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31 Cards in this Set
- Front
- Back
How long must symptoms be noted before a diagnosis of schizophrenia is made?
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At least 6 months.
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What is the age of onset for men? women?
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Men: 15-25 years
Women: 25-35 years |
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T/F: Schizophrenia is more prevalent in men than women.
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False: equal prevalence in both sexes
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T/F: Schizophrenia occurs equally in all cultural and ethnic groups.
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True
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Positive symptoms of schizophrenia (4)
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Delusions, hallucinations, agitation, and talkativeness
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Negative symptoms (6)
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Lack of motivation, social withdrawal, flat affect, cognitive disturbances, poor grooming, poor speech content
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T/F: The traditional antipsychotics treat positive symptoms.
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True: Negative symptoms respond better to atypical antipsychotics.
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What are the three phases of schizophrenia?
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Prodromal - avoid social activities, physical complain, interest in religion/the occult/philosophy
Psychotic phase - lose touch with reality, disorders of perception, thought content, though process, form of thought Residual phase - in touch with reality, but abnormal behavior (social withdrawal, flat or inappropriate affect, peculiar thinking) |
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Illusions and hallucinations are disorders of _____________.
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Perception
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Disorders of though content include ___________ (2).
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Delusion and idea of reference
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Impaired abstraction ability and neologisms (inventing new words) are disorders of ________________.
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Though processes
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Disorders of form of thought include ____________ in which patients shift between subjects in unrelated ways and _______________ in which the patient moves further from the point during conversation.
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1. Loose associations
2. Tangentiality |
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Prognosis:
Acute or chronic? |
Chronic, downhill course over years that stabilizes in mid-life.
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Suicide is a major risk of schizophrenia. What are some factors that are protective?
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Older at onset of illness
Married Social relationships Female Good employment history Mood symptoms (schizoaffective) Positive symptoms Few relapses |
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Occurrence:
General population ____ Child with one schizophrenic parent/sibling ____ Child with two schizophrenic parents ____ Monozygotic twin ____ |
1%
12% 40% 50% This shows evidence of genetic factors. Chromosome markers on 6, 8, and 13 have been implicated in some studies. |
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Season of birth with the greatest prevalence?
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Cold weather months - possible association with viral infection of mother in second trimester of pregnancy.
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What is the meaning of the "downward drift" hypothesis?
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Social deficits cause patients to drift down social scale, so many are in lower socioeconomic status groups (e.g. homeless).
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Evidence of neural pathology:
Frontal lobes? Ventricles? |
Decreased use of glucose in frontal lobes (using PET).
Lateral and third ventricles are enlarged; abnormal symmetry and changes in brain density may also be present. Ventricle enlargement is associated with negative symptoms (and therefore worse prognosis). |
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What neurotransmitter has been implicated? What is its metabolite?
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Dopamine
Metabolite is elevated: homovanillic acid (HVA) |
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What disturbance is present in eye movements?
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Poor smooth visual pursuit in 50-80% of patients and their relatives.
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Differential:
Medical illnesses, medications, and other psychotic disorders. List some other conditions that must be considered: |
Manic phase of bipolar disorder
Cognitive disorders Substance-related disorders Brief psychotic disorder Schizophreniform disorder Schizoaffective disorder Delusional disorder Shared delusional disorder (folie a deux) |
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Name the subtype:
Poor grooming, disheveled appearance, inappropriate emotional responses, disinhibition, onset before 25 years of age. |
Disorganized schizophrenia
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Name the subtype:
Stupor or agitation, lack of coherent speech, bizarre posturing (waxy flexibility), currently rare form (treated with antipsychotic agents) |
Catatonic schizophrenia
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Name the subtype:
Delusions of persecution, better functioning and older age at onset than other subtypes. |
Paranoid schizophrenia
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Name the subtype:
Characteristics of more than one subtype. |
Undifferentiated schizophrenia
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Name the subtype:
One previous schizophrenic episode and subsequent continued symptoms but no psychotic symptoms. |
Residual schizophrenia
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Name the disorder and give its prognosis:
Psychotic symptoms >1day, but <1month; often precipitating psychosocial factors |
Brief psychotic disorder; 50-80% recover completely
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Name the disorder and give its prognosis:
Psychotic and residual symptoms lasting 1-6 months. |
Schizophreniform disorder; 33% recover completely
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Name the disorder and give its prognosis:
Symptoms of mood disorder and psychotic symptoms. |
Schizoaffective disorder; lifelong social/occupational impairment, but more functioning than schizophrenics.
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Name the disorder and give its prognosis:
Fixed, persistent, nonbizarre delusional system. |
Delusional disorder; 50% complete recovery
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Name the disorder and give its prognosis:
Development of delusions in person in close relationship with someone with delusional disorder. |
Shared delusional disorder (folie a deux); 10-40% recover completely
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