Schizophrenia

Question 1

Define positive symptoms

Answer 1

Active presence of abnormal phenomena

Question 2

List some positive symptoms

Answer 2

Hallucinations, delusions, thought disorder

Question 3

Define negative symptoms

Answer 3

Deficits in normal behaviour

Question 4

List some negative symptoms

Answer 4

• less speech
• less interest or motivation
• less emotional expression
• less feeling or interest
• blunted affect
• avolition
• alogia
• anhedonia
• sociality

Question 5

Which type of symptoms respond better to intensive psychosocial treatment?

Answer 5

Negative

Question 6

What are delusions

Answer 6

False beliefs which are a misrepresentation of reality; held in a fixed way; typically personal

Question 7

List common forms of delusion

Answer 7

• persecutory
• referential
• grandiose
• somatic
• delusions of control
• thought insertion
• thought broadcasting

Question 8

Persecutory delusions

Answer 8

Person/group/system is trying to harm you

Question 9

Referential delusions

Answer 9

Certain gestures/comments/environmental cues are directed at you e.g. radio is sending you a message

Question 10

Grandiose delusions

Answer 10

Belief that one has special powers or abilities, special significance, or has been given a special mission

Question 11

Somatic delusions

Answer 11

Clearly unrealistic, often bizarre belief about one’s own body e.g. rats have eaten internal organs

Question 12

Delusions of control

Answer 12

Belief that one is controlled by mysterious external forces

Question 13

Thought insertion

Answer 13

Belief that someone is putting thoughts into one’s head

Question 14

Thought broadcasting

Answer 14

Belief that others can hear one’s thoughts

Question 15

What are hallucinations?

Answer 15

Experiences that are interpreted as perceptions, but without the external stimulus

Question 16

Characteristics of voices/auditory hallucinations

Answer 16

• voices distinct from one’s own
• can be multiple different voices
• majority are negative voices

Question 17

List some disorders of thought and language

Answer 17

• confused thinking -unusual and idiosyncratic
• disorganised or incoherent speech - derailment, associations
• difficulty concentrating

Question 18

Neologisms

Answer 18

Use of made up words that have little or no meaning to others

Question 19

Loose associations or derailment

Answer 19

Drifts off on a train of associations evoked by an idea of the past

Question 20

Perseveration

Answer 20

Inappropriate but persistent repetition of the same words or train of thought

Question 21

Clanging

Answer 21

Stringing together of words or sounds on the basis of rhyming

Question 22

Blocking

Answer 22

Train of thought interrupted by silence before idea is completed then thought being conveyed cannot be recalled

Question 23

Blunted affect or affective flattening

Answer 23

Emotions seem dampened, person’s emotional expression is reduced

Question 24

Avolition

Answer 24

Difficulty getting motivated and initiating goal directed action

Question 25

Alogia

Answer 25

Reduced speech output

Question 26

Anhedonia

Answer 26

Decreased ability to experience pleasure or remember previously pleasurable events

Question 27

Asociality

Answer 27

Refers to lack of interest in social interactions

Question 28

List some differential diagnoses for schizophrenia

Answer 28

- attenuated psychotic syndrome - brief psychotic disorder - schizophreniform psychosis - substance induced psychosis - organic psychosis - schizoaffective disorder

Question 29

Attenuated psychotic syndrome

Answer 29

Possibly prodromal for schizophrenia

Question 30

Brief psychotic disorder

Answer 30

Symptoms similar but last less than one month

Question 31

Schizophreniform psychosis

Answer 31

Symptoms similar but last between 1-6 months

Question 32

Substance induced psychosis

Answer 32

On withdrawal of substance, symptoms should resolve

Question 33

Organic psychosis

Answer 33

Need to investigate head injuries, look at concussive and impaired symptoms

Question 34

Schizoaffective disorder

Answer 34

Presence of psychotic symptoms within a mood episode and outside a mood episode (2 or more weeks)

Question 35

What are the phases of a psychotic episode

Answer 35

1. prodromal 2. active or acute 3. residual 4. remission or recovery

Question 36

Prodromal

Answer 36

The lead up to something; onset; early signs; some changes in perceptions

Question 37

Active or acute

Answer 37

Floridly psychotic, exhibiting clear psychotic symptoms

Question 38

Residual

Answer 38

Acute symptoms have resolve but still some signs of disorder or negative symptoms remain

Question 39

Remission or recovery

Answer 39

No psychotic symptoms remain

Question 40

What percentage of schizophrenics are employed?

Answer 40

10-20%

Question 41

When is typical onset?

Answer 41

Between 16-28

Question 42

What percentage of the global population is affected?

Answer 42

About 1%

Question 43

What is the percentage risk for genetic predisposition?

Answer 43

75%

Question 44

What are some other factors that can combine to cause schizophrenia?

Answer 44

- pre pregnancy factors - pregnancy stress - social stress - environmental stress - neurobiology (dopamine hypothesis)

Question 45

What is the risk for an adopted child of mother with psychotic disorder?

Answer 45

22%

Question 46

Which endophenotypes can be used to identify schizophrenia early?

Answer 46

- saccadic eye movement - social cognition - cognitive deficits

Question 47

What are endophenotypes?

Answer 47

Biological markers

Question 48

Stress-diathesis

Answer 48

Underlying vulnerabilities to schizophrenia can be impacted by stress and hence it could emerge

Question 49

Definition of psychosis

Answer 49

When perceptions and sensations lose touch with reality around you

Question 50

Contributions of John Haslam

Answer 50

- looked at schizophrenia from a scientific level | - believed they could be helped

Question 51

Contributions of Philippe Pinel

Answer 51

- took over management of Bicetre asylum - released prisoners from their chains - gradually discharged people - improved nutrition - stopped blood letting - forbade harsh treatment

Question 52

Contributions of Emil Kraepelin

Answer 52

- distinguished between schizophrenia and mood disorders | - first to characterise dementia praecox (schizophrenia)

Question 53

Contributions of Eugene Bleuler

Answer 53

- introduced the term schizophrenia (split brain) | - saw schizophrenia as splitting between emotional and intellectual functions

Question 54

Two or more of the following:

Answer 54

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

Question 55

Benefits of effective psychoeducation

Answer 55

- reduce number of relapses/episodes - reduce the need for hospitalisation - improve adherence with pharmacological and psychological treatment

Question 56

What is the modern recovery oriented approach

Answer 56

Personal recovery is about being able to create and live a meaningful life in a community of choice, with or without mental issues

Question 57

Which type of treatment works best for positive symptoms?

Answer 57

Anti-psychotic medications

Question 58

List 4 examples of inappropriate affect and disorganised behaviour

Answer 58

- extremely active/excited or lethargic - catatonic behaviour - unusual behaviour based on hallucinations and delusions - inappropriate affect

Question 59

Prevalence of schizophrenia

Answer 59

0.2 - 1.5%