Schizophrenia and Psychotic Disorders Quiz
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Questions and Answers

What is a characteristic symptom of catatonic behavior?

  • Inappropriate laughter
  • Excessive verbal communication
  • Resistance to instructions (correct)
  • Negligence in hygiene

Which statement about the gender distribution of schizophrenia is accurate?

  • Women typically have an earlier onset than men.
  • It occurs equally in men and women.
  • Schizophrenia is more common in women after age 45.
  • Men have a higher incidence of schizophrenia overall. (correct)

What is catatonic excitement?

  • A state of extreme anxiety
  • A type of social withdrawal
  • Complete lack of motor response
  • Purposeless and excessive motor activity (correct)

At what age range do women typically experience the onset of schizophrenia?

<p>Ages 25 to 35 (B)</p> Signup and view all the answers

What is a common feature of disorganized behavior?

<p>Bizarre choice in clothing (D)</p> Signup and view all the answers

Which of the following statements about the prognosis of schizophrenia is accurate?

<p>Earlier onset generally correlates with a poorer long-term prognosis. (A)</p> Signup and view all the answers

Which condition is associated with catatonic symptoms aside from schizophrenia?

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

What is the global incidence rate of schizophrenia?

<p>4-5 per 1,000 people (C)</p> Signup and view all the answers

Which of the following best describes non-bizarre delusions?

<p>Beliefs that stem from ordinary life experiences and are plausible. (D)</p> Signup and view all the answers

What characterizes bizarre delusions?

<p>Beliefs that lack a basis in reality and cannot happen in normal circumstances. (C)</p> Signup and view all the answers

Which of the following is an example of a bizarre delusion?

<p>Maintaining that one can communicate telepathically with animals. (D)</p> Signup and view all the answers

What does the term somatic refer to in the context of delusions?

<p>The belief of having a severe disease without medical evidence. (A)</p> Signup and view all the answers

Which of the following statements regarding thought broadcasting is true?

<p>It is a belief that one’s thoughts can be shared or heard by others telepathically. (C)</p> Signup and view all the answers

Delusions of control refer to which of the following beliefs?

<p>Believing that one's body or actions are manipulated by external forces. (B)</p> Signup and view all the answers

Which aspect of delusions is most commonly referenced when discussing positive symptoms in psychological disorders?

<p>Altered perceptions of reality, often through delusions. (D)</p> Signup and view all the answers

What is a celotypical delusion primarily concerned with?

<p>The belief that a significant other is unfaithful. (C)</p> Signup and view all the answers

What commonly affects the life expectancy gap of individuals with schizophrenia?

<p>Social isolation and stigma (B)</p> Signup and view all the answers

Which of the following characteristics is typical of delusional disorder?

<p>Presence of non-bizarre delusions (B)</p> Signup and view all the answers

Which type of delusional disorder involves the belief that someone is in love with the individual?

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

What is a defining feature of brief psychotic disorder?

<p>Full remission after episodes (C)</p> Signup and view all the answers

Which of the following accurately describes the onset of psychotic symptoms in brief psychotic disorder?

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

What is a common risk factor for brief psychotic disorder?

<p>Major psychosocial stress (C)</p> Signup and view all the answers

Which symptom is NOT characteristic of patients with delusional disorder?

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

In which age group is brief psychotic disorder most commonly observed?

<p>Individuals in their 20s and 30s (A)</p> Signup and view all the answers

Which hypothesis suggests that excessive dopamine activity in limbic regions underlies positive symptoms of schizophrenia?

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

Which type of symptoms can NMDA receptor antagonists mimic in individuals?

<p>Schizophrenia-like symptoms (B)</p> Signup and view all the answers

What is a common outcome of clozapine and olanzapine antipsychotics in treating schizophrenia?

<p>Reduction of symptoms without extrapyramidal side effects (C)</p> Signup and view all the answers

What deficiency does the GABAergic hypothesis suggest contributes to schizophrenia?

<p>Deficiency in GABA (A)</p> Signup and view all the answers

What is a key feature of schizophrenia's active phase?

<p>Disorganized, illogical speech or behavior (D)</p> Signup and view all the answers

What abnormalities in the cannabinoid system are associated with schizophrenia?

<p>Deficits in parvalbumin expression (A), Reduced GAD67 mRNA levels (D)</p> Signup and view all the answers

Which statement regarding dopamine's role in schizophrenia is accurate?

<p>Reduced dopamine activity primarily affects the prefrontal cortex (B)</p> Signup and view all the answers

Which of the following may support the dopamine hypothesis in schizophrenia?

<p>Amphetamine-induced psychosis (C)</p> Signup and view all the answers

How does schizophrenia generally affect life expectancy?

