Psychiatric Disorders II Flashcards

1
Q

Which gender has: an earlier onset with schizophrenia?

A

Males

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2
Q

Which gender has: poorer premorbid adjustment with schizophrenia?

A

Males

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3
Q

Which gender has: less cognitive impairment with schizophrenia?

A

Females

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4
Q

Which gender has: more brain structural abnormalities with schizophrenia?

A

Males

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5
Q

Which gender has: a better outcomes with schizophrenia?

A

Females

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6
Q

Which gender has: a later onset with schizophrenia?

A

Females

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7
Q

Which gender has: more negative s/sx with schizophrenia?

A

Males

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8
Q

Which gender has: symptoms that are more affect laden onset with schizophrenia?

A

Females

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9
Q

Which gender has: tend not to marry with schizophrenia?

A

Males

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10
Q

What percent of schizophrenics develop by age 30 in males?

A

90%

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11
Q

What is the most common presentation of bipolar disorder?

A

Depression and anxiety

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12
Q

True or false: there is a high comorbidity of anxiety with schizophrenia

A

True

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13
Q

What are the comorbidities that are common in the schizophrenic population? (3)

A
  • Anxiety
  • OCD
  • Panic
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14
Q

True or false: Schizotypal or paranoid personalities often proceed the onset of schizophrenia

A

True

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15
Q

True or false: there are high rates of substance abuse with schizophrenia

A

True (50% use tobacco)

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16
Q

What is the usual age range in prison? How does this compare to the onset of schizophrenia?

A

Both young

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17
Q

What percent of schizophrenics smoke?

A

50%

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18
Q

What is the effect of smoking with schizophrenia?

A

Decreases hallucinations

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19
Q

What is a schizoaffective disorder?

A

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

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20
Q

What are the diagnostic criteria for schizoaffective disorder? What is the duration that is needed?

A

Delusions or hallucinations for 2 or more weeks in the absence of a major episode during the lifetime duration of the illness

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21
Q

How do the negative s/sx with schizoaffective disorder compare to full schizophrenia

A

less severe and less persistent

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22
Q

True or false: anosognosia is common, and more severe and pervasive with schizoaffective disorder than in schizophrenia

A

False–less severe and pervasive

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23
Q

What is the prevalence of schizoaffective disorder? How does this compare to schizophrenia?

A

1/3 as common as schizophrenia, with a lifetime prevalence of 0.3%

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24
Q

Which gender has a higher prevalence of schizoaffective disorder?

A

Females

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25
Q

What is the duration of substance induced psychotic disorder?

A

s/sx that persist more than 1 month after stopping acute withdrawal or severe intoxication

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26
Q

True or false: s/sx of substance induced psychotic disorder precede the onset of use

A

True

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27
Q

What percent of individuals with a first episode of psychosis are reported to have substance induced psychotic disorder?

A

7-25%

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28
Q

True or false: in order to diagnose substance induced psychotic disorder, the disturbances must not occur during a delirium

A

True

29
Q

What are the three major categories of medical disorders that can cause psychosis?

A
  • Neurological conditions
  • Endocrine conditions
  • Metabolic conditions
30
Q

What is the prevalence of psychotic disorders 2/2 a medical condition?

A

0.21% to 0.54%

31
Q

What is the prevalence of psychotic disorders in the 65+ age group?

A

0.74%

32
Q

What is the disease that appears over 80 years old that is the usual cause for psychosis?

A

One of the major neurocognitive disorders that causes dementia

33
Q

What are the criteria for catatonia?

A

-Associated with a mental or medical condition

34
Q

What is the usual clinical picture of catatonia?

A
  1. stupor
  2. Cataplexy
  3. Waxy flexibility
  4. Mutism
35
Q

What is echolalia seen with catatonia?

A

Mimicking speech of others

36
Q

What is echopraxia seen with catatonia?

A

Mimicking others’ movements

37
Q

What is stereotypy seen with catatonia?

