Schizophrenia Spectrum/Other Psychotic Disorders Flashcards
A person whose biological mother and father have both received a diagnosis of schizophrenia is about _____ times more likely to receive the same diagnosis as a person whose only biological relative with schizophrenia is his or her non-twin sibling.
A. 50
B. 16
C. 5
D. 2
Answer C is correct. To identify the correct answer to this question, you need to know that the risk for receiving a diagnosis of schizophrenia is about 46% for a person whose biological mother and father have received the diagnosis, while the risk is about 9% for a person whose biological non-twin sibling is the only relative who has received the diagnosis. Forty-six divided by 9 is 5.1, which means that a person whose biological mother and father have received the diagnosis of schizophrenia is about 5 times more likely to receive the diagnosis than a person whose only relative with schizophrenia is a biological non-twin sibling.
The most likely diagnosis for a client who had auditory hallucinations and disorganized speech for five weeks and odd behaviors and anhedonia for an additional seven months is:
A. major depressive disorder with psychotic features.
B. schizophreniform disorder.
C. schizoaffective disorder.
D. schizophrenia.
Answer D is correct. The DSM-5-TR diagnosis of schizophrenia requires the presence of at least two active-phase symptoms for at least one month with at least one symptom being delusions, hallucinations, or disorganized speech plus continuous signs of the disorder (e.g., odd behaviors and avolition) for at least six months.
Which of the following is considered the most effective antipsychotic drug for treatment-resistant schizophrenia?
A. haloperidol
B. chlorpromazine
C. clozapine
D. risperidone
Answer C is correct. Clozapine is an evidence-based drug for treatment-resistant schizophrenia. It is recommended by the American Psychiatric Association and is FDA-approved for this purpose.
A reformulated version of the dopamine hypothesis proposes that the negative symptoms of schizophrenia are due to:
A. dopamine hyperactivity in certain subcortical areas.
B. dopamine hypoactivity in certain subcortical areas.
C. dopamine hyperactivity in certain cortical areas.
D. dopamine hypoactivity in certain cortical areas.
Answer D is correct. The research has not provided entirely consistent results but suggests that the factors that contribute to the positive and negative symptoms of schizophrenia differ: One theory is that the positive symptoms are due to dopamine hyperactivity in subcortical regions of the brain (especially in certain striatal areas), while the negative symptoms are due to dopamine hypoactivity in cortical regions (especially in the prefrontal cortex). See, e.g., R. Kuepper, M. Skinbjerg, and A. Abi-Dargham, The dopamine dysfunction in schizophrenia revisited: New insights into topography and course, in G. Gross and M. A. Geyer (Eds.), Current antipsychotics (pp. 1-26), New York, Springer, 2012.
A person who abuses an amphetamine or other ________-enhancing drug may develop symptoms similar to those associated with schizophrenia.
A. ACh
B. dopamine
C. serotonin
D. GABA
Answer B is correct. Knowing that the dopamine hypothesis is one of the explanations for the etiology of schizophrenia would have helped you identify the correct answer to this question. One of the factors that led to the dopamine hypothesis was the observation that high doses of amphetamines and other drugs that increase dopamine activity can produce hallucinations, delusions, and other symptoms associated with schizophrenia.
As reported by I. I. Gottesman (1991), the concordance rate for schizophrenia is about ___% for monozygotic twins and ____% for dizygotic twins.
A. 50; 30
B. 50; 25
C. 48; 24
D. 48; 17
Answer D is correct. Reported concordance rates vary somewhat. However, this question is asking specifically about the rates reported by I. I. Gottesman, who is frequently cited in the literature. He reported a 48% rate for monozygotic (identical) twins and a 17% rate for dizygotic (fraternal) twins.
A poor prognosis for people with schizophrenia is least associated with which of the following?
A. female gender
B. anosognosia
C. early age of onset
D. predominantly negative symptoms
Answer A is correct. A poorer prognosis for schizophrenia has been linked to several factors, including those listed in answers B, C, and D. In contrast, female gender is associated with a better prognosis.
A high level of expressed emotion by family members toward patients with schizophrenia has been linked to:
A. caregiver burnout.
B. substance use by the patient.
C. a better prognosis.
D. an increased risk for relapse.
Answer D is correct. High expressed emotion refers to a high degree of criticism, hostility, and emotional overinvolvement. High expressed emotion in family members has been linked to an increased risk for relapse for patients with schizophrenia and several other mental disorders.
Schizoaffective disorder is likely to be the appropriate diagnosis for a client if her psychotic symptoms have:
A. always occurred with concurrent mood symptoms.
B. occurred concurrently with mood symptoms except for a period of at least two weeks when her psychotic symptoms were absent.
C. occurred concurrently with mood symptoms except for a period of at least two weeks when her mood symptoms were absent.
D. occurred concurrently with mood symptoms except for a period of at least one month when her mood symptoms were absent.
Answer C is correct. Schizoaffective disorder is characterized by concurrent symptoms of schizophrenia and a major depressive or manic episode for most of the duration of the illness, but with the presence of delusions or hallucinations for two or more weeks without mood symptoms.
