DSM 5 EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
Schizophrenia Spectrum & Psychotic Other Disorders - ANSWER Characterized by
abnormalities of one or more: delusions,hallucinations, disorganized thinking (speech),
disorganized or abnormal motor (including catatonia) & negative symptoms. Severity is
rated by assessing the primary symptoms of psychosis on a 5point scale for each so
based on presence & strength of the screen from 0 (not present) to 4 (present &
severe). Disorders presented in order of severity.
Delusions (thinking) - ANSWER Fixed, false beliefs that are unchangeable. Content
varies and can be bizarre or non-bizarre. Non-bizarre are situations that are possible
and bizarre are those that are clearly implausible
Hallucinations (perception) - ANSWER Vivid & clear perceptions that occur w/out
external stimuli. May occur in any sensory modality. Auditory experiences are the most
common and tend to be experienced as voices that are distinct from one's own thoughts
Disorganized Thinking - ANSWER Usually inferred from speech - person switches from
topic to topic (derailment or loose associations) or provides answers that diverge from
questions asked (tangentiality)
Grossly Disorganized or Abnormal Motor Behavior (including catatonia) - ANSWER May
range from childlike silliness to unexpected agitation, typically interfering with
goal-directed behaviors and activities of daily living. Catatonia is a marked decrease in
reactivity that ranges from resistance to instructions (negativism), to maintaining odd
posture,to lack of verbal or motor response (mutism and stupor). Can also involve
excessive motor activity (catatonic excitement) repeated stereotype movement,
grimacing, and echoing of speech.
Negative Symptoms - ANSWER Include diminished emotional expression and avolition
(decrease in self-initiated purposeful activities), alogia (reduced speech output),
anhedonia (diminished pleasure) & asociality (lack of interest in social interactions)
Specifier w/catatonia - ANSWER Can be coded for any of the disorders. Criteria involve
a clinical picture that is dominated by 3 or more: stupor (no psychomotor activity),
catalepsy (posture is held passively, against gravity), waxy flexibility (resistance to
positioning by another), mutism (no verbal response), negativism (no response
instructions or external stimuli), posturing (actively maintaining a posture against
gravity), mannerism (caricature of normal actions), stereo to be repetitive non-goal
directed movements, agitation, grimacing, echolalia (mimicking another's speech) or
echopraxia (imitating another's movement)
,Schizotypal Personality Disorder - ANSWER Is considered part of the schizophrenia
spectrum and is also in the personality disorders.
Delusional Disorder - ANSWER One or more delusions for at least one month with no
additional symptoms found in schizophrenia. The person's behavior is relatively
unimpaired and is not obviously. If manic or major depressive episodes occur concur
with the delusions, the duration of the moon episode is brief relative to the duration of
the delusion. Specifiers include erotomanic type, grandiose type, jealous type,
persecutory type, somatic type, mixed type, and unspecified type. Specifier with bizarre
content if bizarre. Onset is typically in middle to late adulthood & the most common
subtype is persecutory
Erotomanic type - ANSWER Involves delusions and which another person, usually of
higher status, is in love with the individual
Grandiose type - ANSWER Characterized by delusions of inflated self-worth, power,
knowledge, or a special relationship to a deity or famous person
Jealous type - ANSWER Involves delusions in which the person believes that a sexual
partner is being unfaithful
Persecutory type - ANSWER Characterized by delusions in which the person is being
persecuted or ill treated, which may trigger violent behavior
Somatic type - ANSWER Involved illusion relating to body functions and sensations
Mixed type - ANSWER Involves characteristics of more than one of the types of without
any single theme predominating
Unspecified type - ANSWER Delusions who's themes are not characteristic of any of the
types
Brief Psychotic Disorder - ANSWER Characterized by one or more: delusions,
hallucinations, disorganized speech, or grossly disorganized or catatonic behavior. The
episode lasts from one day to one month with eventual return to premorbid level of
functioning. Specifiers: with Mark stressor, without marked stressor, or with
postpartum onset. With catatonia is also used.
Schizophreniform Disorder - ANSWER Symptoms are identical to schizophrenia and
distinguished only by duration. Diagnosis is made when the duration of the illness is at
least one month but less than six. If person has not recovered after onset "provisional"
is added to the dx and will be changed to schizophrenia after 6 months. Specifiers
include with good prognostic features & without good prognostic features. catatonia is
also used if present
Good prognostic features - ANSWER Include two or more: onset of prominent psychotic
symptoms within four weeks of the first noticeable change in behavior (acute onset),
confusion or perplexity, good premorbid social and occupational functioning, and
absence of flat or blunted affect.
