Psychology Chapter on Schizophrenia and Delusions
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Questions and Answers

What is a characteristic feature of delusional perception?

  • Emotional instability
  • Confusion in speech
  • Physical aggression
  • Attributing delusional significance to normal perceptions (correct)

    • Which type of disorder has a duration of symptoms between 1 month and 6 months?

  • Schizophreniform Disorder (correct)
  • Schizoaffective Disorder
  • Brief Psychotic Disorder
  • Delusional Disorder

    • Which of the following statements about individuals with delusional disorder is true?

  • They typically exhibit severe cognitive deficits.
  • They avoid social interactions completely.
  • They often show extreme emotional instability.
  • Their behavior may appear normal when not discussing delusions. (correct)

    • Which symptom is categorized under cognitive symptoms of schizophrenia?

    <p>Problems with attention (C)</p> Signup and view all the answers

    Which of the following disorders is not classified in the DSM-5 under the schizophrenia spectrum?

    <p>Bipolar Disorder (B)</p> Signup and view all the answers

    What role do delusional beliefs often play in psychosocial functioning?

    <p>They can contribute to poor psychosocial functioning. (C)</p> Signup and view all the answers

    Which of the following symptoms is not typically associated with schizophrenia?

    <p>Excessive productivity (C)</p> Signup and view all the answers

    What common characteristic is noted in those with delusional disorder?

    <p>Apparent normality when delusions are not discussed (D)</p> Signup and view all the answers

    What does the term 'schizophrenia' derive from in Ancient Greek?

    <p>Split and mind (A)</p> Signup and view all the answers

    Which of the following is considered a core symptom of schizophrenia as outlined by Bleuler?

    <p>Disordered thought associations (B)</p> Signup and view all the answers

    In the context of schizophrenia, what are 'first rank symptoms'?

    <p>Symptoms that are pathognomic and specific to schizophrenia (D)</p> Signup and view all the answers

    What does the symptom of 'autism' refer to in schizophrenia?

    <p>Loss of awareness of external events (C)</p> Signup and view all the answers

    Which of the following symptoms is categorized as a secondary core symptom of schizophrenia?

    <p>Blunted affect (C)</p> Signup and view all the answers

    Which of the following statements about 'ambivalence' as a symptom of schizophrenia is accurate?

    <p>It indicates an apparent inability to make decisions. (B)</p> Signup and view all the answers

    What is a primary characteristic of the core symptoms of schizophrenia?

    <p>They stem from assumed organic deficits. (C)</p> Signup and view all the answers

    What phenomenon does the term 'Echo de la Pensée' describe?

    <p>Hearing one's thoughts articulated by an external voice. (D)</p> Signup and view all the answers

    What phenomenon describes when alien thoughts are inserted into a patient's mind by an external agency?

    <p>Thought Insertion (B)</p> Signup and view all the answers

    Which of the following best describes the experience of Thought Broadcasting?

    <p>Others can overhear or access the patient's thoughts. (D)</p> Signup and view all the answers

    What term is used for when a patient's emotions are influenced by an external agency?

    <p>Passivity of Affect (C)</p> Signup and view all the answers

    What phenomenon describes the feeling that a patient's physical impulses are controlled by an external agency?

    <p>Passivity of Impulse (A)</p> Signup and view all the answers

    Which statement best exemplifies the concept of Somatic Passivity?

    <p>A patient feels pain in their knee due to external rays. (D)</p> Signup and view all the answers

    In what way did the 29-year-old housewife describe the experience of Thought Insertion?

    <p>Her mind acted like a screen reflecting another's thoughts. (A)</p> Signup and view all the answers

    What is the main characteristic of Passivity of Volition?

    <p>External agencies dictate the patient's actions. (A)</p> Signup and view all the answers

    Which experience describes a patient feeling emotions that are not their own, as if projected by an external agency?

    <p>Passivity of Affect (D)</p> Signup and view all the answers

    What is the typical age range for peak risk of developing schizophrenia?

    <p>15-35 years (C)</p> Signup and view all the answers

    Which of the following is NOT considered an organic condition that may mimic schizophrenia?

    <p>Anxiety disorders (C)</p> Signup and view all the answers

    At what mean age is schizophrenia typically diagnosed in males?

    <p>28 years (D)</p> Signup and view all the answers

    What is the approximate lifetime prevalence of schizophrenia?

    <p>1% (B)</p> Signup and view all the answers

    Which of the following substances is associated with drug-induced psychotic disorder?

    <p>Cannabis (D)</p> Signup and view all the answers

    How does the presentation of schizophrenia differ between genders?

