Schizophrenia DSM-5 Quiz

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Questions and Answers

Which of the following symptoms is NOT part of the DSM-5 criteria for Schizophrenia?

Delusions

Extreme euphoria (correct)

Disorganized speech

Hallucinations

What is a hallmark feature of psychosis as defined in the content?

Heightened sensory perception

Improved social functioning

Loss of contact with reality (correct)

Increased emotional expression

In the context of Schizophrenia, what is indicated by negative symptoms?

Increased production of speech

Diminished emotional expression (correct)

Intense hallucinations

Euphoria in social interactions

How long must symptoms persist for a diagnosis of Schizophrenia according to the DSM-5?

At least 6 months, including some active symptoms Signup and view all the answers

During which stage of life does Schizophrenia typically appear?

Young adulthood Signup and view all the answers

Which of the following is an example of catatonic behavior in Schizophrenia?

Lack of motion or response Signup and view all the answers

What does the term 'deterioration of functioning' refer to in the context of Schizophrenia?

Loss of personal, social, and occupational capabilities Signup and view all the answers

Which of the following is primarily responsible for defining Schizophrenia as a thought disorder?

Strange perceptions and disturbed thought processes Signup and view all the answers

What distinguishes positive symptoms of schizophrenia from negative symptoms?

Positive symptoms involve the presence of abnormal thoughts or behaviors. Signup and view all the answers

Which of the following is NOT considered a positive symptom of schizophrenia?

Emotional blunting Signup and view all the answers

In the diagnosis of schizophrenia, when can a concurrent diagnosis be made in the presence of a history of autism spectrum disorder?

If prominent delusions or hallucinations are present for at least 1 month. Signup and view all the answers

What is the major characteristic of delusions of reference?

Interpreting random events as having personal significance. Signup and view all the answers

Which type of hallucination is the most commonly experienced by individuals with schizophrenia?

Auditory hallucinations Signup and view all the answers

What type of disturbance is categorized as a negative symptom of schizophrenia?

Affective flattening Signup and view all the answers

Which of the following statements accurately describes delusions of persecution?

They are the most common type of delusion. Signup and view all the answers

What is a critical factor in ruling out schizoaffective disorder in a patient?

Absence of major depressive or manic episodes during active symptoms. Signup and view all the answers

What is a common cognitive feature observed in individuals with schizophrenia?

Looseness of association Signup and view all the answers

Which therapy approach emphasizes training social interactions and relationships?

Social skills training Signup and view all the answers

What mental status examination feature is characterized by reduced emotional responsiveness?

Flattened affect Signup and view all the answers

Which of the following represents a negative symptom of schizophrenia?

Withdrawn behavior Signup and view all the answers

What is a primary contributing factor to brain volume reductions in individuals diagnosed with schizophrenia?

Poor cardiorespiratory fitness Signup and view all the answers

How might a person with schizophrenia exhibit thought process difficulties?

Poverty of thought content Signup and view all the answers

Which clinical feature is NOT typically associated with schizophrenia?

Increased empathy Signup and view all the answers

In the case of John, what behavior indicates a potential catatonic state?

Prolonged periods of immobility Signup and view all the answers

What type of delusion involves the belief that one's feelings, thoughts, and actions are controlled by others?

Delusion of control Signup and view all the answers

Which symptom is characterized by long pauses before responding or a general reduction in the amount and content of speech?

Alogia Signup and view all the answers

Which of the following best describes the concept of 'neologisms'?

Made-up words that have no meaning Signup and view all the answers

What symptom is indicative of the inability to experience pleasure or enjoyment in life?

Anhedonia Signup and view all the answers

What cognitive symptom is characterized by deficits in attention, memory, and executive functions?

Cognitive symptoms Signup and view all the answers

What does the term 'flat affect' refer to in schizophrenia symptoms?

The inability to express emotions Signup and view all the answers

Which phenomenon involves the repetition of words or phrases by a patient?

Perseveration Signup and view all the answers

Which negative symptom is characterized by a tendency to withdraw from social interactions?

Asociality Signup and view all the answers

What is the peak age at onset for the first psychotic episode in females?

26 and up Signup and view all the answers

Which of the following factors has NOT been correlated with an increased risk of schizophrenia?

Exposure to heavy metal toxins Signup and view all the answers

What is the approximate prevalence of schizophrenia in the general population?

1% Signup and view all the answers

Which subtype of schizophrenia characterizes individuals displaying odd beliefs?

Paranoid type Signup and view all the answers

Which combination best describes the onset of schizophrenia symptoms?

Abrupt or insidious with varying durations Signup and view all the answers

Which of the following statements about risk factors for schizophrenia is correct?

Stress is correlated with increased risk but is not conclusive. Signup and view all the answers

Which statement about the prevalence of schizophrenia in minority ethnic groups is accurate?

They exhibit higher incidence rates compared to the general population. Signup and view all the answers

Which subtype of schizophrenia includes symptoms such as emotional withdrawal and lack of motivation?

