Schizophrenia and Psychotic Disorders

Question 1

What are the 5 psychotic domain symptoms?

Answer 1

• Delusions
• Hallucinations
• Disorganized speech
• Disorganized or catatonic behavior
• Negative symptoms

The core domain symptoms are delusions, hallucinations, disorganized speech, and negative symptoms.

Question 2

What is a delusion of grandeur?

Answer 2

A fixed belief that one has exceptional abilities or is famous

This is a type of delusion commonly seen in schizophrenia.

Question 3

Differentiate between a positive and negative symptom with examples.

Answer 3

Positive symptom: Hallucinations
Negative symptom: Avolition

Positive symptoms add to the individual’s experience, while negative symptoms reflect a decrease in normal functions.

Question 4

What are Bleuler’s 4 As of schizophrenia?

Answer 4

• Affect (diminished emotional expression)
• Association (disorganized thinking)
• Ambivalence (conflicting feelings)
• Autism (social withdrawal)

These symptoms contrast with Schneider’s first-rank symptoms.

Question 5

What characterizes the Active Phase of schizophrenia?

Answer 5

Presence of at least 2 psychotic domain symptoms for 1+ month

At least one symptom must be a core domain symptom.

Question 6

True or False: Hallucinations are the most common type of psychotic symptom.

Answer 6

True

Auditory hallucinations are particularly prevalent.

Question 7

What is the typical onset age for schizophrenia?

Answer 7

Late teens

Onset may be slightly later in women.

Question 8

Define the term ‘disorganized speech’ in the context of schizophrenia.

Answer 8

Speech lacks normal logical connections between thoughts

Patients may exhibit symptoms like loose associations and word salad.

Question 9

What is the difference between a bizarre and a non-bizarre delusion?

Answer 9

Bizarre delusion: Clearly implausible
Non-bizarre delusion: Physically possible

This distinction is important for diagnosing delusional disorders.

Question 10

List the types of extrapyramidal symptoms associated with antipsychotic treatment.

Answer 10

• Parkinsonism
• Akathisia
• Dystonia
• Tardive dyskinesia
• Neuroleptic malignant syndrome

Each type has distinct clinical symptoms and onset timing.

Question 11

What is the dopamine hypothesis of schizophrenia?

Answer 11

Disruption in dopamine pathways leads to positive and negative symptoms

Excess dopamine is associated with positive symptoms, while deficiency in certain areas is linked to negative symptoms.

Question 12

What characterizes the residual phase of schizophrenia?

Answer 12

Symptoms are less severe, often consisting of negative symptoms or subthreshold forms

This phase follows the active phase.

Question 13

Fill in the blank: The DSM no longer subtypes schizophrenia except to specify ‘with _______’.

Answer 13

catatonia

This reflects changes in how schizophrenia is classified in the DSM.

Question 14

What is ‘dual diagnosis’ in the context of schizophrenia?

Answer 14

Co-occurrence of mental illness and substance use disorder

This is common among patients with schizophrenia.

Question 15

What is the role of Electroconvulsive Therapy (ECT) in treating schizophrenia?

Answer 15

Not usually as effective as medications but may be useful for catatonic subtype

ECT is considered for specific cases.

Question 16

What is the significance of the ‘downward drift’ phenomenon in schizophrenia?

Answer 16

Higher prevalence of low socioeconomic status among patients

This often results from the impact of the illness on functioning.

Question 17

What are the common neuropsychological impairments seen in schizophrenia?

Answer 17

• Attention
• Memory
• Verbal fluency
• Executive functions

These impairments affect daily functioning and quality of life.

Question 18

What is the primary difference between first-generation and second-generation antipsychotics?

Answer 18

First-generation primarily block dopamine receptors; second-generation block both dopamine and serotonin receptors

This difference influences the range of symptoms treated and side effects experienced.

Question 19

What is a characteristic symptom of catatonia?

Answer 19

Posturing

Catatonia involves multiple motor/behavioral abnormalities, including waxy flexibility and non-responsiveness.

Question 20

What defines Schizophreniform Disorder?

Answer 20

Identical symptoms to schizophrenia but with duration of 1+ month but less than 6 months

Sometimes provisional for schizophrenia until the 6-month duration is reached.

Question 21

What is a common misconception about violence in individuals with schizophrenia?

Answer 21

Schizophrenics are not at higher risk of homicide

Despite media portrayal, the risk of violence is often exaggerated.

Question 22

Describe the variant of delusional disorder that is socially-transmissible.

Answer 22

A delusion develops in the context of a close relationship with a psychotic individual

This is also known as ‘Shared Psychotic Disorder’.

Question 23

What is the Somatic Type in Delusional Disorder?

Answer 23

Belief involving bodily functions/sensations, such as parasitosis, malodorous, organ dysfunction

Somatic Type reflects a specific delusional belief about physical health.

Question 24

Differentiate between Body Dysmorphic Disorder (BDD) and Illness Anxiety Disorder (IAD).

Answer 24

BDD involves appearance-related delusions; IAD involves health worries without delusions

BDD and IAD are differentiated by the presence of delusions in BDD.

Question 25

What is the Unspecified Type of Delusional Disorder?

Answer 25

Theme is none of the above ## Footnote Unspecified Type indicates that the delusion does not fit established categories.

Question 26

What characterizes the Active Phase of Schizophrenia in Schizoaffective Disorder?

Answer 26

Occurs concurrently with a major mood episode and lasts 2+ weeks without mood symptoms ## Footnote Active Phase is essential for diagnosing Schizoaffective Disorder.

Question 27

What are the subtypes of Schizoaffective Disorder?

Answer 27

* Bipolar Type (if mania is experienced) * Depressive Type (if depression is experienced without mania) ## Footnote Subtypes help classify the disorder based on mood symptoms.

Question 28

What is the duration of psychotic symptoms in Schizoaffective Disorder?

Answer 28

6 months of concurrent psychotic and depressed symptoms, with 3 additional months of psychosis after depression resolves ## Footnote This duration is crucial for diagnosis.

Question 29

What is the key feature of Major Depressive Disorder with psychotic features?

Answer 29

Concurrent psychotic and depressed symptoms for 6 months ## Footnote Important for differentiating from other disorders.

Question 30

What are the genetic factors associated with Delusional Disorder?

Answer 30

More common in individuals with family members who have Delusional Disorder or schizophrenia ## Footnote Genetic predisposition plays a significant role.

Question 31

What neurotransmitter imbalances are associated with Delusional Disorder?

Answer 31

Dopamine and serotonin imbalance ## Footnote Neurotransmitter dysfunction is thought to contribute to the disorder.

Question 32

What environmental factors may trigger Delusional Disorder?

Answer 32

* Stress * Isolation * Alcohol and drug abuse ## Footnote Environmental influences can exacerbate symptoms.

Question 33

What is known about the etiology of Schizoaffective Disorder?

Answer 33

Unknown but thought to overlap with schizophrenia ## Footnote The relationship with schizophrenia complicates understanding of the disorder.

Question 34

What are common treatments for Delusional and Schizoaffective Disorders?

Answer 34

* Antipsychotic medications * Individual psychotherapy * Cognitive-behavioral therapy (CBT) * Psychosocial therapy * Family therapy ## Footnote A combination of therapies addresses both symptoms and underlying issues.