Test: Schizophrenia Spectrum and Other Psychotic Disorders - 1 - NEET PG MCQ

The term "dementia praecox" (often spelled "precox") was coined by Emil Kraepelin, a German psychiatrist, in the late 19th century. Kraepelin used this term to describe a chronic, deteriorating psychotic disorder characterized by early onset (typically in adolescence or early adulthood) and progressive cognitive decline. He distinguished it from other mental disorders, such as manic-depressive illness, based on its course and outcome. Later, Eugen Bleuler renamed the condition "schizophrenia" in 1911, emphasizing the fragmentation of thought processes rather than inevitable dementia.

The term schizophrenia was introduced by a Swiss psychiatrist named Eugen Bleuler in the early 20th century. He used this term to describe a group of mental health disorders that affect how a person thinks, feels, and behaves.

Bleuler believed that schizophrenia was not just one illness but a range of symptoms that could appear in various combinations. He focused on the idea that it could involve a disconnection between thoughts, emotions, and behaviour, which is why the term "schizophrenia," meaning "split mind," was chosen.

His work was significant because it helped to change the perception of mental illness and laid the groundwork for future research and treatment methods.

The term 'catatonia' was first introduced by the German psychiatrist Kahlbaum. He described it in the context of mental disorders, highlighting its characteristics and symptoms. This condition is marked by a range of behaviours, including immobility, mutism, and unusual movements. Understanding Kahlbaum's contribution helps in recognising the historical context of catatonia in psychiatry.

Automatisms are typically associated with epilepsy, characterized by seemingly purposeful behaviors for which the patient has no memory afterward. They are not observed in schizophrenia.

While SFRS have been linked to schizophrenia, they are not exclusive to this condition. They can be observed in all the disorders referenced in this question. Nevertheless, if it were not a PGI question and a single option had to be selected, it would be schizophrenia.

Schizophrenia can be linked with various personality types. Here are the main types associated with it:

• Athletic - This personality is typically energetic and physically active.
• Pyknic - This type is often characterised by a round physique and a sociable nature.
• Asthenic - This personality is usually slim and tends to be more reserved.

Each of these personality types can display symptoms related to schizophrenia, but it is important to remember that the condition can manifest differently in each individual.

Late onset schizophrenia typically occurs when symptoms begin after the age of 45. This form of schizophrenia often presents differently compared to earlier onset cases.

Here are some key points about late onset schizophrenia:

• Onset Age: Symptoms usually emerge after 45 years.
• Prognosis: The outlook is generally poor, as this type tends to be more resistant to treatment.
• Hallucinations: Individuals may experience olfactory hallucinations, which are sensations of smell that are not present.

Schizophrenia exhibits greater heritability than bipolar disorder (mania), which itself has a higher heritability when compared to depression.

All have been involved, but the most significant are dopamine and serotonin.

The HVA is a by-product of dopamine metabolism, and dopamine levels are typically elevated in schizophrenia. Numerous studies have demonstrated that HVA levels are heightened in individuals with schizophrenia.

Schizophrenia is linked to increased activity in themesolimbic andmesocortical pathways of the brain. These pathways are part of the dopaminergic system, which involves dopamine, a chemical that helps transmit signals in the brain.

• Themesolimbic pathway is associated with emotions and reward. Overactivity here can lead to symptoms such as hallucinations and delusions.
• Themesocortical pathway affects cognitive functions and emotional regulation. Its overactivity can contribute to difficulties in thinking and social interactions.

In summary, the primary cause of schizophrenia is the overactivity in themesolimbic/mesocortical pathways.

Schizophrenia includes various symptoms, but elation is not one of them. Here are the symptoms typically associated with schizophrenia:

• Delusions: False beliefs that are strongly held despite contradictory evidence.
• Auditory hallucinations: Hearing voices or sounds that are not present.
• Catatonia: A state of unresponsiveness or extreme inactivity.

In summary, elation is not a common symptom of schizophrenia.

Auditory hallucinations represent the most prevalent form of hallucinations in schizophrenia, with third-person auditory hallucinations being particularly typical of this condition.

In fact, the accurate response is none. There is no individual symptom or sign that is exclusively indicative of schizophrenia. Nevertheless, previously, Schneider's first rank symptoms were viewed as pathognomonic. Therefore, the most suitable answer in this context is B.

Formal thought disorder, hallucinations in the third person, and inappropriate emotions (inappropriate affect) are typical features of schizophrenia.

Hallucinations associated with schizophrenia tend to be intermittent.

Akathisia is an adverse effect associated with antipsychotic medications. While ambivalence may seem perplexing in this context, it is important to note that ambitendency simply refers to ambivalence in motor activities.

Akinesia, which denotes an absence of voluntary movements, is another term used to describe stupor.

Cataplexy is a characteristic associated with narcolepsy.

Catatonic schizophrenia includes several key features, but one characteristic does not belong. The features commonly seen are:

• Mutism: This is a lack of speech despite being awake and aware.
• Echolalia: This refers to the repetition of phrases or words spoken by others.
• Waxy flexibility: This is when a person's limbs can be moved and will stay in that position.

However, increased deep tendon reflexes is not typically associated with catatonic schizophrenia. This feature is more related to other neurological conditions.

The central delusion is that the wife is having an affair, with the rest of the history extending from this belief (e.g., a friend providing support and people speaking negatively). The absence of thought disorder and inappropriate behavior, as noted, argues against a diagnosis of schizophrenia.