Residual type Signup and view all the answers

Study Notes

Schizophrenia

Schizophrenia is a chronic, disabling brain disorder affecting approximately 1% of Americans.
It's characterized by a loss of contact with reality, significantly impaired perception and response to the environment, and impaired functioning.
Symptoms include hallucinations (false sensory perceptions) and/or delusions (false beliefs), often leading to erratic behavior.
There is no cure, but treatment can manage serious symptoms.
The DSM-5 defines schizophrenia as a severe, chronic, and potentially disabling thought disorder, characterized by deteriorated personal, social, and occupational functioning due to unusual perceptions, disturbed thought processes, unusual emotions, and motor abilities.
Remission and relapse are typical throughout the lifespan.

Psychosis

Psychosis is a state marked by a loss of contact with reality, where the ability to perceive and respond to the environment is significantly impaired.
Psychosis can manifest as hallucinations (false sensory perceptions), and/or delusions (false beliefs).
Psychosis can be substance-induced or caused by brain injury.
Most psychoses are in the form of schizophrenia.

DSM-5 Criteria for Schizophrenia

A. Two (or more) of the following, present for a significant portion of a one-month period; at least one must be (1), (2), or (3) :
- Delusions
- Hallucinations
- Disorganized speech
- Catatonic behavior
- Negative symptoms (diminished emotional expression)
B. For a significant time since the disturbance began, functioning in one or more major areas (e.g., work, relationships, self-care) is markedly below previous levels.
C. Continuous signs of the disorder persist for at least six months, including at least one month of symptoms meeting Criterion A (active-phase symptoms). Disorders like schizoaffective and mood disorders with psychotic features must be ruled out.
D. The disturbance is not attributable to effects of a substance or another medical condition.
E. If a history of autism spectrum disorder or a childhood communication disorder exists, additional schizophrenia diagnosis is made only if prominent delusions or hallucinations—in addition to other required schizophrenia symptoms—are present for at least one month (or less if successfully treated).

Symptoms of Schizophrenia

Positive symptoms: Disorders of commission (things patients do or think). Includes hallucinations, delusions, and disorganized behavior.
- Hallucinations: Sensory perceptions occurring in the absence of external stimuli; commonly auditory, but can involve any sense.
- Delusions: Beliefs with no basis in fact; faulty interpretations of reality. Examples include delusions of reference, persecution, grandeur, and control.
- Bizarre or disorganized behavior: Includes loose associations (derailment), neologisms (made-up words), perseveration (repetition of words/statements), and clang (rhyming).
Negative symptoms: Disorders of omission (things patients do not do). Includes lack of speech, flat affect, anhedonia (inability to experience pleasure), asociality, avolition (lack of motivation), and apathy.
- Poverty of speech (alogia): Long lapses before answering questions, or reduction in speech quantity/content.
- Blunted and flat affect: Show less emotion than most people; lack of eye contact, expressionless face.
- Anhedonia: Loss of pleasure or enjoyment. Loss of volition (motivation, directedness).
- Social withdrawal (asociality): Withdraw from social environment; breakdown of social skills.
Cognitive symptoms: Deficits in attention, working memory, verbal learning, memory, and executive functions.

Onset and Prevalence

Symptoms typically become apparent between ages 18 and 35; onset before adolescence is rare.
The peak age of onset for the first psychotic episode is between 20 and 25 for males and 26 and up for females.
Onset can be abrupt, happening virtually overnight.
Schizophrenia prevalence is about one percent of the general population.

Risk Factors

Birth month has been correlated with schizophrenia, particularly late winter/early spring (possible link to flu season).
Higher incidence in urban areas and some minority ethnic groups.
Other genetic and environmental factors potentially linked, including pregnancy/labor complications with hypoxia, older fathers, stress, infection, malnutrition, and maternal diabetes (exact causal links remain inconclusive).

Causes

Schizophrenia is a result of a combination of genetic predisposition and environmental, social, and psychological factors.
Neurodevelopmental abnormalities and target features play a role, often leading to brain dysfunction and imbalanced brain chemicals.

Subtypes of Schizophrenia

Paranoid type
Disorganized type
Catatonic type
Undifferentiated type
Residual type

Clinical Features

Mental status examination: Includes observation of appearance, behavior, mood, feelings, and affect; presence of perceptual disturbances and thought content/form. Cognitive functioning, insight, and judgment are also assessed.

Treatments

Biological therapies (medication).
Psychosocial therapies (social skills training, family-oriented therapies, group/individual therapy, assertive community treatment (ACT), cognitive behavioral therapy (CPT)).

Additional Notes

Physical inactivity and poor cardiorespiratory fitness can be correlated to brain volume reductions.
A Beautiful Mind Evaluation video available online.
Case study presenting a 27-year-old male with schizophrenia, experiencing a decline in behavior (specifically, immobility and strange posture) and reduced insight into illness.

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Description

Test your understanding of the DSM-5 criteria for Schizophrenia and key concepts surrounding this mental health disorder. This quiz covers symptoms, diagnosis, and distinguishing features of Schizophrenia, including negative and positive symptoms. Dive into the intricacies of psychosis and the hallmark signs of this complex condition.