Schizophrenia

Question 1

How is schizophrenia defined?

Answer 1

“split mind”- divergence between behavior and thought; chronic and debilitating, no clouding of conciousness

Question 2

What is schizophrenia caused by?

Answer 2

gene/environment interaction

Question 3

What is schizophrenia exacerbated by?

Answer 3

stress

Question 4

What is meant by “downward drift” schizophrenia?

Answer 4

patient gradually loses social stature, income, relationships and support

Question 5

How does the psychosis of schizophrenia present?

Answer 5

hallucinations, delusions, abnormalities in thought/organization

Question 6

What is an illusion?

Answer 6

misperception of real external stimuli

Question 7

What is a hallucination?

Answer 7

sensory perception not generated by external stimuli

Question 8

What is an idea of reference?

Answer 8

false conviction that one is subject to attention by others

Question 9

What is a delusion?

Answer 9

false beliefs not correctable by logic

Question 10

What is a loss of ego boundaries?

Answer 10

not knowing where ones mind and body end and wheres others begins

Question 11

What is Alogia?

Answer 11

lack of informative content in speech

Question 12

What is echolalia?

Answer 12

repeating statements of others/associating words by their sounds

Question 13

What is thought blocking?

Answer 13

halt in the train of thinking (usually because of hallucination)

Question 14

What are neologisms?

Answer 14

inventing new words

Question 15

What is circumstantiality?

Answer 15

unnecessary and voluminous details while answering a question but eventually arriving at an answer

Question 16

What is tangentiality?

Answer 16

beginning response in a logical fashion but getting further away from the topic and never answering the question

Question 17

What are loose associations?

Answer 17

illogically jumping from one subject to another

Question 18

What are the diagnostic criteria for schizophrenia?

Answer 18

• 2 or more of: delusions, hallucinations, disorganized or catatonic behavior, negative symptoms or disorganized speech
• social/occupational dysfxn (lower than before onset)
• duration of atleast 6 months w/ 1 month of sx
• schizoaffective and mood disorder exclusion

Question 19

What are the following symptoms described as, positive or negative? delusions, hallucinations, agitation, talkativeness, thought disorder

Answer 19

positive

Question 20

What are the following symptoms described as, positive or negative? lack of motivation, social withdrawal, flattened affect, cognitive disturbances, poor grooming and speech

Answer 20

negative

Question 21

Which type of symptoms respond well to both traditional and atypical antipsychotics?

Answer 21

positive

Question 22

Which symptoms only sometimes respond to atypical antipsychotics?

Answer 22

negative

Question 23

Who responds better to antipsychotic medication?

Answer 23

women

Question 24

How is the prodromal period of disease characterized?

Answer 24

• avoidance of social activity
• quiet and passive
• interest in religion of philosophy
• physical complaints
• anxiety and depression

Question 25

How is the psychotic period of disease characterized?

Answer 25

- loss of touch with reality | - positive symptoms

Question 26

How is the residual period of disease characterized?

Answer 26

- between psychotic episodes - in touch with reality but doesn't behave normally - negative symptoms

Question 27

What are patients on antipsychotics at risk of producing and why?

Answer 27

tardive dyskinesia; because of cumulative days of D2 drug blockade

Question 28

What types of changes occur structurally in the brain with schizophrenia?

Answer 28

- hypofrontality - lateral and 3rd ventricle enlargement - asymmetry - decreased volume - decreased alpha waves

Question 29

Which 2 pathways are hypothesized to be associated with schizophrenia in the Dopamine Hypothesis?

Answer 29

- positive-excess dopamine in mesolimbic pathway | - negative- low dopamine in mesocortical pathway

Question 30

Which neurotransmitter do the newer atypical antipsychotics target?

Answer 30

serotonin (decrease levels)

Question 31

Which subtype of schizophrenia may have increased NE levels?

Answer 31

paranoid subtype

Question 32

What is a leading hypothesis in the etiology of schizophrenia?

Answer 32

NMDA receptor hypoactivity

Question 33

Explain the pathway behind the positive symptoms according to the glutamate hypothesis.

Answer 33

1) bad NMDA receptors 2) loss of inhibition from GABA interneurons 3) increased firing from VTA sending extra dopamine to the limbic system 4) psychosis * *Mesolimbic pathway**

Question 34

Explain the pathway behind the negative symptoms according to the glutamate hypothesis.

Answer 34

GLU-GABA-GLU-GABA-DA | faulty NMDA receptors ends with a loss of dopamine to the frontal lobe via the mesocortical pathway

Question 35

What is the differential diagnosis for Schizophrenia?

Answer 35

- general medical conditions - manic phase of bipolar - substance induced

Question 36

What is the time period of brief psychotic disorder?

Answer 36

1-29 days

Question 37

What is the time period of schizophreniform disorder?

Answer 37

1-6 months

Question 38

What is schizoaffective disorder?

Answer 38

schizophrenia+mania/depression

Question 39

What is shared psychotic disorder?

Answer 39

one person is delusion and a 2nd person develops the same delusion

Question 40

What do all of the effective antipsychotics target?

Answer 40

block D2 receptors in the mesolimbic dopamine path

Question 41

Why is the compliance rate with antipsychotics low and what can be done about this?

Answer 41

- unpleasant side effects and poor patient insight | - Use long acting injectable depot

Question 42

What types of psychotherapy can be helpful with schizophrenia patients?

Answer 42

CBT, family therapy, peer/mentor support

Question 43

Which of the following are good prognostic indicators: female, younger onset, married, no social relationships, good employment hx, no presence of mood symptoms or positive symptoms, or few relapses

Answer 43

good-female, married, good employment hx and few relapses | bad-younger onset, no social relationships, no mood symptoms or positive symptoms

Question 44

What are command hallucinations?

Answer 44

the patients hallucination tells them to do something (suicide, murder etc)