Schizophrenia and Psychotic Disorders Lecture

Comperehensive flashcards covering the definition, symptoms, epidemiology, etiology, diagnosis, treatment, and subtypes of schizophrenia and other psychotic disorders as presented in the lecture notes.

How is psychosis defined in clinical terms?

Psychosis is defined as a gross impairment in reality testing, an inability to distinguish what is real from what is not real, a loss of contact with reality, and a distorted perception of reality.

Who introduced the term schizophrenia and in what year?

Bleuler introduced the term in $1911$.

What are the lifetime prevalence and gender distribution for schizophrenia?

The lifetime prevalence is approximately $1\%$ and it affects men and women equally in a $1:1$ ratio.

What are the average ages of diagnosis for men and women with schizophrenia?

Men are typically diagnosed at $23$ years, while women are diagnosed at $26$ years.

What are the three major clusters of schizophrenia symptoms?

The clusters are Positive symptoms, Negative symptoms, and Cognitive symptoms.

Define hallucinations and identify the most common type in schizophrenic patients.

Hallucinations are sensory perceptions without an actual external stimulus; auditory hallucinations are the most common, occurring in about $74\%$ of patients.

What are delusions?

Delusions are fixed, false unshakable beliefs that remain despite evidence to the contrary and cannot be accounted for by the individual's cultural or religious background.

What are the '5 A’s' that categorize negative symptoms in schizophrenia?

1. Anhedonia (loss of enjoyment), 2. Affect (flat), 3. Alogia (poverty of speech), 4. Avolition (apathy), 5. Attention (poor).

According to Schneider, what are the first rank symptoms of schizophrenia?

1. Thought insertion, 2. Thought broadcasting, 3. Thought withdrawal, 4. Thought echo, 5. Passivity phenomena (somatic, affect, volition), 6. Auditory hallucinations (second person, third person, running commentary), and 7. Delusional perception.

What are the three phases of schizophrenia?

1. Prodromal (decline in functioning preceding the first episode), 2. Psychotic (perceptual disturbances and delusions), and 3. Residual (mild symptoms and social withdrawal following an active episode).

What are the DSM-5 diagnostic criteria for schizophrenia regarding symptom duration?

Two or more symptoms must last for at least $1$ month (one must be delusions, hallucinations, or disorganized speech), with continuous signs of the disorder for at least $6$ months.

What is the genetic risk for schizophrenia in monozygotic (MZ) versus dizygotic (DZ) twins?

The risk is $46\%$ for MZ twins and $12\%$ for DZ twins.

What is the Dopamine Theory of schizophrenia?

The theory suggests the disorder is due to excess levels of dopamine, supported by the facts that drugs reducing dopamine alleviate symptoms and amphetamines (which increase dopamine) can induce psychosis.

What factors support the neuro-developmental hypothesis of schizophrenia?

Increased frequency of winter births (potential prenatal viral infection), obstetrical complications leading to brain damage, low birth weight, and shortened gestational periods.

What structural brain abnormalities are consistently found in schizophrenia patients?

Reduced gray matter and volume, and enlarged lateral and third ventricle spaces.

What is the 'downward drift' theory?

The theory that finding schizophrenia more often in persons of low socioeconomic status or urban centers is a result of having the illness rather than the cause of it.

How do first-generation antipsychotics differ from second-generation antipsychotics?

First-generation (e.g., Haloperidol) block dopamine receptors and have a high risk of EPSs (Extra-pyramidal side effects). Second-generation (e.g., Olanzapine) have fewer motor side effects but can cause weight gain and glucose dysregulation.

What are the statistical outcomes for patients with schizophrenia?

Complete recovery: $20\%$, recurrent course with deficits: $50\%$, chronic illness with functional disability: $20\%$, and suicide: $10\%$.

Contrast the onset characteristics for a better versus worse prognosis in schizophrenia.

A later, acute onset with a precipitant factor suggests a better prognosis, while an early, gradual onset without a precipitant factor suggests a worse prognosis.

What are the duration and characteristics of Brief Psychotic Disorder?

Symptoms last from $1$ day to $1$ month, often triggered by extreme stress, and resolve quickly with no residual impairment.

How is Schizophreniform Disorder distinguished from Schizophrenia?

Schizophreniform has the same symptoms but the duration is greater than $1$ month but less than $6$ months, and patients return to baseline functioning.

What defines Schizoaffective Disorder?

It involves symptoms of both schizophrenia and a mood disorder, with periods of psychosis occurring both with and without mood symptoms.

Which substances are associated with intoxication-induced psychosis?

Alcohol, Amphetamine (MDMA), Cannabis, Cocaine, Hallucinogens, Inhalants, Opioids, PCP, and Sedatives/hypnotics/anxiolytics.

Define Delusional Disorder and its types.

A chronic, unshakeable delusional system in an otherwise normal-functioning person. Types include Erotomanic, Grandiose, Somatic, Persecutory, Jealous, and Mixed.

What are the cognitive symptoms of schizophrenia and which brain region is involved?

Impairments in memory, attention, learning, and executive functioning (planning/organization), which are related to dysfunction of the prefrontal cortex.