DSM-5 Criteria and Neurobiology of Somatic Symptom and Schizophrenia Disorders

What are the DSM-5 criteria for somatic symptom disorder?

At least 1 somatic symptom that is distressing or disrupts daily life, lasting for more than 6 months, with excessive thoughts related to the symptom, health-related anxiety, and disproportionate concerns.

What characterizes illness anxiety disorder?

Preoccupation with fears of having a serious disease despite no significant symptoms, lasting more than 6 months, with excessive behaviors or avoidance of medical care.

What symptoms are associated with functional neurological symptom disorder?

Sudden development of neurological symptoms such as paralysis, seizures, blindness, or aphonia, affecting motor or sensory function, and incompatible with medical disorders.

What is the prevalence of functional neurological symptom disorder?

Less than 1%, more common in women.

What challenges exist in diagnosing functional neurological disorder?

Patients often seek medical care rather than mental health support, and referral to mental health services may be seen as invalidating.

What did the mystery illness in Le Roy, NY demonstrate about somatic symptoms?

Tic-like symptoms appeared randomly among girls with no detected environmental or infectious cause, highlighting the impact of stress on real symptoms.

What neurobiological factors contribute to somatic symptom-related disorders?

Heightened activity in the anterior insula, anterior cingulate cortex, and somatosensory cortex, leading to a greater propensity for somatic symptoms.

What cognitive-behavioral factors influence somatic symptom disorders?

Attention to bodily sensations and interpretation of those sensations can lead to help-seeking behaviors and assuming the sick role.

How do social and cultural factors affect somatic symptom disorders?

These disorders are more common in individuals from rural areas and lower socioeconomic status, with symptom modeling influencing their development.

What is the role of CBT in treating somatic symptom-related disorders?

CBT aims to identify and change triggering emotions, modify cognitions about symptoms, alter behaviors, and reduce attention to bodily sensations.

What are the DSM-5 criteria for schizophrenia?

Two or more of the following: delusions, hallucinations, disorganized speech, disorganized behavior, negative symptoms, with functioning decline lasting more than 6 months.

What is the lifetime prevalence of schizophrenia?

Approximately 1%, with a slightly higher prevalence in men and more frequent diagnoses in African Americans.

What are common comorbidities with schizophrenia?

Anxiety disorders, mood disorders, and ADHD.

What distinguishes schizophreniform disorder from schizophrenia?

Schizophreniform disorder has the same symptoms but lasts between 1 to 6 months, often triggered by extreme stress.

What is the heritability estimate for schizophrenia?

Approximately 77%, indicating a strong genetic component.

What do twin studies reveal about the risk of developing schizophrenia?

MZ twins have a 44% risk, while DZ twins have a 12% risk of developing the disorder.

What is the dopamine hypothesis in relation to schizophrenia?

The disorder is associated with high levels of dopamine; amphetamines that increase dopamine can induce psychosis.

How do families influence the course of schizophrenia?

Family dynamics can affect the likelihood of relapse, with supportive environments potentially reducing relapse rates.

What psychological factors increase vulnerability to stress in schizophrenia?

Greater vulnerability to stress leads to increased negative mood.

How do families influence the likelihood of relapse in schizophrenia?

High levels of conflict, hostility, critical comments, and emotional overinvolvement increase the likelihood of relapse.

What is the bidirectional association in schizophrenia relapse?

Expression of unusual thoughts by the person with schizophrenia leads to increased critical comments from family, which in turn increases unusual thoughts.

What do retrospective studies reveal about individuals who develop schizophrenia?

They look back at the childhood and adolescence of those diagnosed with schizophrenia.

What do prospective studies indicate about schizophrenia development?

They follow groups of children into adulthood to see who develops schizophrenia.

What are the characteristics of first-generation antipsychotics?

They reduce positive and disorganization symptoms only, with 30% not responding; side effects include sedation, dizziness, and tremors.

What are the benefits of second-generation antipsychotics?

They are effective at reducing positive and disorganization symptoms and more effective at improving negative symptoms and cognitive function; side effects include weight gain and type 2 diabetes.

What is the overall response rate to antipsychotics?

Only 23% of patients had a good response to antipsychotics.

What psychosocial treatments are recommended for schizophrenia?

PORT recommends medication along with psychosocial interventions like social skills training, CBT, and family therapy.

What role does family therapy play in treating schizophrenia?

Family therapy instills hope, educates about the disorder, and teaches problem-solving skills.

What are the symptoms of anorexia according to DSM-5 criteria?

Restriction of food leading to very low body weight, intense fear of weight gain, and body image disturbance.

What characterizes bulimia nervosa?

Recurrent episodes of binge eating followed by compensatory behaviors to prevent weight gain, typically occurring in secret.

What defines binge-eating disorder?

Recurrent episodes of binge eating at least once a week for three months without compensatory behaviors.

What is the prevalence of anorexia and its comorbidities?

Anorexia is comorbid with depression, OCD, phobias, and has a high suicide rate of ~20%.

What are the physical complications associated with anorexia?

Low blood pressure, heart problems, gastrointestinal issues, brittle hair, and electrolyte depletion.

What psychological factors are associated with eating disorders?

Body dissatisfaction, desire for thinness, perfectionism, and excessive concern about weight.

How does society influence eating disorders?

Criticism from family and peers, unrealistic media portrayals, and stigma associated with being overweight contribute to the disorders.

What is the effectiveness of SSRIs in treating eating disorders?

SSRIs are effective for treating bulimia only, as it is often comorbid with depression.

What are the treatment goals for anorexia?

The immediate goal is to increase weight to avoid medical issues, followed by maintenance of weight gain.

What is the primary treatment for bulimia?

Cognitive Behavioral Therapy (CBT) is the most validated treatment to challenge societal standards and improve eating patterns.

What is the focus of treatment for binge-eating disorder?

CBT is effective in teaching self-monitoring and self-control skills.