    <p>Men typically present earlier and more severely. (A)</p> Signup and view all the answers

    Which of the following neurological conditions is NOT associated with schizophrenia?

    <p>Asthma (C)</p> Signup and view all the answers

    Which remark about the sex ratio in schizophrenia is accurate?

    <p>Men are diagnosed earlier and only slightly more often. (B), It affects men and women equally. (D)</p> Signup and view all the answers

    What is the Duration of Untreated Psychosis (DUP)?

    <p>The time from the first psychotic symptom to the initiation of antipsychotic treatment (C)</p> Signup and view all the answers

    How does a longer DUP affect a patient's outcome at 6 months?

    <p>Predicts worse outcomes in various symptom areas (C)</p> Signup and view all the answers

    What is commonly required for patients with a long DUP during their first contact?

    <p>Hospital admission (A)</p> Signup and view all the answers

    Which of the following statements about the 'Rule of Thirds' is true?

    <p>One third will have a single episode and recover completely (D)</p> Signup and view all the answers

    Which factor is associated with a bad prognosis in psychosis?

    <p>Continual psychotic symptoms with notable deterioration (D)</p> Signup and view all the answers

    What aspect complicates the diagnosis of schizophrenia compared to other medical disorders?

    <p>It is primarily defined by psychological symptoms (C)</p> Signup and view all the answers

    What improvement is achieved by reducing DUP through early detection in cases of psychosis?

    <p>Better overall outcomes and quality of life (C)</p> Signup and view all the answers

    Severe symptoms in patients with long DUP can lead to which of the following difficulties?

    <p>Deterioration in social and occupational life (C)</p> Signup and view all the answers

    What does the drift hypothesis suggest about schizophrenia sufferers in urban areas?

    <p>They tend to migrate to urban areas as a result of their illness. (D)</p> Signup and view all the answers

    Which factor is associated with a higher prevalence of schizophrenia among second-generation immigrants in the UK?

    <p>Poor integration into society. (A)</p> Signup and view all the answers

    What is one possible biological cause for the increased prevalence of schizophrenia among those born in certain months?

    <p>Increased exposure to viral infections. (A)</p> Signup and view all the answers

    What does a concordance rate of about 50% in monozygotic twins indicate regarding schizophrenia?

    <p>Genetic and environmental factors are equally involved in its expression. (A)</p> Signup and view all the answers

    Which of the following is NOT considered an environmental risk factor for schizophrenia?

    <p>High socioeconomic status. (B)</p> Signup and view all the answers

    What is social defeat, in the context of schizophrenia, defined as?

    <p>Being excluded from the majority group. (D)</p> Signup and view all the answers

    Which symptom must be present in attenuated form for a diagnosis of attenuated psychotic syndrome?

    <p>Intact reality testing despite symptoms. (A)</p> Signup and view all the answers

    How does socioeconomic background typically affect schizophrenia sufferers?

    <p>Observed socioeconomic differences result from social drifting. (B)</p> Signup and view all the answers

    Study Notes

    Schizophrenia and Psychotic Disorders

    • Schizophrenia is a mental disorder characterized by "splitting" of psychic functions.
    • Eugen Bleuler coined the term schizophrenia in 1911.
    • Bleuler believed that a "loosening" of thoughts and feelings is a primary symptom.
    • Core symptoms are divided into fundamental and accessory.
    • Fundamental symptoms are specific to schizophrenia; accessory symptoms are shared with other disorders.
    • Fundamental symptoms are also divided into primary and secondary.
    • Primary symptoms arise from an organic deficit.
    • Secondary symptoms develop from a primary disturbance.
    • Primary symptoms include delusions and hallucinations.
    • 4 key fundamental symptoms (4As) include: associations (loosening of thought), affect (blunted), autism (loss of awareness), and ambivalence (inability to make decisions).

    Core Symptoms of Schizophrenia

    • Schneider (1959) identified first-rank symptoms (symptoms specific to schizophrenia).
    • These symptoms often involve auditory hallucinations.
    • Delusions of control (e.g., thoughts are inserted into or removed from one's mind by an external agency).
    • Delusions of passivity: affect, volition, and impulses (the belief that one's feelings, will, or impulses are controlled by external forces).

    4As (All Fundamental Symptoms)

    • Associations (loosening of thought): a disordered pattern.
    • Affect (blunted): diminished emotional response to stimuli.
    • Autism: a loss of awareness of external events, with preoccupation with self and one's own thoughts.
    • Ambivalence: an inability to make decisions.

