Exam Questions and CORRECT Answers
schizophrenia spectrum & other psychotic disorders - CORRECT ANSWER -
schizophrenia - CORRECT ANSWER -*schizophrenia is a psychiatric disorder involving
chronic or recurrent psychosis ==> psychosis is a REQUIREMENT (whether they have it
currently or in the past) and a primary feature
*it causes significant disability due to the severity of acute symptoms and the chronic residual
symptoms people can experience, even with treatment
-considered one of the most disabling diagnosis ==> number 6 worldwide
*antipsychotic medications have been shown to be very helpful with some symptoms of
schizophrenia and less helpful with others; they also have many significant side effects
*therapy-based treatment can help with the symptoms of schizophrenia that make it difficult for
patients to stay well.
psychosis - CORRECT ANSWER -*a severe mental condition in which there is
disorganization of personality, deterioration in social functioning, and loss of contact with or
distortion of reality; there may be evidence of hallucinations and delusional thinking
epidemiology - CORRECT ANSWER -*prevalence of 1% worldwide; higher in
immigrant populations
*co-occuring conditions include anxiety, depression, and substance abuse ==> this is due to
patients finding ways to cope (substance abuse) and feeling like someone is constantly out to get
them (anxiety)
*age: on average, 18-25 for men & 25-35 for women; additional onset in women after
menopause
,*gender differences = 1:4 men to 1:0 women
*risk factors are multifactoral and include genetic, developmental, biochemical, environmental,
psychosocial
==> must have the genes for schizophrenia in order to have schizophrenia manifest ==> must
combine those genes to a certain extent with some kind of environmental stress
*cost is high for both medical expenses and loss of work
etiology - CORRECT ANSWER -*complex interaction between genes and environment
*genetic risk factors likely most significant
*gene research continues
*monozygotic twin concordance is about 50% (some say higher); dizygotic twin concordance is
10-15%
*environmental risk factors include:
-obstetrical complications ==> experience issues with delivery, exposure to certain viruses in
utero
-cannabis use ==> individuals who have the gene for schizophrenia, cannabis is the pathway to
developing schizophrenia
-inflammation
-cigarette smoking
-immigration
-poverty/low SES
,etiology (neurobiology) - CORRECT ANSWER -*now understood as a disease of the
brain
*dopamine hypothesis is that symptoms are caused by excess dopamine
*dopamine hypothesis likely incomplete (antipsychotics block D2 receptors but symptoms often
remain)
*other NTs involved include serotonin, acetylcholine, glutamate, and GABA
**dopamine is elevated in schizophrenia and causes **positive symptoms (hallucinations,
delusions) ==> happening in the pre-frontal cortex
-antipsychotics work by BLOCKING dopamine ==> getting rid of hallucinations by bringing the
dopamine elevation down
-when dopamine is lowered all over the brain ==> cause pseudoparkinsonism
-when dopamine is messed with how it interfaces with the hypothalamic pituitary access ==>
causes gynecomastia and lactation in men
altered neurodevelopment - CORRECT ANSWER -*these kids brains develop differently
-had changes in brain that could have happened years before they have a psychotic break
neurodegeneration - CORRECT ANSWER -*having schizophrenia for decades leads to
major brain changes (through white/gray matter)
summary - CORRECT ANSWER -*schizophrenia is a biologically-based disease, the
onset of which is influenced by factors in the internal (endogenous) and external (exogenous)
environment
what is the schizophrenia spectrum? - CORRECT ANSWER -**a grouping of disorders
that all require psychosis as a main feature
, *variables (differences) include
-durations of symptoms (length of time with symptoms)
-etiology (cause of symptoms)
-presence of catatonia
-hx of MDD and/or manic symptoms
-plausibility/implausibility of delusions
schizophrenia spectrum & other psychotic disorders - CORRECT ANSWER -
***schizophrenia (greater then 6 months)
***schizophreniform disorder (up to 6 months) (this disorder often progresses to schizophrenia)
***brief psychotic disorder (up to 24 hours-1 month)
*schizoaffective disorder (have to have features of major depressive disorder and/or mania)
-schizophrenia with a mood component
*delusional disorder
*substance-induced psychotic disorder
*psychotic disorder associated with a medical condition
*differences between these disorders are in the duration of the time the patient has had the
symptoms
overview of symptoms (requirement of diagnoses) - CORRECT ANSWER -*chronic or
recurrent psychosis
*disturbances (or impairment) in thought processes, perception and affect causing severe loss of
social and occupational function
*presentation includes positive sx (things that are there that shouldn't be there), negative sx
(things that aren't there, but should be there), and cognitive sx (show up on psych testing ==>
patient will take a hit in the ability to function cognitively: memory is impaired, fluidity of
thought/performance, etc.)