<p>It decreases life expectancy by 15-25 years (A)</p> Signup and view all the answers

What is the significance of NMDA receptor trafficking in schizophrenia according to recent research?

<p>It leads to altered signaling and may contribute to symptoms. (D)</p> Signup and view all the answers

What is one of the main predictors of health risks in schizophrenia patients?

<p>Sedentary lifestyle and substance abuse (C)</p> Signup and view all the answers

What effect do D2-blocking antipsychotics have on dopamine levels in psychotic patients?

<p>They decrease presynaptic dopamine. (A)</p> Signup and view all the answers

Which neurotransmitter system is likely involved in schizophrenia beyond dopamine?

<p>Multiple neurotransmitter systems (C)</p> Signup and view all the answers

What is a significant contributor to increased mortality in schizophrenia-related deaths?

<p>Coronary heart disease (C)</p> Signup and view all the answers

Which of the following is NOT a limitation of the hypothesis regarding dopamine in schizophrenia?

<p>Conclusive evidence of decreased D2 receptors (B)</p> Signup and view all the answers

What lifestyle factor exacerbates health risks for individuals with schizophrenia?

<p>Smoking rates between 60-80% (D)</p> Signup and view all the answers

What characterizes the primary case in shared psychosis?

<p>The primary case is typically chronically ill. (B)</p> Signup and view all the answers

Which condition describes a scenario where two individuals develop the same delusion simultaneously?

<p>Folie simultanée (A)</p> Signup and view all the answers

What is a common result of separating the primary and secondary cases?

<p>The secondary case may abandon the delusion. (B)</p> Signup and view all the answers

Which of the following pairs are least likely to be involved in shared psychosis?

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

What describes the secondary case in a shared psychosis relationship?

<p>They are more passive and suggestible. (A)</p> Signup and view all the answers

In what rare cases can shared psychosis involve more than two people?

<p>Folie à famille (C)</p> Signup and view all the answers

Which emotional state is most associated with the secondary case?

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

What might lead a secondary case to maintain their delusion after separation?

<p>Strong emotional attachment (C)</p> Signup and view all the answers

Flashcards

Somatic Delusion

A false belief that one has a serious medical condition without medical evidence. Often, the cause is thought to be external.

Celotypical Delusion

A delusion centered on the belief that one's lover is unfaithful.

Religious Delusion

A false, held belief related to religious or spiritual matters.

Non-Bizarre Delusions

Delusions based on ideas that could theoretically occur in real life; plausible but believed falsely.

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Bizarre Delusions

Implausible delusions not based on real-life experiences; usually involve a loss of control or manipulation by outside forces.

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Thought Withdrawal

A delusion that an outside force has taken one's thoughts away.

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Thought Insertion

A delusion that thoughts are being put into one's mind by an outside force.

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Delusions of control

A delusion that one's body or actions are being controlled by an outside force.

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Dopamine Hypothesis

Suggests that excessive dopamine activity in brain regions like the nucleus accumbens (mesolimbic pathway) is linked to positive symptoms of schizophrenia.

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Evidence for Dopamine Hypothesis

Amphetamine-induced psychosis and the effectiveness of D2-blocking antipsychotics support this hypothesis.

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PET Studies and Dopamine

Positron Emission Tomography (PET) scans show increased dopamine levels in the brains of patients experiencing acute psychosis.

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GABAergic Hypothesis

Suggests that a deficiency in GABA, the main inhibitory neurotransmitter, contributes to schizophrenia.

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Reduced GABA Levels

Reduced GAD67 mRNA in key brain areas and deficits in parvalbumin-containing GABA interneurons may lead to abnormal pyramidal activity.

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NMDA Receptor Hypothesis

Suggests that disruptions in NMDA receptor function play a role in schizophrenia.

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NMDA Receptor Antagonists

Substances that block NMDA receptors, such as ketamine, can mimic schizophrenia-like symptoms.

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Cannabinoid Hypothesis

Implicates both exogenous cannabinoids (like cannabis) and abnormalities in the endogenous cannabinoid system in the development of schizophrenia.

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Disorganized behavior

A category of symptoms in mental illness characterized by unusual behavior, hygiene neglect, and inappropriate social interactions.

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Catatonic excitement

A state of purposeless, excessive motor activity without a clear reason, often seen in catatonic behavior.

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Negativism (catatonia)

A symptom of catatonic behavior where the individual resists instructions or attempts to communicate.

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Catatonic stupor

A state of complete lack of verbal and motor response, often seen in catatonic behavior.

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Schizophrenia prevalence

Schizophrenia affects about 4-5 people out of 1000, with rates varying globally.