    DSM-5 Categorization of Psychotic Disorders

    • Schizophrenia
    • Schizophreniform Disorder
    • Schizoaffective Disorder
    • Delusional Disorder
    • Brief psychotic Disorder
    • Substance/Medication-Induced Psychotic Disorder
    • Psychotic Disorder Due to Another Medical Condition
    • Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
    • Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

    Schizophreniform Disorder

    • Similar to schizophrenia, but the duration is shorter (1 month to 6 months).

    Schizoaffective Disorder

    • Presence of a major mood episode (depressive or manic) concurrent with schizophrenia criteria.
    • Distinguishing characteristic is that symptoms of delusions or hallucinations are present for at least 2 weeks without a major mood episode.

    Brief Psychotic Disorder

    • Symptoms present for at least one day but less than one month.
    • Full return to premorbid functioning.

    Delusional Disorder

    • Presence of one or more delusions of a duration of one month or longer.
    • Criterion A (for schizophrenia) is never met.

    Delusional Themes

    • Delusions of persecution
    • Delusions of control
    • Delusions of reference
    • Delusions of misidentification
    • Delusions of grandeur
    • Religious delusions
    • Nihilistic delusions
    • Somatic delusions
    • Delusions of jealousy
    • Delusions of love

    Epidemiology

    • Lifetime prevalence varies depending on diagnostic criteria.
    • Point prevalence is about 0.4%.
    • Peak risk is 15-35 years.
    • Prevalence similar across populations and relatively stable over time.
    • Higher prevalence seen in immigrants.

    Genetic Risk Factors

    • Concordance rate in monozygotic twins is approximately 50%, indicating a strong genetic component.
    • Genetic and environmental factors equally contribute to the expression of the disorder.

    Environmental Risk Factors

    • Obstetric complications
    • Immigration
    • Childhood trauma (abuse/neglect)
    • Winter birth (January-April in Northern hemisphere)
    • Urban living
    • Bullying
    • Cannabis use

    Social Defeat

    • Negative experience of being excluded from the majority group.

    Clinical High-Risk States (CHR)

    • States preceding psychosis.
    • Includes basic symptoms (perceptual and cognitive): COPERS (cognitive-perceptual basic symptoms), and COGDIS (cognitive disturbances).
    • UHR (ultra-high risk) criteria:
    • Attenuated positive symptoms (APS)
    • Brief limited intermittent psychotic symptoms (BLIPS).
    • Genetic risk/functional decline (GRFD).

    Attenuated Psychotic Syndrome (DSM-5)

    • One or more psychotic symptoms present in an attenuated form.

    Duration of Untreated Psychosis (DUP)

    • Time from first psychotic symptom to adequate antipsychotic treatment initiation.
    • Longer DUP correlates negatively with treatment outcomes leading to more severe illness.

    Treatment of First Episode Psychosis

    • Agreed choice of antipsychotic with patient/carer.
    • Titrate to minimum effective dose and follow up.
    • Reassess over 2-3 weeks and adjust to response/tolerability
    • Effective = continue at the dose
    • Not effective = change to another medication and repeat the titration process

    Antipsychotic Side Effects

    • Metabolic side effects
    • Movement side effects (EPS)
    • Cardiac side effects
    • Anticholinergic side effects
    • Prolactin-related sexual dysfunction
    • Sedation

    Depot preparations (long-acting injections)

    • Pros: better bioavailability, less potential misuse, and ensures regular contact with healthcare.
    • Cons: variable absorption, potential for adverse effects, and potential for poor compliance.

    Prognostic Factors

    • Good prognosis: acute onset, late onset, no precipitating factors, female sex, no family history.
    • Bad prognosis: insidious onset, early onset, negative symptoms, negative symptoms, male sex, family history.

    Difficulty with Diagnosing Schizophrenia

    • Symptoms are not always objective (no physical test for diagnosis).
    • Defining schizophrenia based on symptoms; symptoms vary amongst patients.
    • The classification could not accurately reflect a true disease or distinct disease entity.

    Tools

    • PANSS (Positive And Negative Syndrome Scale): for psychosis, clinician-rated, used across cultures for consistency.
    • CAPE: (Clinician-rated, self-rated): for psychotic-like experiences.
    • SIS-R (Schizotypal Personality Questionnaire): for schizotypy, clinician-rated.
    • CAARMS (Clinical High-Risk Assessment for Psychosis): clinician-rated; for (CHR) states;
    • SIPS (Short Intermittent Psychotic Symptoms): for CHR states; clinician-rated.

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    Schizophrenia and Psychotic Disorders PDF

    Description

    Test your knowledge on the key features of schizophrenia and delusional disorders. This quiz covers characteristics, symptoms, and classifications as outlined in psychology texts. Gain a deeper understanding of these complex mental health conditions through a series of insightful questions.

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