Schizophrenia

_______ is a group of disorders marked by withdrawal from reality, illogical thinking, hallucinations, delusions, and emotional and behavioral disturbances.

Schizophrenia is a devastating illness which causes a schizo, or ______ between a person's emotions, behaviors and cognitions

A patient with a first degree relative with schizophrenia has a (#) time risk of developing schizophrenia

T/F People who have schizophrenia are more likely to be born in the summer

Which of the following is false regarding epidemiology of schizophrenia? A) more prevalent in urban areas B) more prevalent in NE and western US C) associated with higher mortality rate D) more common in men vs women E) there is a greater risk of developing schizophrenia if born of father >60 years of age

Approximately (#)% of patients with schizophrenia attempt suicide

Suicide is more common in the first (#) years of the illness

Schizophrenia is related to an excess of: A) serotonin B) dopamine C) norepinephrine

Delusions, hallucinations, hostility, and disorganized thinking are considered (positive / negative) symptoms of schizophrenia

Blunted or manic affect, impairment in associations between thoughts and actions, autism, and ambivalence are considered (positive / negative) symptoms of schizophrenia

T/F The majority of schizophrenic patients smoke

T/F Smoking may decrease positive symptoms in schizophrenia

What are the two most commonly abused substances in schizophrenia? A) cannabis B) heroin C) cocaine D) LSD

Substance use is associated with a (good / poor) prognosis in schizophrenia

15-45% of which population is diagnosed with schizophrenia? A) elderly B) children C) homeless D) institutionalized

T/F The cost of treating schizophrenia exceeds that of all combined cancers

The concordance rate for monozygotic twins in schizophrenia is approximately (#)%

The dopamine theory of schizophrenia posits that schizophrenia results from too (much / little) dopaminergic activity

All of the following are seen in schizophrenia, EXCEPT: A) Enlargement of the lateral and third ventricles B) Reduced symmetry in the temporal, frontal, and occipital lobes C) Increase in size of region involved with the Limbic system D) Abnormalities in Prefrontal Cortex (symptoms mimic lobotomies)

A patient presents with one month of grossly disorganized and catatonic behavior with ambivalence, social withdrawal (autism), and a blunted affect. Does he meet criteria A for schizophrenia?

A patient must have continuous signs of the disturbance for how long before schizophrenia can be diagnosed? A) 1 month B) 6 months C) 12 months D) 2 years

Pre-diagnosis, patients were noted to be quiet and passive, introverted with few friends as children, and avoidant of social activities. What phase of schizophrenia does this describe? A) prodromal phase B) premorbid phase C) active phase D) residual phase

T/F Prodromal signs and symptoms are almost invariably recognized after diagnosis

Following diagnosis, you are speaking to your patient's wife and she reports the patient was noted to be declining at his job and started to become preoccupied with the existence of aliens before the onset of his psychosis. She states there was a change, but it wasn't something she really recognized until he was diagnosed with schizophrenia. What phase of schizophrenia does this describe? A) prodromal phase B) premorbid phase C) active phase D) residual phase

All of the following are good prognoses in Schizophrenia, EXCEPT: A) female gender B) family history of mood disorder C) Paranoid subtype with hallucinations/delusions D) Disorganized subtype with apathy, blunted affect, anhedonia E) Late age of onset

All of the following are bad prognoses in Schizophrenia, EXCEPT: A) Early age of onset B) Poor pre-illness functioning C) Family history of schizophrenia D) Family history of mood disorder E) Disorganized subtype with apathy, blunted affect, anhedonia

A lack of psychosis in a schizophrenic patient is a (positive / negative) symptom

T/F Patients with schizophrenia can range from completely disheveled, out of control patients to ones obsessively groomed, completely silent

What is the most common type of hallucination in schizophrenia? A) visual B) tactile C) auditory D) olfactory

What is the term for speech in which the central idea is not communicated, as may be a form of thought disorder seen in schizophrenia? A) looseness of associations B) derailment C) tangentiality D) circumstantiality

What is the term for repetition of words or phrases voiced by others, as may be a form of thought disorder seen in schizophrenia? A) verbigeration B) derailment C) tangentiality D) echolalia

What is the term for meaningless repetition of words or phrases, as may be a form of thought disorder seen in schizophrenia? A) verbigeration B) derailment C) tangentiality D) echolalia

What is the term for repetition of the same response to different stimuli, as may be a form of thought process disorder seen in schizophrenia? A) verbigeration B) preservation C) tangentiality D) idiosyncratic associations

T/F Patients with schizophrenia are usually not oriented to person, time, and place

T/F In outpatients, the level of cognitive impairment is a better predictor of level of function than is the severity of the psychotic symptoms

Classically patients with schizophrenia have (good / poor) insight into the nature and the severity of their disorder.

