8: Schizophrenia Spectrum and Other Psychotic Disorders

Question 1

Prevalence of Schizophrenia

Answer 1

1% of the population

Question 2

Phases of Schizophrenia

Answer 2

Prodromal (Declining functioning, no hallucinations)
Active (Greater than 1 month of active symptoms)
Residual (Stabilized state of residual disorder after recovery)

Question 3

Schizophrenia occurs more often among…

Answer 3

…the impoverished

Question 4

Prognostic factors for schizophrenia (3)

Answer 4

1. Premorbid functioning
2. Age (younger emergence = greater severity)
3. Rapidity of onset

Question 5

Overt expression of unusual perceptions, thoughts, and beliefs

Answer 5

Positive symptoms

Question 6

The inability to distinguish between the real and the unreal

Answer 6

Psychosis

Question 7

Positive symptoms of schizophrenia (4)

Answer 7

• Heightened perceptions
• Hallucinations
• Delusions
• Disordered thinking and speech

Question 8

Negative symptoms of schizophrenia (4)

Answer 8

• Loss of volition
• Social withdrawal
• Poverty of speech
• Blunted and flat affect

Question 9

False belief that oneself or one’s loved ones are being persecuted, watched, or conspired against

Answer 9

Persecutory delusions

Question 10

Belief that everyday events, objects, or other people have unusual personal significance

Answer 10

Delusion of reference

Question 11

Belief that one’s thoughts are being controlled by outside forces

Answer 11

Delusions of thought insertion

Question 12

False belief that one has great power, knowledge, or talent

Answer 12

Grandiose delusion

Question 13

Psychomotor symptoms of schizophrenia

Answer 13

Awkward movements, repeated grimaces, or odd gestures

Question 14

Extreme onset of psychomotor symptoms in schizophrenia constitutes…

Answer 14

Catatonia

Question 15

The disorganized thinking of those afflicted by schizophrenia is called…

Answer 15

Formal thought disorder

Question 16

Criteria for Schizophrenia

Answer 16

1. One positive symptom and one other symptoms for at least 1 month
2. Social/occupational dysfunction
3. Lasts at least 6 months

Question 17

A possible cause for schizophrenia may be a ____ at work

Answer 17

Diathesis-stress relationship

Question 18

Considerations for medications (4)

Answer 18

• Impact on quality of life
• Subjectivity tolerability
• Cost
• Convenience

Question 19

Types of antipsychotic medications

Answer 19

• Conventional (alleviates positive symptoms more than negative symptoms; can cause extrapyramidal symptoms)
• Atypical (may or may not be better; no pyramidal symptoms; risks for weight gain, abnormal lipid levels, and sexual dysfunction)

Question 20

Mood disorder in conjunction with schizophrenia

Answer 20

Schizoaffective disorder

Question 21

Schizophrenia which lasts for 1 to 6 months

Answer 21

Schizophreniform disorder

Question 22

Schizophrenia which lasts only 1 day to 1 month

Answer 22

Brief psychotic disorder

Question 23

Disorder characterized by emergence of delusions with no other symptoms

Answer 23

Delusional disorder

Question 24

Disorder characterized by social deficits and cognitive or perceptual distortions

Answer 24

Schizotypal personality disorder

Question 25

Psychosis that occurs among 2 close people

Answer 25

Shared psychotic disorder

Question 26

Drugs that treat schizophrenia by blocking reuptake of dopamine

Answer 26

- Phenothiazines | - Neuroleptics

Question 27

In schizophrenia, excess dopamine may be present in the...

Answer 27

Mesolimbic pathway

Question 28

Social drift and schizophrenia

Answer 28

Schizophrenia disrupts education and functioning, leading to drift downwards in social class

Question 29

Hostility and/or over-involvement by family members/friends of a mentally ill person

Answer 29

Expressed emotion

Question 30

Neurological side effect of medication that involves involuntary movements of the tongue, face, mouth, or jaw

Answer 30

Tardive dyskinesia

Question 31

Factors that helped bring out depopulation of state mental hospitals (3)

Answer 31

- Antipsychotic drugs - Legal rights for the mentally ill - Deinstitutionalization movement

Question 32

Trends in mental treatment (5)

Answer 32

- Conflict over rights vs needs - Fragmentation of MH system - Criminal justice system problems and overhaul - Grass roots advocacy and recovery - Evidence-based treatments

Question 33

Evidence-based Treatments (6)

Answer 33

- Integrated Dual Disorder Treatment - Illness/Wellness Management and Recovery (Understand illness and develop approach for treatment) - Supported Employment (Job with assistance and support) - Assertive Community Treatment (ACT) - Cognitive-Behavioral Treatment - Psychoeducational Family Intervention

Question 34

ACT (4)

Answer 34

- Services targeted at SMI - ACT team provides all services - Shared team responsibility - Community-based interventions

Question 35

Psychoeducational Family Intervention (4)

Answer 35

- Education about mental illness - Focus on family support and crisis intervention - Problem solving - Reducing expressed emotion

Question 36

Effective factors for SMI treatment (5)

Answer 36

- Positive view of people with SMI - Self-determination focus - Oriented towards recovery - Learning and skill training - Use of nonprofessional resources