Psychology: Schizophrenia Overview
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Questions and Answers

What percentage of the population does schizophrenia occur in?

  • 0.5%
  • 2%
  • 5%
  • 1% (correct)

    • What is the suicide rate among patients with schizophrenia?

  • 50%
  • 20%
  • 5%
  • 10% (correct)

    • What is the risk of developing schizophrenia if you have a monozygotic twin with the disorder?

  • 40%
  • 60%
  • 20%
  • 50% (correct)

    • What is the main reason why patients with schizophrenia tend to drift down the socioeconomic scale?

    <p>Social deficits</p> Signup and view all the answers

    What is the main theory behind the development of schizophrenia?

    <p>Dopamine hypothesis</p> Signup and view all the answers

    What is the main characteristic of the residual phase of schizophrenia?

    <p>Negative symptoms</p> Signup and view all the answers

    What is the effect of stimulant drugs on dopamine availability in patients with schizophrenia?

    <p>Increase dopamine availability</p> Signup and view all the answers

    Why are patients with schizophrenia more likely to be found in lower socioeconomic groups?

    <p>Due to their social deficits</p> Signup and view all the answers

    What is the main characteristic of the frontal lobes in patients with schizophrenia?

    <p>Decreased use of glucose</p> Signup and view all the answers

    What is the main factor that improves the prognosis of schizophrenia?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic age range for the onset of schizophrenia in men?

    <p>15-25 years</p> Signup and view all the answers

    What is the primary difference between positive and negative symptoms of schizophrenia?

    <p>Positive symptoms are things additional to expected behavior, while negative symptoms are things missing from expected behavior.</p> Signup and view all the answers

    What is the primary characteristic of the prodromal phase of schizophrenia?

    <p>Avoidance of social activities and new interest in religion</p> Signup and view all the answers

    Which of the following is a characteristic of schizophrenia?

    <p>Abnormal affect and social withdrawal</p> Signup and view all the answers

    What is the primary difference between the effects of traditional and atypical antipsychotic agents on symptoms of schizophrenia?

    <p>Traditional antipsychotics are more effective for positive symptoms, while atypical antipsychotics are more effective for negative symptoms.</p> Signup and view all the answers

    What is the primary characteristic of patients with predominantly negative symptoms of schizophrenia?

    <p>They have more neuroanatomic and metabolic abnormalities.</p> Signup and view all the answers

    What is the primary feature of the active phase of schizophrenia?

    <p>Loss of touch with reality</p> Signup and view all the answers

    Which of the following is a positive symptom of schizophrenia?

    <p>Delusions</p> Signup and view all the answers

    What is the primary characteristic of the residual phase of schizophrenia?

    <p>Residual symptoms after the active phase</p> Signup and view all the answers

    What is the primary feature of schizophrenia in terms of demographics?

    <p>It occurs equally in men and women, and in all cultures and ethnic groups studied.</p> Signup and view all the answers

    What is the severity rating of hallucinations in which a person is severely pressured to respond to auditory hallucinations or is very upset by the voices?

    <p>4</p> Signup and view all the answers

    Which of the following is NOT a medical illness that can cause psychotic symptoms and mimic schizophrenia?

    <p>Diabetes</p> Signup and view all the answers

    Which of the following medications is NOT likely to cause psychotic symptoms?

    <p>Beta blockers</p> Signup and view all the answers

    Which of the following psychiatric illnesses is most likely to be associated with psychotic symptoms?

    <p>Mood disorder</p> Signup and view all the answers

    What is the primary advantage of atypical antipsychotic agents over traditional antipsychotics?

    <p>Fewer side effects</p> Signup and view all the answers

    What is the main purpose of psychological treatments in schizophrenia?

    <p>To provide long-term support and foster compliance with medication</p> Signup and view all the answers

    Which of the following personality disorders is characterized by odd behavior and avoidance of social relationships?

    <p>Schizotypal personality disorder</p> Signup and view all the answers

    What is the common characteristic of all psychotic disorders?

    <p>Loss of touch with reality</p> Signup and view all the answers

    Which of the following is an example of a long-acting injectable 'depot' form of antipsychotic medication?

    <p>Haloperidol decanoate</p> Signup and view all the answers

    What is the rating of abnormal psychomotor behavior in which a person exhibits severe abnormal or bizarre motor behavior or almost constant catatonia?

