIA ( person mimics or mirrors someone else’s movements)
Other common symptoms are motor resistance to simple commands, posturing, rigidity, automatic obedience, and repetitive movements

Behavior (4)
Stupor
Cataplexy
Posturing
Waxy Flexibility

Speech (2)
Mutism
Echolalia

Affect (3)
Negativism
Agitation
Grimacing

Movement (3)
Mannerisms
Echopraxia
Stereotypy

Question 5

What are the positive symptoms of Schizophrenia? They occur due to (hyper/hypo)dopaminergic activity in the meso(limbic/cortical) region. What is the brain region involved responsible for?

Answer 5

Symptoms that have no physiological counterpart, include:
Delusions
Hallucinations
Disorganized Speech
Disorganized Behavior/ Catatonic Behavior
They occur due to hyperdopaminergic activity in the mesolimbic region of the brain. The mesolimbic area is responsible for executive and motivational functions.

Question 6

What are the negative symptoms of Schizophrenia? They occur due to (hyper/hypo)dopaminergic activity in the meso(limbic/cortical) region. The involved brain region is responsible for?

Answer 6

Absence of normal processes of functioning produce negative symptoms, such as:
1). Anhedonia
2). Avolition
3). Alogia
4). Attention loss
5). Asocialty
Negative symptoms occur due to hypodopaminergic activity in the meso-cortical region of the brain.
Mesocortical pathway is responsible for emotional response, motivation and cognition control.

Question 7

Give Bleuler’s 4 As.

Answer 7

1). Affect Blunting
2). Association loosening
3). Ambivalence (inability to make a decision)
4). Autism (preoccupation with self)

Question 8

Diagnosis of Schizophrenia according to DSM-5 and ICD-11.

Answer 8

DSM-5
Three types of symptoms:
1). Positive
2). Negative
3). Cognitive Deficits (not a diagnostic tool)
2 Symptoms must be present (one has to be a positive symptom) for a duration of 6 months, with the occurrence of the active phase in the past 1 month.

ICD-11
At least two symptoms must be present, including positive, negative, depressive, manic, psychomotor, and cognitive symptoms.
Of the two symptoms, one core symptom needs to be present (5):
delusions
hallucinations
thought insertion
thought withdrawal thought disorder
Symptoms should have been present for most of the time during a period of at least 1 month.

NOT BECAUSE OF SUBSTANCE ABUSE OR ANY OTHER DISORDER.

Question 9

Give the phases of Schizophrenia.

Answer 9

Three Phrases
1). PRODROMAL
social withdrawal, difficulty concentrating, lack of motivation
2). ACTIVE
Positive Symptoms
3). RESIDUAL
Negative Symptoms remain
Depression

Question 10

Which subtype has the best prognosis and which one has the worst?
Which has the highest risk of suicide?

Answer 10

Best: Catatonic since motor symptoms are prominent
Worst: Simple since negative symptoms are prominent with no history of positive symptoms.
Post-schizophrenic depression has the highest risk of depression.

Question 11

Which subtype has the best prognosis and which one has the worst?
Which has the highest risk of suicide?

Answer 11

Best: Catatonic since motor symptoms are prominent
Worst: Simple since negative symptoms are prominent with no history of positive symptoms.
Post-schizophrenic depression has the highest risk of depression.