,Schizophrenia - ANSWER Diagnostic criteria require the presence of two or more sx of
psychosis each for a significant time during a 1 month period. At least one sx must be
hallucinations, disorganized speech, or delusions. Since onset the person must be
functioning at a level markedly below previous functioning for a significant portion of
time in areas such as work, personal relations or self-care. Signs must persist for at
least 6 months with at least 1 month of active sx. During prodromal or residual periods,
the signs of disturbance May include only negative symptoms or two or more symptoms
in attenuated (weakened) forms.
Schizophrenia onset & course - ANSWER Typically occurs between late teens and early
30s with onset prior to adolescence rarely occurring. Median age is early to mid 20s for
men and late 20s for women. It may be abrupt or gradual and in most cases involve a
prodromal phase which is characterized by deterioration in overall functioning in the
beginning. The course is variable but full remission is rather uncommon, some
individuals have a course characterized by exacerbations and remissions while other
show progressive deterioration
Schizophrenia prognosis - ANSWER Prognosis is best with good prior functioning,
abrupt onset, fewer negative symptoms, minimal cognitive impairment & female gender
(females tend to have fewer negative symptoms). Later on that has been associated with
better prognosis however the effect of age on onset on prognosis is likely related to
gender as females have a later age of onset. Suicide risk is high.
Schizophrenia & genes - ANSWER First-degree relatives have a concordance rate of
10% and have a greater risk of developing schizophrenia than the general population.
Identical twins have a 50% concordance rate, the risk of developing schizophrenia when
both parents have the disorder is about 45%. Relatives of individuals with schizophrenia
havoc increased risk of developing other schizophrenia spectrum disorders including
schizotypal and paranoid personality disorders and delusional disorder
Schizophrenia & brain - ANSWER MRI of the brain the persons with schizophrenia
showing enlargement of the lateral and third ventricles, a smaller cerebral cortex, and a
smaller thalamus (the filter for sensory input). PET scans indicate decreased frontal
lobe activity which have been associated with the negative symptoms
Treatment for Schizophrenia - ANSWER Medication management is a key component
and typically life long. Most common are antipsychotics. Psychosocial interventions
such as CBT and family psychoeducation. Expressed emotion by family members has
been shown to predict relapse many family approaches work to decrease expressed
emotion and focus on strength and resiliency. Social skills training teach skills related to
communication, service, disease management and independent living.
, Schizoaffective Disorder - ANSWER Uninterrupted period of illness during which there
has been a major mood episode concurrent with the sxs of schizophrenia and delusions
or hallucinations for at least 2 weeks w/out prominent mood sxs. Mood symptoms are
present for the majority of the course of the disorder but the schizophrenia symptoms
are prominent. With Catatonia is used if sxs are present
Schizoaffective Dis Bipolar type - ANSWER Used if a manic episode is part of the
presentation, whether or not a major depressive episode occurs
Schizoaffective Dis Depressive type - ANSWER Used only if major depressive episodes
are part of the presentation
Substance/medication induced psychotic disorder - ANSWER Substances that can
induce a psychotic disorder include alcohol, cannabis, hallucinogens (including PCP),
inhalants, sedatives, hypnotics, anxiolytics and stimulants including (cocaine)
Psychotic disorder due to another medical condition - ANSWER Medical conditions that
are known to manifest with delusions or hallucinations include neurological conditions,
in the kindest orders, and metabolic condition. Specifiers include with delusions or with
hallucinations
Catatonic disorder due to another medical condition - ANSWER Medical conditions that
are known to manifest with catatonia including neurological conditions and metabolic
conditions
Other specified/unspecified schizophrenia spectrum and other psychotic disorder -
ANSWER Psychotic like symptoms below threshold for full psychosis
Bipolar and related disorders - ANSWER Three types of mood episodes: manic,
depressive, hypomanic. episodes should be specified as mild moderate or severe. Full
criteria not met it should be specified as in partial remission or in full remission. Other
specifiers include: with anxious distress, with mixed features, with rapid cycling, with
mood congruent or mood incongruent psychotic features, with catatonia, with
peripartum onset, and with seasonal pattern.
