Week 1

Question 1

What are the five domains that define schizophrenia spectrum and other psychotic disorders?

Answer 1

1. Delusions: Fixed beliefs resistant to contradictory evidence.
2. Hallucinations: Perception-like experiences without external stimuli, often auditory.
3. Disorganized Thinking (Speech): Includes derailment, tangentiality, or incoherence.
4. Grossly Disorganized or Abnormal Motor Behavior: Includes catatonia.
5. Negative Symptoms: E.g., diminished emotional expression, avolition, alogia, anhedonia, asociality.

Question 2

What are the common types of delusions in psychotic disorders?

Answer 2

1. Persecutory: Belief of being harmed or harassed.
2. Referential: Belief that certain cues are directed at oneself.
3. Grandiose: Belief in exceptional abilities or fame.
4. Erotomanic: False belief that another person is in love with them.
5. Nihilistic: Belief of an impending catastrophe.
6. Somatic: Preoccupation with bodily health or functions.

Question 3

What are the prominent negative symptoms in schizophrenia?

Answer 3

1. Diminished Emotional Expression: Reduced facial, eye, and vocal expressions.
2. Avolition: Decrease in self-initiated purposeful activities.
3. Alogia: Reduced speech output.
4. Anhedonia: Decreased pleasure in previously enjoyable activities.
5. Asociality: Lack of interest in social interactions.

Question 4

What are the diagnostic criteria for Brief Psychotic Disorder?

Answer 4

1. Presence of one or more symptoms: delusions, hallucinations, disorganized speech, or grossly disorganized/catatonic behavior.
2. Duration: At least 1 day but less than 1 month.
3. Full return to premorbid functioning.
4. Not attributable to another condition, substance, or mood disorder.

Question 5

What are the core diagnostic criteria for schizophrenia?

Answer 5

1. Two or More Symptoms (for 1 month): Delusions, hallucinations, disorganized speech, disorganized behavior, or negative symptoms.
2. Functional Impairment: Markedly below pre-onset functioning in work, relationships, or self-care.
3. Duration: Continuous signs for at least 6 months.
4. Exclusion of schizoaffective disorder or mood disorders with psychosis.

Question 6

What are hallucinations?

Answer 6

Perception-like experiences without an external stimulus, vivid and involuntary.

Question 7

What types of hallucinations are there?

Answer 7

1. Auditory (most common): Hearing voices, distinct from one’s own thoughts.
2. Visual, tactile, gustatory, or olfactory hallucinations.

Question 8

How are hallucinations classified in psychotic disorders?

Answer 8

Must occur in a clear sensorium; hypnagogic (falling asleep) or hypnopompic (waking up) hallucinations are normal.

Question 9

Must occur in a clear sensorium; hypnagogic (falling asleep) or hypnopompic (waking up) hallucinations are normal.

Answer 9

1. Loose Associations/Derailment: Switching from one topic to another.
2. Tangentiality: Answers unrelated or loosely related to questions.
3. Incoherence/Word Salad: Severely disorganized, incomprehensible speech.
   Note: Must impair communication significantly for diagnosis.

Question 10

What are the features of catatonia in psychotic disorders?

Answer 10

1. Decreased Reactivity: Resistance to instructions (negativism), mutism, stupor.
2. Motor Symptoms: Rigidity, bizarre postures, purposeless excessive motor activity.
3. Other Features: Grimacing, echolalia (repeating others’ speech), echopraxia (mimicking movements).
   Context: Can occur in schizophrenia, mood disorders, or medical conditions.

Question 11

What are the diagnostic criteria for Delusional Disorder?

Answer 11

1. One or More Delusions: Present for at least 1 month.
2. No other symptoms of schizophrenia.
3. Functioning Not Markedly Impaired: Behavior is not bizarre outside the delusions.
4. Excludes substance-induced or medically-related causes.
   Subtypes: Erotomanic, grandiose, jealous, persecutory, somatic, mixed, or unspecified.

Question 12

How does schizophreniform disorder differ from schizophrenia?

Answer 12

1. Symptoms: Identical to schizophrenia (delusions, hallucinations, disorganized speech, etc.).
2. Duration: Lasts at least 1 month but less than 6 months.
3. Impairment: Social/occupational functioning impairment not required.
4. May include a “provisional” diagnosis if recovery is uncertain.

Question 13

What distinguishes schizoaffective disorder from schizophrenia or mood disorders?

Answer 13

1. Criteria A of Schizophrenia: Delusions, hallucinations, or disorganized speech.
2. Mood Symptoms: Depressive or manic episodes present for the majority of the illness.
3. Psychosis Alone: Delusions or hallucinations for at least 2 weeks without mood symptoms.
4. Excludes substance-induced or medical causes.

Question 14

What are the known risk factors for developing schizophrenia?

Answer 14

1. Genetic: Family history of schizophrenia or related disorders.
2. Prenatal: Hypoxia, infection, malnutrition, or maternal stress during pregnancy.
3. Environmental: Urban upbringing, minority ethnicity, and late winter/early spring birth.
4. Physiological: Advanced paternal age and perinatal complications.

Question 15

What distinguishes delusional disorder from schizophrenia?