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Onset of schizophrenia in males

Men usually experience schizophrenia between ages 18 and 25, with a higher incidence in adolescence and early adulthood.

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Onset of schizophrenia in females

Women typically develop schizophrenia between ages 25 and 35 but can also experience a second peak after 45.

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Later schizophrenia onset

A later onset of schizophrenia is generally associated with better long-term outcomes.

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Delusional Disorder

A mental health disorder characterized by persistent, false beliefs (delusions) that cannot be explained by other mental health conditions.

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Erotomanic Delusion

A delusion centered on the belief that someone, often a famous person or someone of higher status, is in love with the individual.

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Grandiose Delusion

A belief in having exceptional abilities, knowledge, or importance, often involving delusions of fame, power, or wealth.

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Jealous Delusion

A conviction that one's romantic partner is being unfaithful, despite evidence to the contrary.

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Persecutory Delusion

A belief that one is being harassed, targeted, or conspired against by others.

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Brief Psychotic Disorder

A mental health disorder characterized by sudden onset of psychotic symptoms (e.g., hallucinations, delusions) that last for at least one day but less than a month.

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Prefrontal Hypodopaminergia

Reduced dopamine activity in the prefrontal cortex, a brain area involved in executive function, planning, and motivation. This is thought to contribute to negative symptoms and cognitive difficulties in schizophrenia.

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Mesocortical Pathway

A pathway in the brain that connects the ventral tegmental area (VTA) to the prefrontal cortex. This pathway is involved in motivation, reward, and cognition. Dopamine dysfunction in this pathway is believed to be implicated in schizophrenia.

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Schizophrenia Duration

The duration of schizophrenia involves at least one month of active psychotic symptoms and at least six months of total illness, including prodrome, acute phase, and residual symptoms.

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Schizophrenia Symptoms

Hallmarks of schizophrenia include disorganized speech, bizarre behavior, impaired cognition, and dysfunction in one or more life domains. The symptoms are not attributable to substance use or other medical conditions.

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Schizophrenia Prognosis

Individuals with schizophrenia have a reduced life expectancy due to increased risks of metabolic, cardiovascular, respiratory, and infectious diseases. These risks are exacerbated by lifestyle factors and antipsychotic side effects.

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Nicotine Use in Schizophrenia

Over 90% of schizophrenia patients smoke, potentially due to nicotine's ability to temporarily reduce positive symptoms and improve some cognitive impairments.

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Schizophrenia-Related Deaths

Around 75% of deaths related to schizophrenia are due to coronary heart disease.

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Schizophrenia: Multi-Neurotransmitter System

Although dopamine dysfunction plays a significant role, schizophrenia likely involves multiple neurotransmitter systems, as evidence suggests other neurotransmitters and inconsistent findings on dopamine receptor density are implicated.

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Shared Psychosis

A rare mental disorder where two or more individuals develop the same delusion, with one person usually influencing the other.

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Primary Case

The individual in shared psychosis who is usually chronically ill and influences the other person to adopt their delusions.

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Secondary Case

The individual in shared psychosis who is more passive, suggestible, and may adopt the delusions of the primary case.

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Folie à Deux

A specific type of shared psychosis where two individuals develop the same delusion.

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Folie Simultanée

A form of shared psychosis where two individuals develop the same delusion at the same time.

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Separation and Delusions

Sometimes, the secondary case in shared psychosis may abandon the delusion after separation from the primary case.

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Family Relationships

Shared psychosis most commonly occurs in family settings, like sister-sister, husband-wife, or mother-child relationships.

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Multiple Cases

While uncommon, shared psychosis can involve more than two individuals (e.g., folie à trois, quatre, cinq, or folie à famille).

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Study Notes

Schizophrenia Spectrum and Other Psychotic Disorders

  • Schizophrenia is a complex group of disorders, not a single disease, with varied causes, presentations, and progressions.
  • The fundamental nature of the illness is unclear.
  • Symptoms include changes in perception, emotion, cognition, thinking, and behavior.
  • Symptoms vary significantly between individuals and over time, but the effects are always severe and long-lasting.
  • Diagnosis relies entirely on psychiatric history and mental status examination. No specific tests exist.
  • Most tests are used to rule out other causes of psychosis.
  • Common misunderstandings lead to inadequate care and social ostracism for patients and families.

Objectives

  • Describe the psychopathology of psychosis (Positive, Negative, Cognitive, Speech, Behavior).
  • Identify disorders in the psychotic spectrum and their key characteristics.