COMPLETE SOLUTIONS
Schizophrenia Spectrum & Psychotic Other Disorders - ANSWER Characterized by
abnormalities of one or more: delusions,hallucinations, disorganized thinking (speech),
disorganized or abnormal motor (including catatonia) & negative symptoms. Severity is
rated by assessing the primary symptoms of psychosis on a 5point scale for each so
based on presence & strength of the screen from 0 (not present) to 4 (present &
severe). Disorders presented in order of severity.
Delusions (thinking) - ANSWER Fixed, false beliefs that are unchangeable. Content
varies and can be bizarre or non-bizarre. Non-bizarre are situations that are possible
and bizarre are those that are clearly implausible
Hallucinations (perception) - ANSWER Vivid & clear perceptions that occur w/out
external stimuli. May occur in any sensory modality. Auditory experiences are the most
common and tend to be experienced as voices that are distinct from one's own thoughts
Disorganized Thinking - ANSWER Usually inferred from speech - person switches from
topic to topic (derailment or loose associations) or provides answers that diverge from
questions asked (tangentiality)
Grossly Disorganized or Abnormal Motor Behavior (including catatonia) - ANSWER May
range from childlike silliness to unexpected agitation, typically interfering with
goal-directed behaviors and activities of daily living. Catatonia is a marked decrease in
reactivity that ranges from resistance to instructions (negativism), to maintaining odd
posture,to lack of verbal or motor response (mutism and stupor). Can also involve
excessive motor activity (catatonic excitement) repeated stereotype movement,
grimacing, and echoing of speech.
Negative Symptoms - ANSWER Include diminished emotional expression and avolition
(decrease in self-initiated purposeful activities), alogia (reduced speech output),
anhedonia (diminished pleasure) & asociality (lack of interest in social interactions)
Specifier w/catatonia - ANSWER Can be coded for any of the disorders. Criteria involve
a clinical picture that is dominated by 3 or more: stupor (no psychomotor activity),
catalepsy (posture is held passively, against gravity), waxy flexibility (resistance to
positioning by another), mutism (no verbal response), negativism (no response
instructions or external stimuli), posturing (actively maintaining a posture against
gravity), mannerism (caricature of normal actions), stereo to be repetitive non-goal
directed movements, agitation, grimacing, echolalia (mimicking another's speech) or
echopraxia (imitating another's movement)
,Schizotypal Personality Disorder - ANSWER Is considered part of the schizophrenia
spectrum and is also in the personality disorders.
Delusional Disorder - ANSWER One or more delusions for at least one month with no
additional symptoms found in schizophrenia. The person's behavior is relatively
unimpaired and is not obviously. If manic or major depressive episodes occur concur
with the delusions, the duration of the moon episode is brief relative to the duration of
the delusion. Specifiers include erotomanic type, grandiose type, jealous type,
persecutory type, somatic type, mixed type, and unspecified type. Specifier with bizarre
content if bizarre. Onset is typically in middle to late adulthood & the most common
subtype is persecutory
Erotomanic type - ANSWER Involves delusions and which another person, usually of
higher status, is in love with the individual
Grandiose type - ANSWER Characterized by delusions of inflated self-worth, power,
knowledge, or a special relationship to a deity or famous person
Jealous type - ANSWER Involves delusions in which the person believes that a sexual
partner is being unfaithful
Persecutory type - ANSWER Characterized by delusions in which the person is being
persecuted or ill treated, which may trigger violent behavior
Somatic type - ANSWER Involved illusion relating to body functions and sensations
Mixed type - ANSWER Involves characteristics of more than one of the types of without
any single theme predominating
Unspecified type - ANSWER Delusions who's themes are not characteristic of any of the
types
Brief Psychotic Disorder - ANSWER Characterized by one or more: delusions,
hallucinations, disorganized speech, or grossly disorganized or catatonic behavior. The
episode lasts from one day to one month with eventual return to premorbid level of
functioning. Specifiers: with Mark stressor, without marked stressor, or with
postpartum onset. With catatonia is also used.
Schizophreniform Disorder - ANSWER Symptoms are identical to schizophrenia and
distinguished only by duration. Diagnosis is made when the duration of the illness is at
least one month but less than six. If person has not recovered after onset "provisional"
is added to the dx and will be changed to schizophrenia after 6 months. Specifiers
include with good prognostic features & without good prognostic features. catatonia is
also used if present
Good prognostic features - ANSWER Include two or more: onset of prominent psychotic
symptoms within four weeks of the first noticeable change in behavior (acute onset),
confusion or perplexity, good premorbid social and occupational functioning, and
absence of flat or blunted affect.
