Schizophrenia

Question 1

Familial prevalences for schizophrenia

Answer 1

Prevalence of schizophrenia in:

General population: 1%

Non-twin sibling of schizophrenia patient: 8%

Child with one parent with schizophrenia: 12%

Dizygotic twin of a schizophrenia patient: 12%

Child with two parents with schizophrenia: 40%

Monozygotic twin of a schizophrenia patient: 47%

Question 2

Definition of late onset schizophrenia

Answer 2

Onset > 45

Question 3

Prognostic significance of mood symptoms in schizophrenia

Answer 3

Good prognostic indicator

Question 4

The commonest cause of early mortality in schizophrenia

Answer 4

Cardiovascular

Question 5

Thinking a stranger is someone you know

Answer 5

Fregoli delusion

Question 6

The prevalence of schizophrenia is roughly equal in men and women T/F

Answer 6

T

Question 7

What has the CPA set as an acceptable waiting time for assessment in non-urgent first episode of psychosis referrals? #CanMed

Answer 7

Two weeks

Question 8

Neurocognitive testing is a robust predictor of functioning in first episode psychosis and should be undertaken at initial assessment T/F #CanMed

Answer 8

T

Question 9

What proportion of individuals with q2211.2 deletion have schizophrenia? #CanMed

Answer 9

25%

Question 10

What is the lifetime risk for suicide in schizophrenia? #CanMed

Answer 10

Around 5%

Question 11

Antipsychotic therapy reduces the risk of violence and crime in individuals with schizophrenia T/F #CanMed

Answer 11

T

Question 12

Psychotic symptoms like persecutory delusions are associated with violence in schizophrenia T/F #Canmed

Answer 12

T

Question 13

When should you change antipsychotic if there is no response in first episode? #CanMed

Answer 13

Four weeks

Question 14

For how long should treatment with antipsychotics be continued after resolution of positive symptoms in FEP? #CanMed

Answer 14

18 months

Question 15

How do CanMed define an adequate trial of clozapine?

Answer 15

At least 8 but preferably 12 weeks of Rx at 400mg/d with trough levels over 350ng/ml for once day dosing or 250ng/ml for twice day

Question 16

What proportion of individuals with schizophrenia meet criteria for TRS? #CanMed

Answer 16

25-30%

Question 17

Treatment of choice for schizophrenia with aggression #CanMed

Answer 17

Clozapine

Question 18

According to CanMed what is the minimum effective dose of family intervention in schizophrenia for individuals in close contact w family members?

Answer 18

Ten sessions over a three month period

Question 19

According to CanMed what should be offered to all patients who have not adequately responded to antipsychotic medication?

Answer 19

CBT for psychosis

Question 20

Lifetime prevalence of delusional disorder

Answer 20

0.2% DSM V

Question 21

Delusional disorder may be more prevalent in older individuals T/F

Answer 21

T DSM V

Question 22

Duration of episode of disturbance in brief psychotic disorder in DSM V

Answer 22

At least 1 day but less than 1 month

Question 23

Two of which 5 criteria for a schizophrenia diagnosis in DSM V

Answer 23

1. Delusions
2. Hallucinations
3. Disorganised speech
4. Grossly disorganised or catatonic behaviour
5. Negative symptoms

Question 24

Length of duration of symptoms for a diagnosis of delusional disorder in DSM V

Answer 24

One month

Question 25

According to K&S what characterizes the delusions of delusional disorder?

Answer 25

They are non-bizarre, ie about potentially normal scenarios like being in love, being followed etc. In contract to delusions in schizophrenia which are more likely to be bizarre

Question 26

Mean age of onset in delusional disorder

Answer 26

About 40

Question 27

There is a slight preponderance of female pts in delusional disorder T/F

Answer 27

T (K&S)

Question 28

Schizophrenia in elderly ppl respond poorly to medication T/F

Answer 28

F (K&S)

Question 29

Lifetime prevalence of schizoaffective disorder

Answer 29

0.5-0.8%

Question 30

Which schizoaffective ppl do better, affective or psychotic predominant?

Answer 30

Affective

Question 31

Mood and psychotic symptoms have to co-exist for how long for a diagnosis of schizoaffective disorder in DSM V?

Answer 31

2/52

Question 32

The most important risk factor for suicide in schizophrenia

Answer 32

MDE (K&S)

Question 33

What percentage of pts with post-partum psychosis have a family psychiatric history (& what is it of?)

Answer 33

50% fam hx of mood disorders

Question 34

Rate of postpartum psychosis

Answer 34

1-2/1000 births

Question 35

When does postpartum psychosis arise?

Answer 35

Always within 8 wks of delivery, mean onset is after 2-3 weeks, can occur after a few days

Question 36

In late onset schizophrenia symptoms become less marked as the pt ages T/F

Answer 36

T (K&S)

Question 37

Command hallucinations are a risk factor for suicide in schizophrenia T/F

Answer 37

T

Question 38

By definition ppl with delusional disorder do not have prominent or sustained hallucinations T/F

Answer 38

T (K&S). But they might rarely have auditory

Question 39

Most common types of delusion in delusional disorder (2)

Answer 39

Persecutory and jealous-type (K&S)

Question 40

Morbid jealousy in schizophrenia- women predominate T/F

Answer 40

T

Question 41

Othello syndrome men predominate T/F

Answer 41

T

Question 42

What characterizes de clerambault syndrome (erotomania)?

Answer 42

The delusional conviction that another person, usually of higher status, is in love with him or her. Often has a sudden onset. Object of a higher rank, and is the first to fall in love, and is the first to make advances. Pt rationalises paradoxical behaviour of object. Hallucinations are absent. Can occur with schizophrenia, mood disorders, or organic pathology

Question 43

Men with erotomania predominate in forensic populations and women in community samples T/F

Answer 43

T

Question 44

Insidious onset is typical in delusional disorder T/F

Answer 44

F, it's usually sudden onset according to K&S

Question 45

Good prognostic factors in delusional disorder

Answer 45

1. Being female 2. Good premorbid functioning 3. Onset before age 30 4. Sudden onset 5. Short duration of illness 6. Presence of precipitating factors

Question 46

Time cutoffs for brief psychotic disorder

Answer 46

One day to one month