Schizophrenia & Psychotic Disorders

Question 1

Schizophrenia

Answer 1

A. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be 1, 2, or 3:
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior.
5. Negative symptoms (i.e., diminished emotional expression or avolition).
B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care is markedly below the level achieved prior to the onset.
C. Continuous signs of the disturbance persist for at least 6 months, which must include:
-at least 1 month (or less if successfully treated) of Criterion A symptoms
-and may include periods of prodromal or residual symptoms
-these prodromal or residual periods may include only negative symptoms or two or more less severe versions of Criterion A symptoms

Question 2

Schizophrenia

Answer 2

Disturbed
-behavior
-Thinking
-Emotions
-Perceptions
Acute episodes
-Delusions
-Hallucinations
-Incoherent Speech
-Bizarre Behavior
Between episodes may still seem "flat"

Question 3

Onset

Answer 3

Emerges late teens –> early 20s

• Prodomal
• Acute
• Residual

Question 4

Prevalence

Answer 4

1% lifetime prevalence
-...Roughly 2 million in US
-...roughly 24 million in the world 
Nearly 1 million get treatment each year 
-~330,000 need hospitalization
Men at great risk of developing
-Earlier (18-25, vs 25-35 for women)
-More severe

Question 5

Risk Factors?

Answer 5

• Users of cavvabis are 40% more likely to develop disorders like schizophrenia
• Heaviest users are 200% more likely
• Perhaps a factor in 14% of psychotic problems
• Cannabis-sensitive neuroreceptors implicated in schizophrenia
• Methamphetamine users are 1100% more likely to develop psychotic disorders
• Dependent users are 3300% more likely

Question 6

Type I versus Type II

Answer 6

Type 1:

• More flagrant or positive symptoms
• Hallucinations
• Delusions
• Loose associations
• Abrupt onset
• Preserved intellectual ability
• More favorable response to medication

Type II:

• More deficit or negative symptoms
• Lack of emotional expression
• Low or absent levels of motivation
• Loss of ability to experience pleasure
• Social withdrawal
• Poverty of speech
• More gradual onset, intellectual impairment
• Worse response to drugs

Question 7

Other psychotic Disorders

Answer 7

• Brief psychotic disorder
• Delusional disorder
• Schizophreniform disorder
• Schizoaffective Disorder