Flashcards in Psychiatric Disorders II Deck (69):
1
Which gender has: an earlier onset with schizophrenia?
Males
2
Which gender has: poorer premorbid adjustment with schizophrenia?
Males
3
Which gender has: less cognitive impairment with schizophrenia?
Females
4
Which gender has: more brain structural abnormalities with schizophrenia?
Males
5
Which gender has: a better outcomes with schizophrenia?
Females
6
Which gender has: a later onset with schizophrenia?
Females
7
Which gender has: more negative s/sx with schizophrenia?
Males
8
Which gender has: symptoms that are more affect laden onset with schizophrenia?
Females
9
Which gender has: tend not to marry with schizophrenia?
Males
10
What percent of schizophrenics develop by age 30 in males?
90%
11
What is the most common presentation of bipolar disorder?
Depression and anxiety
12
True or false: there is a high comorbidity of anxiety with schizophrenia
True
13
What are the comorbidities that are common in the schizophrenic population? (3)
-Anxiety
-OCD
-Panic
14
True or false: Schizotypal or paranoid personalities often proceed the onset of schizophrenia
True
15
True or false: there are high rates of substance abuse with schizophrenia
True (50% use tobacco)
16
What is the usual age range in prison? How does this compare to the onset of schizophrenia?
Both young
17
What percent of schizophrenics smoke?
50%
18
What is the effect of smoking with schizophrenia?
Decreases hallucinations
19
What is a schizoaffective disorder?
a mental disorder characterized by abnormal thought processes and deregulated emotions. The diagnosis is made when the patient has features of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not strictly meet diagnostic criteria for either alone
20
What are the diagnostic criteria for schizoaffective disorder? What is the duration that is needed?
Delusions or hallucinations for 2 or more weeks in the absence of a major episode during the lifetime duration of the illness
21
How do the negative s/sx with schizoaffective disorder compare to full schizophrenia
less severe and less persistent
22
True or false: anosognosia is common, and more severe and pervasive with schizoaffective disorder than in schizophrenia
False--less severe and pervasive
23
What is the prevalence of schizoaffective disorder? How does this compare to schizophrenia?
1/3 as common as schizophrenia, with a lifetime prevalence of 0.3%
24
Which gender has a higher prevalence of schizoaffective disorder?
Females
25
What is the duration of substance induced psychotic disorder?
s/sx that persist more than 1 month after stopping acute withdrawal or severe intoxication
26
True or false: s/sx of substance induced psychotic disorder precede the onset of use
True
27
What percent of individuals with a first episode of psychosis are reported to have substance induced psychotic disorder?
7-25%
28
True or false: in order to diagnose substance induced psychotic disorder, the disturbances must not occur during a delirium
True
29
What are the three major categories of medical disorders that can cause psychosis?
-Neurological conditions
-Endocrine conditions
-Metabolic conditions
30
What is the prevalence of psychotic disorders 2/2 a medical condition?
0.21% to 0.54%
31
What is the prevalence of psychotic disorders in the 65+ age group?
0.74%
32
What is the disease that appears over 80 years old that is the usual cause for psychosis?
One of the major neurocognitive disorders that causes dementia
33
What are the criteria for catatonia?
-Associated with a mental or medical condition
34
What is the usual clinical picture of catatonia?
1. stupor
2. Cataplexy
3. Waxy flexibility
4. Mutism
35
What is echolalia seen with catatonia?
Mimicking speech of others
36
What is echopraxia seen with catatonia?
Mimicking others' movements
37
What is stereotypy seen with catatonia?
Repetitive, abnormal frequent non-goals directed movement
38
What is the negativism form of catatonia?
Opposition or no response to external stimuli
39
What is the mannerism form of catatonia
Odd, circumstantial caricature of normal actions
40
What percent of inpatients with schizophrenia have catatonia?
35%
41
In order to call catatonia medical, what must be true?
Must be directly related to the medical condition
42
The majority of cases of catatonia are related to what disorders?
Bipolar or MDD
43
Before catatonia can be used as a specifier in a neurodevelopmental disorder, what must be true?
Medical conditions must be ruled out
44
The risk of schizophrenia increases with the age of the mother or father?
Father
45
What is the dopamine model of psychosis?
Increased mesolimbic dopaminergic activity mediated by reciprocal prefrontal dopaminergic hypoactivity
46
What is the glutamate model?
Glutamate NMDA antagonists like PCP produce psychotic, negative and cognitive symptoms in normal and psychotic relapse in schizos
47
What is the viral hypothesis of schizophrenia?
Associated with prenatal infx with flu / rubella
48
What is the diathesis and stress model of schizophrenia?
The patient has inherited vulnerability to schizophrenia that may be manifested by neuropsychological deficits
49
What are the histopathological changes that occur with psychosis (what 4 areas of the brain are smaller)?
Decreased volume of:
-hippocampus
-thalamus
-temporal
-prefrontal cortex
50
True or false: there is a decrease in total gray matter volume with schizophrenia
True
51
What happens to the ventricles with schizophrenia?
Lateral and third ventricles are enlarged
52
Hypofrontality at rest in chronic patients correlates with what type of symptoms?
Negative symptoms
53
What happens to the prefrontal cortex during performance of cognitive tasks with schizophrenia?
Failure to activate
54
What may happen to the cognitive deficits that present at the time of diagnosis with schizophrenia?
May progress
55
What are the three major components of treatment for acute psychotic disorders?
-Containment
-Avoid medication side effects
-Educate and support family
56
What is the homicide rate of psychotic disorders (relative and total incidence)?
Increased 10x but still less than 1% of the population
57
What is the only risk factor for violence within the context of the delusional system?
Auditory command hallucinations
58
True or false: as a group, schizophrenics are more frequently victimized than other individuals
True
59
What is the suicide rate of psychotics? When is the risk highest?
10-15%
Within the first 5 years of illness
60
What percent of schizophrenics die by suicide?
5-6%
61
What is the relative rate of violence with schizophrenia? What happens with treatment?
Higher rates of arrest which decreases with appropriate treatment
62
What is stupor catatonia?
Not relating to the environment
63
What is cataplexy form of catatonia?
Passive induction of posture against gravity
64
What is the waxy flexibility form of catatonia?
Slight ven resistance to positioning
65
What are the criteria for "other specified schizophrenia spectrum and psychotic disorders"?
Does not meet full criteria for one of the disorders listed, but still has symptoms and significant social, occupational, or other functional deficits
66
What is unspecified schizophrenia spectrum and psychotic disorder?
When the clinician chooses not to specify why the criteria are not met like presentations where there is insufficient information
67
Are D1 and D2 receptors increased or decreased in the striatum of patients with schizophrenia?
Increased (maybe)
68
What is the basis for the nicotinic theory of schizophrenia?
nicotine normalizes auditory evoked potential gating deficit in schizophrenic pts
69