onset and initial presentation

Question 1

epidemiology:

Answer 1

causes of health outcomes and diseases in populations

Question 2

prevalence:

Answer 2

proportion of persons who HAVE a condition at or during a particular time period

Question 3

incidence

Answer 3

refers to the proportion or rate of persons who DEVELOP a condition during a particular time period

Question 4

prevalence is important for:

Answer 4

understanding the burden of a disease on society at any given time

Question 5

incidence is important for:

Answer 5

understanding changes in the expression of disease in individuals

Question 6

precise prevalence estimates are difficult to obtain due to:

Answer 6

clinical and methodological factors such as the complexity of diagnosis, overlap with affective disorders, and variation in diagnostic methods

Question 7

males tend to be diagnosed _____ than females so the ratio of males to females is _____ in younger age groups

Answer 7

earlier; higher

Question 8

mortality rates in females is ____ over time and thus, the male to female ratio changes over time

Answer 8

lower

Question 9

prevalence of schizophrenia disorders may be increasing due to:

Answer 9

increase in incidence, life expectancy is increasing, and mental health is becoming less taboo

Question 10

for many years the belief was that the incidence of schizophrenia was constant both:

Answer 10

geographically and temporally

Question 11

why is incidence increasing?

Answer 11

cannabis use and urban living

Question 12

the population attributable risk fraction:

Answer 12

estimate of the proportion of cases of schizophrenia that would have been prevented if no individuals had been exposed to cannabis use

Question 13

urban areas have higher:

Answer 13

population density and poverty which are both risk factors for schhizphreia

Question 14

more ____ tend to live in urban environments which also increases risk for schizo

Answer 14

immigrants

Question 15

urban living also includes these environmental factors that are associated with increased risk of schizo:

Answer 15

poor air quality, low levels of sun exposure, daily life stressors

Question 16

incidence is higher in ____ early but higher in ____ later

Answer 16

men; women

Question 17

the earlier age of onset in men has been attributed to:

Answer 17

male’s brain has greater susceptibility to neurodevelopment disorders

Question 18

the bump in incidence in women could be secondary to:

Answer 18

loss of the antidopmaniergic action of estrogens

Question 19

incidence _____ in age in both sexes

Answer 19

decreases

Question 20

DALY’s stands for:

Answer 20

disability-adjusted life years

Question 21

one DALY equals:

Answer 21

one lost year of healthy life

Question 22

true or false: the onset of schizophrenia in children 12 years or younger is not rare

Answer 22

false

Question 23

what does it mean if a child is diagnosed with childhood onset schizophrenia?

Answer 23

possibly reflects a more homogeneous disease, more severe, worse outcome, likely linked to genetics

Question 24

more than half children with confirmed schizophrenia have:

Answer 24

comorbid mood or anxiety disorders

Question 25

outcome and prognosis for Childhood Onset Schizo are positively correlated with the:

Answer 25

presence and severity of these developmental abnormalities

Question 26

late onset schizophrenia age:

Answer 26

after age 45

Question 27

is late onset schizo more common in males or females?

Answer 27

females (around time of menopause)

Question 28

what is late onset schizophrenia associated with? (6)

Answer 28

1. high levels of occupational functioning 2. being married 3. more severe paranoid delusions 4. more visual, tactile and olfactory hallucinations 5. less severe disorganization 6. less severe negative symptoms

Question 29

risk factors for late onset schizo include: (5)

Answer 29

1. negative life events 2. history of psychotic symptoms 3. poor social networks 4. cognitive impairment 5. functional limitations

Question 30

average age of schizophrenia:

Answer 30

between ages 15-25 for men and 25-35 for women

Question 31

synaptic pruning:

Answer 31

the cleaning away of underutilized synapses; reflected in the thickening of cortex

Question 32

myelination:

Answer 32

development and extension of axons; reflected in increases in white matter

Question 33

child brains show more ___ and less _____ activation

Answer 33

diffused; focused

Question 34

is there higher or lower connectivity in adjacent regions in earlier life?

Answer 34

higher

Question 35

is there stronger or weaker long range connections in adulthood?

Answer 35

stronger

Question 36

changes in connectivity in brain from adolescence to adulthood are strongly impacted by:

Answer 36

life experience

Question 37

if you can identify the disease early enough you can:

Answer 37

prevent the disease from fully developing or at least provide some protection from the worst outcomes AKA, early intervention

Question 38

psychosis prodrome is characterized by:

Answer 38

changes in behavior and cognition, not all ppl experience this stage of illness

Question 39

most noticeable presentation of schizo is:

Answer 39

social withdrawal and impaired functioning

Question 40

true or false: there is no typical presentation of schizophrenia

Answer 40

true

Question 41

schizo onset may be:

Answer 41

progressive or acute

Question 42

progressive:

Answer 42

over months or years

Question 43

acute:

Answer 43

over days or weeks

Question 44

onset of schizo may be preceded by:

Answer 44

other psychiatric symptoms such as anxiety, or no history of psychiatric symptoms

Question 45

are people mostly diagnosed in the emergency department or general medical outpatient visits?

Answer 45

emergency department with that at 84 percent and the other at 19 percent

Question 46

which studies find a delay in receipt of effective treatment?

Answer 46

longitudinal

Question 47

duration of untreated psychosis: (DUP)

Answer 47

time from first psychotic symptom to first psychiatric hospitalization

Question 48

what does the DUP reflect?

Answer 48

the delay to receive treatment after the onset of psychotic symptoms

Question 49

long periods without treatment arise from 2 sources:

Answer 49

intrinsic factors and extrinsic factors

Question 50

examples of intrinsic factors:

Answer 50

symptom severity, patient attitudes

Question 51

extrinsic factors examples:

Answer 51

access to care, insurance, culture

Question 52

longer DUP is associated with ____ severe illness and ____ treatment outcome

Answer 52

more; worse

Question 53

Jonas et al argued that DUP actually reflects:

Answer 53

differences in illness stage and argued that it does not predict a worse illness trajectory but indicates an individuals is farther along in their illness

Question 54

lead time bias results:

Answer 54

those with longer DUP experience greater losses of psychosocial function before heir first hospital admission than those with shorter DUP

Question 55

those with shorter DUP experience:

Answer 55

greater psychosocial function after their first hospital admission than those with lower DUP

Question 56

to conclude that an individual has made a transition from clinical high risk state to actual psychosis, the individual must at very least demonstrate:

Answer 56

the mergence of at least 1 positive psychotic symptom