,Schizophrenia - ANSWER Diagnostic criteria require the presence of two or more sx of
psychosis each for a significant time during a 1 month period. At least one sx must be
hallucinations, disorganized speech, or delusions. Since onset the person must be
functioning at a level markedly below previous functioning for a significant portion of
time in areas such as work, personal relations or self-care. Signs must persist for at
least 6 months with at least 1 month of active sx. During prodromal or residual periods,
the signs of disturbance May include only negative symptoms or two or more symptoms
in attenuated (weakened) forms.
Schizophrenia onset & course - ANSWER Typically occurs between late teens and early
30s with onset prior to adolescence rarely occurring. Median age is early to mid 20s for
men and late 20s for women. It may be abrupt or gradual and in most cases involve a
prodromal phase which is characterized by deterioration in overall functioning in the
beginning. The course is variable but full remission is rather uncommon, some
individuals have a course characterized by exacerbations and remissions while other
show progressive deterioration
Schizophrenia prognosis - ANSWER Prognosis is best with good prior functioning,
abrupt onset, fewer negative symptoms, minimal cognitive impairment & female gender
(females tend to have fewer negative symptoms). Later on that has been associated with
better prognosis however the effect of age on onset on prognosis is likely related to
gender as females have a later age of onset. Suicide risk is high.
Schizophrenia & genes - ANSWER First-degree relatives have a concordance rate of
10% and have a greater risk of developing schizophrenia than the general population.
Identical twins have a 50% concordance rate, the risk of developing schizophrenia when
both parents have the disorder is about 45%. Relatives of individuals with schizophrenia
havoc increased risk of developing other schizophrenia spectrum disorders including
schizotypal and paranoid personality disorders and delusional disorder
Schizophrenia & brain - ANSWER MRI of the brain the persons with schizophrenia
showing enlargement of the lateral and third ventricles, a smaller cerebral cortex, and a
smaller thalamus (the filter for sensory input). PET scans indicate decreased frontal
lobe activity which have been associated with the negative symptoms
Treatment for Schizophrenia - ANSWER Medication management is a key component
and typically life long. Most common are antipsychotics. Psychosocial interventions
such as CBT and family psychoeducation. Expressed emotion by family members has
been shown to predict relapse many family approaches work to decrease expressed
emotion and focus on strength and resiliency. Social skills training teach skills related to
communication, service, disease management and independent living.
, Schizoaffective Disorder - ANSWER Uninterrupted period of illness during which there
has been a major mood episode concurrent with the sxs of schizophrenia and delusions
or hallucinations for at least 2 weeks w/out prominent mood sxs. Mood symptoms are
present for the majority of the course of the disorder but the schizophrenia symptoms
are prominent. With Catatonia is used if sxs are present
Schizoaffective Dis Bipolar type - ANSWER Used if a manic episode is part of the
presentation, whether or not a major depressive episode occurs
Schizoaffective Dis Depressive type - ANSWER Used only if major depressive episodes
are part of the presentation
Substance/medication induced psychotic disorder - ANSWER Substances that can
induce a psychotic disorder include alcohol, cannabis, hallucinogens (including PCP),
inhalants, sedatives, hypnotics, anxiolytics and stimulants including (cocaine)
Psychotic disorder due to another medical condition - ANSWER Medical conditions that
are known to manifest with delusions or hallucinations include neurological conditions,
in the kindest orders, and metabolic condition. Specifiers include with delusions or with
hallucinations
Catatonic disorder due to another medical condition - ANSWER Medical conditions that
are known to manifest with catatonia including neurological conditions and metabolic
conditions
Other specified/unspecified schizophrenia spectrum and other psychotic disorder -
ANSWER Psychotic like symptoms below threshold for full psychosis
Bipolar and related disorders - ANSWER Three types of mood episodes: manic,
depressive, hypomanic. episodes should be specified as mild moderate or severe. Full
criteria not met it should be specified as in partial remission or in full remission. Other
specifiers include: with anxious distress, with mixed features, with rapid cycling, with
mood congruent or mood incongruent psychotic features, with catatonia, with
peripartum onset, and with seasonal pattern.
