SCHIZOPHRENIA

Question 1

neurosis is less severe=

Answer 1

anxiety and mood disorder

-symptoms of stress but not a radical loss of touch with reality

Question 2

psychosis is more severe=

Answer 2

a loss of contact with reality

*can be psychotic but also experience symptoms of neurosis

Question 3

History

Answer 3

Dementia Praecox- Biological = Kraepelin, 1893

Schizophrenia- Freudian = Eugene Bleuler, 1911

Question 4

Epidemiology

Answer 4

• 0.7% of people
• higher prevalence un inner cities/ lower socioeconomic
• 20% of psychiatric hospitals
• 20% attempted suicide admissions
• 2/3 of ‘insanity pleas’ in legal cases

Question 5

Onset

Answer 5

• usually between late teens and mid 30s
• only if symptoms persist for 6 months
• three episodes: prodromal, active and residual

Question 6

DSM-5

Answer 6

NO LONGER SUBTYPES

2 or more for at least a month/signs of disturbance for 6 months or more:

1. delusions (+)
2. hallucinations(+)
3. disorganised speech(+)
4. disorganised behaviour
5. negative symptoms

• diminished level of functioning in work, relationships or self care

Positive symptoms (also includes motor and thought disturbances)= generally more responsive t treatment than negative symptoms

Question 7

Thought broadcasting

Answer 7

one’s own thoughts are being broadcast or transmitted to others

Question 8

Thought withdrawal

Answer 8

ones thoughts are being removed from ones own mind

Question 9

Delusions of grandeur

Answer 9

one is famous or powerful person from past or present

Question 10

Delusions of control

Answer 10

some external force is trying to take control of one’s thoughts

Question 11

Delusions of reference

Answer 11

all happenings revolve around oneself/ centre of attention

Question 12

Delusions of persecution

Answer 12

one is the target of others’ mistreatment, evolution plots, murderous intent

Question 13

Delusions of jealousy

Answer 13

that everyone is jealous of them

Question 14

Hallucinations- sensory perception is not perceived by others

Answer 14

• auditory= sounds and voices outside
• visual= clear or vague
• tactile- tingling, burning, electric shock
• somatic-insects crawling under skin

Question 15

Disorganised thinking and speech

Answer 15

Illogical, disconnected thought and speech patterns

-thought alienation
derailment 
neologisms 
-perseveration 
-clang and rhyming 
-word salad

Question 16

loose associations (cognitive slippage)

Answer 16

repeatedly shifting from topics without apparent or logical connection

Question 17

neologisms

Answer 17

new, seemingly meaningless words formed by combining words

Question 18

disorganised motor disturbances

Answer 18

extreme activity levels, peculiar body movements or postures, strange gestures and grimaces

Question 19

Negative symptoms examples

Answer 19

• flat affect- show no emotion at all
• anhedonia- lack of pleasure or enjoyment
• alogia- reduction in amount and meaningful content of speech
• avolition- feeling drained of energy and unable to initiate course of action
• inability to engage in routine or goal-directed activities
• inability to feel pleasure; lack of interest or enjoyment in activities or relationships

Question 20

The prodromal phase

Answer 20

• changed occur in weeks, months, years before
• irritability
• fragmentary psychotic symptoms
• avoidance of work and social functioning
• “attenuated general functioning”

Question 21

The active phase

Answer 21

• “Florid” psychotic symptoms (distortions in thinking, delusions, hallucinations(
• anxiety, depressions and fear
• difficult to distinguish between manic episode
• dangerous with presence of paranoid elements

Question 22

The residual phase

Answer 22

• symptoms ease a bit
• same symptoms may persist

*not a DSM term

Question 23

Schizoaffective disorders

Answer 23

• presence of schizophrenia and bipolar

* some clinicians think schizophrenia is a group of disorders- different symptoms = different treatments

Question 24

Genetics

Answer 24

• 80% heritability (17% fraternal-prenatal and 48% identical twins)
• adoption studies
• epigenetics- changing of expression of genes to be coded
• mutations are rare

Question 25

Risk Factors - The dopamine hypothesis

Answer 25

excessive levels of dopamine or sensitivity to dopamine (uptake) *antipsychotic drugs lower dopamine amounts

Question 26

Risk Factors - Enlarged ventricles

Answer 26

- CT scene and MRI - deteriorations or atrophy of brain- increased blood flow - increased compared to twin or sibling

Question 27

Risk Factors - substance abuse

Answer 27

- biological vulnerability - may not be first exposure, may be fourth or fifth - ecstatcy, alcohol, cocaine, marijuana, crystal meth

Question 28

Risk Factors - Stress

Answer 28

of life events and trauma -in combination with biological vulnerability - hallucinations often be meaningfullly linked to earlier trauma or stress - high rates of reports of child abuse and trauma (childhood risk factors)

Question 29

Risk Factors - Smoking

Answer 29

- correlation | - cigarettes used a a from of self-medication, not that cigarettes trigger psychosis

Question 30

Risk Factors - Social causation hypothesis

Answer 30

different standards of healthcare, poorer living conditions which increase stress

Question 31

Risk Factors - Social drift hypothesis

Answer 31

clinical features of psychotic disorder contribute to gradual downward socioeconomic trajectory

Question 32

Treatments for Schizophrenia - Conventional antipsychotic drugs

Answer 32

- reduce positive symptoms of schizophrenia in around 65% of cases * unwanted Parkinson's disease side effects:muscle tremors, muscle rigidity, taking, shuffling feet, lack of facial expression

Question 33

Treatments for Schizophrenia - Atypical antipsychotic drugs

Answer 33

- act of both dopamine and serotonin systems - more effective: help 85% of schizophrenics - help negative and positive symptoms *major danger in side-effects e.e.g agranulocytosis

Question 34

Treatments for Schizophrenia - Group Therapy

Answer 34

Hearing Voices Network | -bring people who suffer from hallucinations together to talk about their experiences and to find their voices

Question 35

Prognosis

Answer 35

- after 5 years, one quarter recover completely - gradually improves, only deterioration in 10% - better prognosis for this diagnosed in adulthood than childhood - 20% of people attempt suicide

Question 36

Recurrence

Answer 36

- 20%have only one episode - 35% go on to have several episodes with no impairment between - about 10% have multiple episode with a static level of functional and personality impairment. between - 35% have multiple episodes with increasing levels of impairment

Question 37

Subclinical symptoms

Answer 37

Experiences associated with schizophrenia- such as paranoid delusional thinking and auditory hallucinations- are observes in an attenuated for in 5-8& of healthy people.

Question 38

Unusual belief in the general population

Answer 38

- 45% beloved in telepathy - 45% believed in the ability to predict the future - 31% believed in ghosts - 21% said there had been ties over the past year when they'd felt that people were against them - 9% said they had believed that they thoughts were being controlled or interfered with by some outside force or person - 1.5% said there had been ties when they'd felt people were plotting to cause them serious harm.