A patient has been diagnosed with schizophrenia. She does not show disorganized speech, catatonic behavior, or a flat affect. There is however, a preoccupation for delusions and frequent auditory hallucinations. What subtype of schizophrenia is this most likely? A) residual B) catatonic C) disorganized D) paranoid

A patient has been diagnosed with schizophrenia. He shows disorganized speech, catatonic behavior, and a flat affect. You have also noted regression to primitive, disinhibited, and unorganized behavior such as a failure to bathe. What subtype of schizophrenia is this most likely? A) residual B) catatonic C) disorganized D) paranoid

A patient has been diagnosed with schizophrenia. You note excessive motor activity that is apparently purposeless, echolalia, and abnormal posturing. What subtype of schizophrenia is this most likely to be? A) residual B) catatonic C) disorganized D) paranoid

A patient has been diagnosed with schizophrenia, noting disturbances in affect and impairment in associations between thoughts and actions, as well as some magical thinking. However there are no predominant positive symptoms such as delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior. What subtype of schizophrenia is this most likely? A) residual B) catatonic C) disorganized D) paranoid

T/F Acute psychotic symptoms require immediate attention

T/F 40 to 50% of patients with schizophrenic become non-compliant in the first 1 to 2 years

T/F Oral medications are more effective in increasing compliance compared to injectable drugs

(Typical / atypical) antipsychotics have more neurological side effects such as extrapyramidal effects and tardive dyskinesia

A patient presents with delusions and disorganized speech with a blunted affect. His symptoms have lasted 4 months and have not affected his job or marriage. No changes in mood. What is this? A) Schizophrenia B) Schizophreniform C) Schizoid D) Schizoaffective

What is NOT an appropriate course of treatment for Schizophreniform disorder? A) hospitalization B) 3-6 month course of antipsychotics C) lithium prophylaxis D) psychotherapy E) all of the above are appropriate

A patient presents with a depressed mood and new onset of hallucinations and altered affect. What is this? A) Schizophrenia B) Schizophreniform C) Schizoid D) Schizoaffective

What is the appropriate treatment for Schizoaffective disorder? A) Combination therapy of mood stabilizers, antidepressants and antipsychotics along with psychotherapy B) Benzodiazepines with psychotherapy C) Short course of mood stabilizers and antidepressants D) All of the above

One week following delivery, JC, who has a diagnosed h/o borderline personality disorder, noted onset of delusions of intrusive thoughts, including the desire to kill her child. Her husband also noted decreased hygiene and frantic behavior. Her symptoms have lasted approximately 1 week before help was sought. What is this? A) Delusional disorder B) Schizophreniform C) Brief psychotic disorder D) Schizoaffective

(Hallucinations / Delusions) are false fixed beliefs not in keeping with the culture

T/F The diagnosis of delusional disorder is made when a person exhibits bizarre delusions of at least 1 month's duration that cannot be attributed to other psychiatric disorders

T/F In delusional disorder, aside from the impact of the delusions or it's ramifications, functioning is not markedly impaired and behavior is not obviously odd or bizarre

In which subtype of delusional disorder does a patient believe another person, usually of higher status, is in love with him/her? A) persecutory B) grandiose C) jealous D) erotomanic E) somatic

In which subtype of delusional disorder does a patient have delusions of inflated worth, power, knowledge, identity, or a special relationship to a deity or famous person? A) persecutory B) grandiose C) jealous D) erotomanic E) somatic

In which subtype of delusional disorder does a patient have delusions that their sexual partner is unfaithful? A) persecutory B) grandiose C) jealous D) erotomanic E) somatic

In which subtype of delusional disorder does a patient have delusions that they are being malevolently treated in some way? A) persecutory B) grandiose C) jealous D) erotomanic E) somatic

In which subtype of delusional disorder does a patient have delusions that they have some physical deficit or medical condition? A) persecutory B) grandiose C) jealous D) erotomanic E) somatic

What is usually the treatment of choice for delusional disorder? A) psychotherapy B) self-limiting (no treatment) C) antipsychotics D) hospitalization