Schizophrenia Q 55
A client is admitted to the psychiatric unit with active psychosis. The physician diagnoses schizophrenia after ruling out several other conditions. Schizophrenia is characterized by:
A. Loss of identity and self-esteem.
B. Multiple personalities and decreased self-esteem.
C. Disturbances in affect, perception, and thought content and form.
D. Persistent memory impairment and confusion.
Correct Answer: C. Disturbances in affect, perception, and thought content and form.
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, defines schizophrenia as a disturbance in multiple psychological processes that affect thought content and form, perception, affect, sense of self, volition, relationship to the external world, and psychomotor behavior. Traditionally, symptoms have divided into two main categories: positive symptoms which include hallucinations, delusions, and formal thought disorders, and negative symptoms such as anhedonia, poverty of speech, and lack of motivation.
Option A: Loss of identity sometimes occurs but is only one characteristic of the disorder. The diagnosis of schizophrenia is clinical; made exclusively after obtaining a full psychiatric history and excluding other causes of psychosis. Risk factors include birthing complications, the season of birth, severe maternal malnutrition, maternal influenza in pregnancy, family history, childhood trauma, social isolation, cannabis use, minority ethnicity, and urbanization.
Option B: Multiple personalities typify multiple personality disorder, a dissociative personality disorder. Mood disorders are commonly accompanied by increased or decreased self-esteem. Most patients with personality disorders often have little to no insight in regards to their maladaptive behavior. They rarely voluntarily present with “personality disorder” or “personality issues” as their chief complaint. More often than not, the patient will present secondarily to psychiatric sequelae of personality disorders. Such sequelae include chronic depression, interpersonal relationship hardships, unsatisfactory academic history, and poor vocational performance.
Option D: Schizophrenia doesn’t cause a disturbance in sensorium, although the client may exhibit confusion, disorientation, and memory impairment during the acute phase. Due to its relative complexity and heterogeneity, the etiology and pathophysiological mechanisms are not fully understood. Despite a low prevalence, schizophrenia’s global burden of disease is immense. Over half of the patients have significant comorbidities, both psychiatric and medical, making it one of the leading causes of disability worldwide.