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HP4 Lecture 7

1

Which of the following statements about schizophrenia is CORRECT?


  The onset of schizophrenia is typically in late adulthood

  The three main components of schizophrenia treatment are psychotropic medication, psychosocial interventions and isolation

  Schizophrenia has a higher incidence in men than in women

  Primary prevention of schizophrenia is currently not possible

  Schizophrenia is a relatively uncommon psychiatric disorder


A is incorrect: The onset of schizophrenia is typically in adolescence or early adulthood B is incorrect: The three main components are psychiatric medication, psychosocial interventions and rehabilitation for to help individuals reintegrate C is incorrect: The incidence is about equal, although onset appears sooner in males D is correct: Primary prevention is not possible because the cause of schizophrenia is unknown E is incorrect: Its prevalence is almost 1% worldwide

2

Which one of the following is NOT one of Schneider's 'first rank symptoms'?


  Voices providing running commentary

  Delusional perception

  Dementia pracecox

  Thought broadcasting

  Thought withdrawal


C is incorrect: This is one of two of Kraeplin's early 'funcional illness' groups

3

Which of the following statements about the presentation of schizophrenia is CORRECT?


  Signs of schizophrenia are externally observable characteristics that are suggestive of its presence

  Odd postures or gestures are symptoms of schizophrenia

  Depression, motor retardation and lack of judgment or insight are common signs of schizophrenia

  Negative symptoms are unusual experiences that are generally absent

  Hallucinations are a distinguishing feature of schizophrenia compared with mood disorders in general


A is correct. B is incorrect: These are signs of schizophrenia C is incorrect: These are negative symptoms of schizophrenia D is incorrect: This is the definition of positive symptoms E is incorrect: Hallucinations are associated with schizophrenia, mood disorders and substance abuse (delusions too)

4

Which of the following statements about the diagnosis of schizophrenia (DSM-IV) is INCORRECT?


  Social or occupational dysfunction must be observed

  Continuous signs of disturbance must be persistent for at least 9 - 12 months

  Substance abuse, neurological conditions and other mood disorders must be excluded

  A diagnosis of schizophreniform disorder can be made if disturbances are ongoing, but for less than the minimum period required for schizophrenia diagnosis

  The presence of both delusions and disorganized behaviour would satisfy one of three required diagnostic criteria


A is correct: Social/occupational dysfunction is the second of the three criteria that must be met B is incorrect: Only 6 months are required C is correct. D is correct: Additionally, if the symptoms last less than one month but more than a day, 'Brief Psychotic Disorder' could be diagnosed E is correct: The first DSM-IV criterion requires at least two "characteristic symptoms": delusions, hallucinations, disorganised speech, grossly disorganised behaviour and any 'negative' schizophrenia symptom

5

Which of the following statements about the possible causes of schizophrenia is CORRECT?


  It is not associated with recreational drug use

  Having an identical twin with schizophrenia confers a 75% risk of schizophrenia as an adult

  Schizophrenia is often associated with a 'single hit' during development

  Schizophrenia is discussed in terms of risk factors because these risk factors have clear causal links with the illness

  Paternal age is a risk factor for schizophrenia


A is incorrect: Recreational drug use is associated. B is incorrect: The risk is only 50%. C is incorrect: Schizophrenia is thought of as being a 'multiple hit' disease over various stages of life. D is incorrect: Risk factors are used because the causes are unknown, and the connection between the illness and known risk factors is not well characterised in all cases. E is correct: Genetic predisposition and paternal age are both schizophrenia risk factors associated.

6

Brain changes in schizophrenia would NOT include:


  Changes associated with a previous psychotic episode, i.e. "toxic psychosis"

  Reduced grey matter mass, for example around the superior temporal gyrus

  Pronounced pruning of prefrontal cortex during development

  Assymetry of the cingulate/paracingulate gyrus

  Abnormalities in function that are observable via functional imaging of metabolite activity


D is correct: assymetry is normal; symmetry is atypical and associated with schizophrenia