Answer 15

1. Single Symptom: Presence of one or more delusions lasting 1+ month.
2. No Schizophrenia Criterion A: Hallucinations are rare or minimal.
3. Functioning: Relatively preserved outside delusional context.

Question 16

What are the diagnostic criteria for schizoaffective disorder?

Answer 16

1. Uninterrupted illness with active psychosis meeting Criterion A for schizophrenia.
2. Major mood episode (depressive or manic) concurrent with psychosis.
3. At least 2 weeks of delusions or hallucinations without mood symptoms.
4. Mood symptoms present for the majority of the illness duration.

Question 17

How is schizophrenia differentiated from related disorders?

Answer 17

1. Brief Psychotic Disorder: Duration <1 month.
2. Schizophreniform Disorder: Duration 1-6 months.
3. Delusional Disorder: Delusions without other Criterion A symptoms.
4. Schizoaffective Disorder: Prominent mood symptoms with psychosis.
5. Substance-Induced Psychotic Disorder: Psychosis linked to substance use.

Question 18

What are common functional consequences of schizophrenia?

Answer 18

1. Impaired educational progress and employment.
2. Social isolation and difficulty maintaining relationships.
3. Persistent self-care challenges due to negative symptoms (e.g., avolition).

Question 19

Delusions

Answer 19

Fixed beliefs that are resistant to contradictory evidence. They can be persecutory, referential, grandiose, erotomanic, nihilistic, or somatic.

Question 20

Avolition

Answer 20

Decreased motivation to initiate and sustain goal-directed activities, leading to long periods of inactivity or lack of interest in social or work activities.

Question 21

Disorganized Speech

Answer 21

Speech that reflects disorganized thinking, such as loose associations, tangentiality, or incomprehensible “word salad.”

Question 22

Negative Symptoms

Answer 22

Symptoms characterized by a loss or reduction in normal functions, including diminished emotional expression, avolition, alogia, anhedonia, and asociality.

Question 23

Catatonia

Answer 23

A state of motor immobility or excessive motor activity that includes resistance to movement, bizarre postures, or purposeless movements.

Question 24

Persecutory Delusions

Answer 24

A belief that one is being harmed, harassed, or conspired against by others, which is the most common type of delusion.

Question 25

Grandiose Delusions

Answer 25

A belief in having exceptional abilities, wealth, or fame beyond reality.

Question 26

Brief Psychotic Disorder

Answer 26

A psychotic episode characterized by delusions, hallucinations, or disorganized speech lasting at least one day but less than one month, with a full return to premorbid functioning.

Question 27

Schizophreniform Disorder

Answer 27

A condition identical to schizophrenia in symptoms but lasting between 1 and 6 months, with or without significant functional impairment.

Question 28

Schizoaffective Disorder

Answer 28

A disorder characterized by symptoms of schizophrenia combined with mood disorder episodes, such as major depressive or manic episodes.

Question 29

Anhedonia

Answer 29

The diminished ability to experience pleasure from previously enjoyable activities or a decreased capacity to recall such pleasure.

Question 30

Asociality

Answer 30

Apparent lack of interest in social interactions, which may stem from limited opportunities or a genuine disinterest.

Question 31

Substance/Medication-Induced Psychotic Disorder

Answer 31

Psychosis directly caused by the physiological effects of a substance, such as drugs, medication, or toxin exposure, which resolves after removal of the agent.

Question 32

Schizophrenia

Answer 32

A disorder lasting at least 6 months, marked by delusions, hallucinations, disorganized speech, catatonia, or negative symptoms, and significant functional impairment.

Question 33

Delusional Disorder

Answer 33

A psychotic disorder with persistent delusions for at least 1 month, without other schizophrenia Criterion A symptoms, and with preserved functionality.

Question 34

Types of Delusions

Answer 34

Persecutory, referential, grandiose, erotomanic, nihilistic, somatic

Question 35

Auditory Hallucinations

Answer 35

Hearing voices distinct from one’s own thoughts

Question 36

Word Salad

Answer 36

Incoherent speech resembling severe linguistic disorganization.

Question 37

Catatonic Excitement

Answer 37

Purposeless, excessive motor activity

Question 38

Prodromal Symptoms

Answer 38

Early signs of schizophrenia, like odd beliefs and withdrawal.

Question 39

Mixed Delusional Disorder

Answer 39

Multiple delusional themes with no dominant type.

Question 40

Grandiose Type (Delusional Disorder)

Answer 40

Belief in unrecognized exceptional talent or importance.

Question 41

Tangentiality

Answer 41

Speech that veers off-topic and does not return.

Question 42

Negative Symptoms Examples

Answer 42

Avolition, alogia, anhedonia, asociality

Question 43

Functional Impairment in Schizophrenia

Answer 43

Poor self-care, unemployment, social withdrawal.

Question 44

First Episode, Acute (Schizophrenia)

Answer 44

Initial presentation meeting diagnostic criteria.

Question 45

Risk Factors for Schizophrenia

Answer 45

Urban upbringing, family history, prenatal complications.

Question 46

Brief Psychotic Disorder Duration

Answer 46

Lasts 1 day to less than 1 month.