    <p>4</p> Signup and view all the answers

    Study Notes

    Schizophrenia Overview

    • Schizophrenia is a chronic, debilitating mental disorder characterized by periods of loss of touch with reality (psychosis), persistent disturbances of thought, behavior, appearance, and speech, abnormal affect, and social withdrawal.
    • Peak age of onset: 15-25 years for men and 25-35 years for women.
    • Occurs equally in men and women, all cultures, and all ethnic groups studied.

    Symptoms of Schizophrenia

    • Positive symptoms:
      • Delusions
      • Hallucinations
      • Agitation
      • Talkativeness
      • Respond well to most traditional and atypical antipsychotic agents
    • Negative symptoms:
      • Lack of motivation
      • Social withdrawal
      • Flattened affect
      • Cognitive disturbances
      • Poor grooming
      • Poor speech content
      • Respond better to atypical than to traditional antipsychotics

    Course of Schizophrenia

    • Three phases: prodromal, active, and residual
    • Prodromal phase:
      • Occurs prior to the first psychotic episode
      • Includes avoidance of social activities, physical complaints, and new interest in religion, the occult, or philosophy
    • Active phase:
      • Patient loses touch with reality
      • Disorders of perception, thought content, thought processes, and form of thought
    • Residual phase:
      • Patient is in touch with reality but does not behave normally
      • Characterized by negative symptoms

    Prognosis

    • Involves repeated psychotic episodes and a chronic, downhill course over years
    • Often stabilizes in midlife
    • Suicide risk: >50% attempt, 10% die in the attempt
    • Better prognosis and lower suicide risk if:
      • Older at onset of illness
      • Married
      • Has social relationships
      • Female
      • Has a good employment history
      • Has mood symptoms
      • Has few negative symptoms
      • Has few relapses

    Etiology

    • Genetic factors:
      • 1% of the population
      • Persons with a close genetic relationship to a patient with schizophrenia are more likely to develop the disorder
      • Markers on many chromosomes associated with schizophrenia
    • Other factors:
      • Season of birth: more people with schizophrenia are born during cold weather months
      • No social or environmental factor causes schizophrenia
      • Downward drift hypothesis: patients tend to drift down the socioeconomic scale due to social deficits

    Neural Pathology

    • Anatomy:
      • Abnormalities of the frontal lobes
      • Lateral and third ventricle enlargement
      • Abnormal cerebral symmetry
      • Changes in brain density
      • Decreased volume of limbic structures (e.g., amygdala, hippocampus)
    • Neurotransmitter abnormalities:
      • Dopamine hypothesis: excessive dopaminergic activity
      • Serotonin hyperactivity implicated
      • Glutamate implicated

    Diagnosis and Severity

    • DSM-5: no longer includes subtypes of schizophrenia, but rather distinguishes patients by the severity of their symptoms
    • Dimensions of Psychotic Symptom Severity:
      • Hallucinations
      • Delusions
      • Disorganized speech
      • Abnormal psychomotor behavior
      • Negative symptoms

    Differential Diagnosis

    • Medical illnesses that can cause psychotic symptoms (e.g., neurologic infection, neoplasm, trauma, disease, temporal lobe epilepsy, endocrine disorders)
    • Medications that can cause psychotic symptoms (e.g., analgesics, antibiotics, anticholinergics, antihistamines, antineoplastics, cardiac glycosides, stereotype hormones)
    • Psychiatric illnesses other than schizophrenia that may be associated with psychotic symptoms (e.g., mood disorders, cognitive disorders, substance-related disorders)
    • Schizotypal, paranoid, and borderline personality disorders are not characterized by frank psychotic symptoms

    Treatment

    • Pharmacologic treatments:
      • Traditional antipsychotics (dopamine-2 [D2]-receptor antagonists)
      • Atypical antipsychotic agents
      • Long-acting injectable "depot" forms
    • Psychological treatments:
      • Individual, family, and group psychotherapy
      • Useful to provide long-term support and to foster compliance with the drug regimen

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    Description

    Learn about schizophrenia, a chronic mental disorder characterized by periods of loss of touch with reality, thought disturbances, and social withdrawal. Discover the peak age of onset and its occurrence in different groups.

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