A

Repetitive, abnormal frequent non-goals directed movement

38
Q

What is the negativism form of catatonia?

A

Opposition or no response to external stimuli

39
Q

What is the mannerism form of catatonia

A

Odd, circumstantial caricature of normal actions

40
Q

What percent of inpatients with schizophrenia have catatonia?

A

35%

41
Q

In order to call catatonia medical, what must be true?

A

Must be directly related to the medical condition

42
Q

The majority of cases of catatonia are related to what disorders?

A

Bipolar or MDD

43
Q

Before catatonia can be used as a specifier in a neurodevelopmental disorder, what must be true?

A

Medical conditions must be ruled out

44
Q

The risk of schizophrenia increases with the age of the mother or father?

A

Father

45
Q

What is the dopamine model of psychosis?

A

Increased mesolimbic dopaminergic activity mediated by reciprocal prefrontal dopaminergic hypoactivity

46
Q

What is the glutamate model?

A

Glutamate NMDA antagonists like PCP produce psychotic, negative and cognitive symptoms in normal and psychotic relapse in schizos

47
Q

What is the viral hypothesis of schizophrenia?

A

Associated with prenatal infx with flu / rubella

48
Q

What is the diathesis and stress model of schizophrenia?

A

The patient has inherited vulnerability to schizophrenia that may be manifested by neuropsychological deficits

49
Q

What are the histopathological changes that occur with psychosis (what 4 areas of the brain are smaller)?

A

Decreased volume of:

  • hippocampus
  • thalamus
  • temporal
  • prefrontal cortex
50
Q

True or false: there is a decrease in total gray matter volume with schizophrenia

A

True

51
Q

What happens to the ventricles with schizophrenia?

A

Lateral and third ventricles are enlarged

52
Q

Hypofrontality at rest in chronic patients correlates with what type of symptoms?

A

Negative symptoms

53
Q

What happens to the prefrontal cortex during performance of cognitive tasks with schizophrenia?

A

Failure to activate

54
Q

What may happen to the cognitive deficits that present at the time of diagnosis with schizophrenia?

A

May progress

55
Q

What are the three major components of treatment for acute psychotic disorders?

A
  • Containment
  • Avoid medication side effects
  • Educate and support family
56
Q

What is the homicide rate of psychotic disorders (relative and total incidence)?

A

Increased 10x but still less than 1% of the population

57
Q

What is the only risk factor for violence within the context of the delusional system?

A

Auditory command hallucinations

58
Q

True or false: as a group, schizophrenics are more frequently victimized than other individuals

A

True

59
Q

What is the suicide rate of psychotics? When is the risk highest?

A

10-15%

Within the first 5 years of illness

60
Q

What percent of schizophrenics die by suicide?

A

5-6%

61
Q

What is the relative rate of violence with schizophrenia? What happens with treatment?

A

Higher rates of arrest which decreases with appropriate treatment

62
Q

What is stupor catatonia?

A

Not relating to the environment

63
Q

What is cataplexy form of catatonia?

A

Passive induction of posture against gravity

64
Q

What is the waxy flexibility form of catatonia?

A

Slight ven resistance to positioning

65
Q

What are the criteria for “other specified schizophrenia spectrum and psychotic disorders”?

A

Does not meet full criteria for one of the disorders listed, but still has symptoms and significant social, occupational, or other functional deficits

66
Q

What is unspecified schizophrenia spectrum and psychotic disorder?

A

When the clinician chooses not to specify why the criteria are not met like presentations where there is insufficient information

67
Q

Are D1 and D2 receptors increased or decreased in the striatum of patients with schizophrenia?

A

Increased (maybe)

68
Q

What is the basis for the nicotinic theory of schizophrenia?

A

nicotine normalizes auditory evoked potential gating deficit in schizophrenic pts

69
Q

What is the basis for the glutamate theory of schizophrenia?

A

Altered receptor densities and subunit compensation in hippocampus and prefrontal cortex