Schizophrenia Spectrum/Other Psychotic Disorders

Question 1

Schizophrenia Spectrum/Other Psychotic Disorders changes from DSM IV to 5, for criteria for schizophrenia

Answer 1

elimination of the allowance that bizarre delusions or two or more voices conversing suffice for a diagnosis the requirements is now at least 2 symptoms and b) at least one of symptoms must be delusions, hallucinations, or disorganized speech. Subtypes have been eliminated(e.g. paranoid disorganized).
A dimensional approach to rating severity for each of the core symptoms was added.

Question 2

Schizophrenia Spectrum/Other Psychotic Disorders changes from DSM IV to 5 in regards to schizoaffective disorder

Answer 2

Schizoaffective disorder is now conceptualized as longitudinal diagnosis and requires that a major mood episode is present for majority of the disorder’s duration.

Question 3

Schizophrenia Spectrum/Other Psychotic Disorders changes from DSM IV to 5 in regards to delusional disorder

Answer 3

There is no longer a requirement that the delusions in delusional disorder are non-bizarre; a specifier is added for bizarre type.

Question 4

Schizophrenia Spectrum/Other Psychotic Disorders changes from DSM IV to 5 regard criteria for catatonia

Answer 4

Criteria for catatonia are described, and may be diagnosed with a specifier for any of psychotic disorders (as well as depressive and bipolar disorders).

Question 5

Schizophrenia Spectrum/Other Psychotic Disorders changes from DSM IV to 5, in regards to schizotypal personality disorder

Answer 5

Schizotypal personality disorder is included both schizophrenia spectrum and personality disorders.

Question 6

Name the disorders in the Schizophrenia Spectrum/Other Psychotic Disorders

Answer 6

Brief Psychotic Disorder
Schizophreniform Disorder
Schizophrenia
Schizoaffective Disorder
Delusional Disorder

Question 7

Q: What are the diagnostic criteria for Brief Psychotic Disorder?

Answer 7

A: The diagnosis requires one or more of four characteristic symptoms for at least one day but less than one month, with at least one symptom being delusions, hallucinations, or disorganized speech. The four symptoms are delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior.

Question 8

Q: How does the DSM-5 define delusions and hallucinations?

Answer 8

A: Delusions are false beliefs firmly held despite contradictory evidence. Hallucinations are perception-like experiences without external stimulation and must be distinguished from illusions, which are misperceptions of actual external stimuli.

Question 9

Q: What is the duration requirement for symptoms in Brief Psychotic Disorder?

Answer 9

A: Symptoms must be present for at least one day but less than one month.

Question 10

Q: What are the diagnostic criteria for Schizophrenia?

Answer 10

A: The diagnosis requires an active phase lasting at least one month with at least two of five characteristic symptoms (delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms), and continuous signs of the disorder for at least six months, including prodromal and/or residual phases.

Question 11

Q: What are the five characteristic symptoms of Schizophrenia?

Answer 11

A: The five symptoms are delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms (e.g., avolition, alogia, anhedonia).

Question 12

Q: What genetic factors are linked to Schizophrenia?

Answer 12

A: Schizophrenia has higher concordance rates with greater genetic similarity: parent (6%), biological sibling (9%), child of one parent with schizophrenia (13%), dizygotic twin (17%), child of two parents with schizophrenia (46%), monozygotic twin (48%).

Question 13

Q: How do neurotransmitters relate to Schizophrenia?

Answer 13

A: The dopamine hypothesis suggests that positive symptoms are due to dopamine hyperactivity in subcortical regions, while negative symptoms are due to dopamine hypoactivity in cortical regions. Other neurotransmitters linked to schizophrenia include glutamate and serotonin.

Question 14

Q: What brain abnormalities are associated with Schizophrenia?

Answer 14

A: Enlarged ventricles and hypofrontality (lower activity in the prefrontal cortex) are linked to Schizophrenia. The disorder involves dysfunction in the temporal-limbic-frontal network causing negative symptoms and disinhibition in subcortical areas causing positive symptoms.

Question 15

Q: What are common comorbid conditions with Schizophrenia?

Answer 15

A: Common comorbid conditions include anxiety disorders, obsessive-compulsive disorder, and tobacco use disorder, with about 70 to 85% of individuals with schizophrenia being tobacco users.

Question 16

Q: Describe the onset, course, and prognosis of Schizophrenia.

Answer 16

A: Onset usually occurs between late teens and early 30s, with males peaking in early- to mid-20s and females in late-20s. Psychotic symptoms often decrease with age, but negative and cognitive symptoms persist. Better prognosis is linked to female gender, acute and late onset, comorbid mood symptoms, positive symptoms, family history of mood disorders, and good premorbid adjustment.

Question 17

Q: What is anosognosia and how does it affect Schizophrenia treatment?

Answer 17

A: Anosognosia is a lack of insight into one’s disorder, associated with non-adherence to treatment and an elevated risk for relapse. High expressed emotion in families (criticism, hostility, emotional overinvolvement) also increases relapse risk.

Question 18

Q: How does the onset and course of Schizophrenia vary across countries?

Answer 18

A: Patients in non-Western developing countries are more likely to have an acute onset, shorter course, and higher remission rates than those in Western industrialized countries. The immigrant paradox shows newly arrived immigrants have better health outcomes than more acculturated immigrants or US-born natives of the same ethnicity.

Question 19

Q: What are the treatment approaches for Schizophrenia?

Answer 19

A: Treatment is multimodal, including psychosocial interventions (e.g., assertive community treatment, CBT for psychosis, family psychoeducation) and antipsychotic drugs, with adjunctive medications for comorbid disorders.

Question 20

Q: What are the diagnostic criteria for Schizoaffective Disorder?

Answer 20

A: The diagnosis requires concurrent symptoms of schizophrenia and a major depressive or manic episode for most of the duration of the illness, with delusions or hallucinations occurring for at least two weeks without mood symptoms.

Question 21

Q: How long must delusions or hallucinations occur without mood symptoms in Schizoaffective Disorder?

Answer 21

A: Delusions or hallucinations must occur for at least two weeks without prominent mood symptoms.

Question 22

Q: What is the duration requirement for Schizophreniform Disorder symptoms?

Answer 22

A: Symptoms must be present for at least one month but less than six months.

Question 23

Q: What are the primary diagnostic criteria for Delusional Disorder?

Answer 23

A: The diagnosis requires one or more delusions for at least one month, with the person’s overall functioning not markedly impaired except for the direct effects of the delusion.

Question 24

Q: What are the subtypes of Delusional Disorder according to the DSM-5?

Answer 24

A: The subtypes are: (a) Erotomanic (belief that another person is in love with them); (b) Grandiose (belief in having great but unrecognized talent or insight); (c) Jealous (belief that spouse or partner is unfaithful); (d) Persecutory (belief of being conspired against, spied on, or maligned); (e) Somatic (delusion involves bodily functions or sensations).

Question 25

Q: What is the duration requirement for Delusional Disorder symptoms?

Answer 25

A: Delusions must be present for a duration of at least one month.