Key Characteristics of Psychotic Spectrum Disorders

  • Delusional Disorder
  • Brief Psychotic Disorder
  • Schizophreniform Disorder
  • Schizophrenia
  • Schizoaffective Disorder
  • Shared Psychotic Disorder
  • Substance-Induced Psychotic Disorder
  • Psychotic Disorder due to Medical Condition

Psychosis

  • Psychosis is a collection of symptoms affecting the mind, marked by a loss of contact with reality, characterized by disrupted thoughts and perceptions.
  • Key features of psychotic disorders include abnormalities in delusions, hallucinations, disorganized thinking (speech), grossly disorganized or abnormal motor behaviors (e.g., catatonia), and negative symptoms.

Positive Symptoms

  • Positive symptoms are excesses or distortions of normal functions, easily noticeable, and fluctuate throughout the illness.
  • Associated with poor quality of life.
  • Include: Hallucinations (auditory, visual, olfactory, tactile, gustatory, and presence hallucinations); Delusions (persecutory, reference, grandiose, erotomanic, nihilistic, control, somatic, and celosotypical); disorganized thinking and speech; disorganized behavior (including catatonia).

Delusions

  • Delusions are fixed, false beliefs, not based in reality, held with strong conviction.
  • Can occur with or without other psychotic symptoms.
  • Types include persecutory, referential, grandiose, erotomanic, nihilistic, control, somatic, and religious delusions.

Non-Bizarre vs. Bizarre Delusions

  • Plausible delusions derive from ordinary life experiences, while implausible or bizarre delusions stem from non-ordinary or unrecognizable experiences.

Negative Symptoms

  • Negative symptoms are deficits in normal functions.
  • These symptoms are often difficult to spot, often precede the first psychotic episode, and persist despite periods of remission.
  • They strongly impact a patient's quality of life, independence, ability to return to work, and social relationships.
  • Negative symptoms include affective flattening, alogia, avolition, anhedonia, and social withdrawal.

Cognitive Symptoms

  • Cognitive impairment is common, affecting 85% of patients, impacting memory, attention learning, executive functioning (planning, problem solving), and comprehension.
  • Cognitive symptoms worsen quality of life, relationships, work, treatment adherence, social functioning, and aspects of daily life(e.g., self-care, cooking).

Disorganized Thinking (Disorganized Speech)

  • Disorganized speech represents a formal thought disorder, characterized by language changes in thought patterns.
  • Includes impairments in forming ideas, expressing thoughts, run-on sentences, jumbled/incoherent words, illogical associations of concepts, and awkward phrasing.
  • Less severe forms may occur during prodromal and residual periods of schizophrenia.

Disorganized Behavior

  • Involves diverse types of inappropriate behaviors.
  • Includes unprovoked outbursts of emotions (laughter, agitation, and violence), inappropriate social behaviors, and severe neglect and bizarreness in hygiene and clothing.
  • Catatonia (a form of disorganized behavior) characterized by reductions in responsiveness, rigid postures, lack of verbal and motor responses, and purposeless motor activity.

Schizophrenia

  • Schizophrenia is a complex group of disorders, prevalent in men in the age group of 18–25 years and in women between 25-35 years.
  • More prevalent in men, but the onset before 10 is rare.

Etiopathophysiology of Schizophrenia

  • Genetic, viral (seasonal), and social factors are hypothesized to contribute to the development of schizophrenia.
  • Neurochemical/biochemical abnormalities (dopamine, serotonin, glutamate, GABA) are implicated.
  • No single cause or abnormality is universally agreed upon.

Diagnostic Criteria (Schizophrenia, Brief Psychotic Disorder, Schizophreniform Disorder, Schizoaffective Disorder)

  • A specific number of symptoms must be present for a determined period.
  • Criteria are based on delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms.
  • Specifiers are based on symptoms and duration.
  • Exclusion criteria are related to other mental disorders or the physiological effects of a substance or other medical conditions.

Substance-Induced Psychotic Disorder

  • Delusions and hallucinations may arise from substance use/withdrawal or exposure to substances (medication) known to cause similar symptoms.

Psychotic Disorder due to Medical Condition

  • Psychotic symptoms can be a direct result of a medical condition.
  • This is supported by the patient's history, physical examination, and laboratory findings.
  • The symptoms, not any other mental disorder, are the primary concern.

Shared Psychotic Disorder

  • This disorder, also known as folie à deux, involves the transmission of delusions from one person to another, typically in close, long-term relationships.
  • The primary case influences the secondary case towards adopting the delusion.

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Schizophrenia Spectrum and Other Psychotic Disorders PDF

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Test your knowledge on the spectrum of schizophrenia and other psychotic disorders. Explore the symptoms, diagnosis, and key characteristics of these disorders. This quiz will help reinforce your understanding of the complexities of psychosis and its impact on individuals.

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