NUR 371 Exam 2 Schizophrenia Review
Questions and Correct Answers
Identify the disorders in which patients have psychosis ✅Schizoaffective
Schizophrenia
Mania
Depression with psychotic features
Dementia
Brief psychotic episode (+/- PD)
Identify which disorders in which patient does not have psychosis ✅Schizoid PD,
Schizotypical PD, Paranoid PD
Epidemiology of Schizophrenia ✅About 1% of the population
Same percent is found internationally and across cultures
75% of all mental health expenditures
High rates of suicide-9-13%
-as many as 50% will attempt
Life span is 10 years less than average
Course of Schizophrenia ✅Premorbid predictive factors
-lack of concentration, lack of coordination, emotional/cognitive deficits
Onset from adolescence to early adult (looking back in time and identifying factors-not
something you can predict)
Episodic acute symptoms (in between still impaired)
Ongoing deficits between acute episodes
Phases of Schizophrenia ✅Prodromal
-3-6 months; long slow slide into active phase; before any active illness; socialization
issues, not going to class, not grooming well, saying a few off things, spending most of
time in bed (up at night), sitting and mumbling
Active:
-florid psychosis (hospitalized); full on hallucinations and delusions
Residual
-impairment between acute episodes; acute episodes become more severe and more
frequent and less severe while residual phase functioning deteriorates; they do not go
back into normal functioning-hallucinations and delusions do not go away they are just
more in the background
Schizoid and Schizotypical stay in what phase ✅Residual phase because they are
never actively psychotic
, Pathogenesis of Schizophrenia ✅Genetics: strong occurrence with family hx
Perinatal insult: viruses in pregnancy; time of year (flu season)
Cognitive deficits
Neuroanatomy and Neurotransmission
Pathogenesis: cognitive deficits ✅Consistent with frontal love and temporal lobe
dysfunction
More predictive of outcome than symptom severity
Stable independent of acute phase symptoms
May present premorbid
More pronounced in higher cognitive functions (memory and executive functioning)
Cognitive impairment findings in the CATIE study ✅Present in almost all persons with
Schizophrenia
Associated with poor functional outcomes
Predicts poor work performance
More predictive of dysfunction than positive or negative symptoms
CATIE: Clinical, Antipsychotics, Trials, in Interventions, Effectiveness
Big study on antipsychotics that had the same results
Cognitive deficits ✅Composite processing speed, attention, working memory, verbal
learning, visual learning, reasoning, social cognition
IQ is separate!!
Neuroanatomy and neurotransmission ✅Dopamine!! (2)
Anatomy
-Mesolimbic
-Mesocortical
-Nigrostriatal
Mesolimbic ✅Positive symptoms-hallucinations, delusions, disorganized speech, and
bizarre behavior
Mesocortical ✅Negative symptoms, cognitive deficits, attention deficits
Turberoinfundibular ✅Endocrine function
Temperature control
Sexual arousal
Circadian rhythm
Nigrostiatal ✅EPS, Tardive dyskinesia
NMS
Questions and Correct Answers
Identify the disorders in which patients have psychosis ✅Schizoaffective
Schizophrenia
Mania
Depression with psychotic features
Dementia
Brief psychotic episode (+/- PD)
Identify which disorders in which patient does not have psychosis ✅Schizoid PD,
Schizotypical PD, Paranoid PD
Epidemiology of Schizophrenia ✅About 1% of the population
Same percent is found internationally and across cultures
75% of all mental health expenditures
High rates of suicide-9-13%
-as many as 50% will attempt
Life span is 10 years less than average
Course of Schizophrenia ✅Premorbid predictive factors
-lack of concentration, lack of coordination, emotional/cognitive deficits
Onset from adolescence to early adult (looking back in time and identifying factors-not
something you can predict)
Episodic acute symptoms (in between still impaired)
Ongoing deficits between acute episodes
Phases of Schizophrenia ✅Prodromal
-3-6 months; long slow slide into active phase; before any active illness; socialization
issues, not going to class, not grooming well, saying a few off things, spending most of
time in bed (up at night), sitting and mumbling
Active:
-florid psychosis (hospitalized); full on hallucinations and delusions
Residual
-impairment between acute episodes; acute episodes become more severe and more
frequent and less severe while residual phase functioning deteriorates; they do not go
back into normal functioning-hallucinations and delusions do not go away they are just
more in the background
Schizoid and Schizotypical stay in what phase ✅Residual phase because they are
never actively psychotic
, Pathogenesis of Schizophrenia ✅Genetics: strong occurrence with family hx
Perinatal insult: viruses in pregnancy; time of year (flu season)
Cognitive deficits
Neuroanatomy and Neurotransmission
Pathogenesis: cognitive deficits ✅Consistent with frontal love and temporal lobe
dysfunction
More predictive of outcome than symptom severity
Stable independent of acute phase symptoms
May present premorbid
More pronounced in higher cognitive functions (memory and executive functioning)
Cognitive impairment findings in the CATIE study ✅Present in almost all persons with
Schizophrenia
Associated with poor functional outcomes
Predicts poor work performance
More predictive of dysfunction than positive or negative symptoms
CATIE: Clinical, Antipsychotics, Trials, in Interventions, Effectiveness
Big study on antipsychotics that had the same results
Cognitive deficits ✅Composite processing speed, attention, working memory, verbal
learning, visual learning, reasoning, social cognition
IQ is separate!!
Neuroanatomy and neurotransmission ✅Dopamine!! (2)
Anatomy
-Mesolimbic
-Mesocortical
-Nigrostriatal
Mesolimbic ✅Positive symptoms-hallucinations, delusions, disorganized speech, and
bizarre behavior
Mesocortical ✅Negative symptoms, cognitive deficits, attention deficits
Turberoinfundibular ✅Endocrine function
Temperature control
Sexual arousal
Circadian rhythm
Nigrostiatal ✅EPS, Tardive dyskinesia
NMS
