Thought Disorders

Question 1

Hypotheses for development of schizophrenia:

Answer 1

• Schizophrenogenic mother
• Dopamine pathway
• Glutamate pathway
• Prenatal/perinatal injury
• Neural migration abnormalities

Question 2

Definition of a thought disorder/psychotic disorder:

Answer 2

• Disorganized thoughts
• Hallucinations or delusions
• Loss of self, physical and mental boundaries
• Gross impairment of reality testing

Question 3

Who develops schizophrenia more? Men or women?

Answer 3

Develop it equally

Question 4

To be diagnosed with schizophrenia, you must have at least two of the following symptoms for at least one month, with at least one of the symptoms being in the top three.

Answer 4

• Hallucinations
• Bizarre delusions
• Disorganized speech
• Grossly disorganized or catatonic behavior
• Negative symptoms (flat/inappropriate affect, alogia, avolition)

Question 5

What are the three exclusion criteria from schizophrenia?

Answer 5

• No mood symptoms that predominate
• No medical causes (thyroid issues for example)
• Not induced by a substance

Question 6

What are the positive symptoms of schizophrenia? (symptoms that are added on to normal behavior of individual)

Answer 6

Hallucinations, delusions, disorganized behavior

Question 7

What are the negative symptoms of schizophrenia? (symptoms that are removed from normal behavior of individual)

Answer 7

• Isolation
• Withdrawal
• Poor hygiene
• Flat affect
• Lack of initiative
• Lack of interest
• Lack of energy

Question 8

How long must you have symptoms to have a diagnosis of schizophrenia?

Answer 8

At least 6 months

Question 9

Which schizophrenia subtype?

Preoccupation w/ one or more delusions or frequent auditory hallucinations

Answer 9

Paranoid schizophrenia

Question 10

Which schizophrenia subtype has best prognosis?

Answer 10

Paranoid schizophrenia

Question 11

Which schizophrenia subtype?

Motoric immobility (catalepsy or stupor), extreme negativism, echopraxia

Answer 11

Catatonic schizophrenia

Question 12

Which schizophrenia subtype still exists in DSM-V?

Answer 12

Catatonic

Question 13

Which schizophrenia subtype?

Absence of prominent delusions, hallucinations, disorganized speech, and grossly catatonic behavior, but there is continuing disturbance as indicated by negative symptoms in attenuated form

Answer 13

Residual schizophrenia

Question 14

What medications can cause thought disorder symptoms?

Answer 14

Steroids, interferons, anticholinergics

Question 15

What neurotransmitter is most associated with hallucinations?

Answer 15

Dopamine

Question 16

What substances can cause psychotic disorders during withdrawal?

Answer 16

Alcohol, sedatives, hypnotics, anxiolytics

Question 17

How does schizophreniform disorder differ from shizophrenia?

Answer 17

• Total duration: @ least 1 month, < 6 mths

- Impaired social/occupational functioning not required

Question 18

Sudden onset of delusions, hallucinations, disorganized speech, catatonic behavior that lasts @ least one day, but < 1 month w/ eventual return to baseline

Answer 18

Brief psychotic disorder

Question 19

One or more non-bizarre delusions that persist for @ least 1 month

Answer 19

Delusional disorder

Question 20

What defines non-bizarre delusions?

Answer 20

Situations that could occur in real life

Ex: being followed, poisoned, infected, loved at a distance (erotomanic), deceived by a spouse, having a disease

Question 21

What fraction of schizophreniform patients return to baseline?

Answer 21

1/3

the other 2/3 are diagnosed w/ schizophrenia

Question 22

What fraction of schizophrenic patients return to baseline?

Answer 22

0% - they go into residual schizophrenia instead

Question 23

Disorder with major mood symptoms (depressed or manic) w/ concurrent psychotic symptoms

Period of illness in which delusions are present for @ least 2 weeks in absence of prominent mood symptoms (DSM IV)

Answer 23

Schizoaffective disorder

Question 24

Folie a Deux

Answer 24

Shared psychotic disorder - two people share a delusion

Question 25

Stress-Diathesis model

Answer 25

Individual has vulnerability or genetic predisposition which, when acted on by stressor, leads to development of schizophrenic symptoms

Question 26

From dopaminergic cell bodes in ventral tegmentum to limbic areas - overactivity

May be important in auditory hallucinations and delusions “positive symptoms”

Answer 26

Mesolimbic pathway

Question 27

Dopaminergic neurons arise in ventral tegmental area and project to dorsolateral prefrontal cortex - underactivity

May be important in negative symptoms and cognitive changes

Answer 27

Mesocortical pathway

Question 28

Pathway altered by antipsychotic drugs causing movement side FX

Answer 28

Nigrostriatal dopamine pathway

Question 29

Pathway affected by antipsychotic drugs causing prolactin related side FX

Answer 29

Tuberoinfundibular pathway

Question 30

All antipsychotics block what type of receptors?

Answer 30

dopamine

Question 31

Glutamate hypothesis

Answer 31

Psychosis result of glutamate hyperactivity - excites cells to death in areas like dorsolateral prefrontal cortex

Question 32

What drug provides evidence for glutamate hypothesis?

Answer 32

PCP - causes abnormal glutamate excitation, resulting in psychosis

Question 33

Schizophrenia arises from abnormal brain dev and manifests clinically during late adolescence and early adulthood due to post-natal brain maturation

Answer 33

Neurodevelopmental hypothesis

Question 34

GLIOSIS

Answer 34

post natal brain injury

Question 35

What post mortem abnormalities are seen in schizophrenia?

Answer 35

Ventriculomegaly, temporal lobe volume decrease, abnormal neural migration (which occurs in utero) in frontal and temporal lobes

Question 36

Which networks are the last to mature in humans?

Answer 36

Frontal lobe networks