Schizophrenia & Psychosis

Topics in this chapter

• Schizophrenia Diagnosis and Features
• Psychotic Spectrum Disorders
• Psychosis Neurobiology and Pathophysiology
• Antipsychotic Pharmacology
• Treatment-Resistant Schizophrenia
• Acute Psychosis and Catatonia Management

Practice questions

1. Question 1Q-F318C4

   A 24-year-old male is brought to the psychiatry outpatient department by his family members who report that he has become increasingly withdrawn, socially isolated, and suspicious over the past 8 months. He believes that the television news anchors are broadcasting secret messages directly intended for him and that his thoughts are being broadcasted to others through the radio. He also exhibits disorganized speech and frequent inappropriate affect. According to the DSM-5 criteria, what is the minimum total duration of disturbance required to diagnose this patient with schizophrenia?

   1. A.1 month
   2. B.3 months
   3. C.6 months
   4. D.12 months
   See the answer and solution
2. Question 2Q-C06C6F

   A 32-year-old man with a 5-year history of treatment-resistant schizophrenia, characterized by persistent persecutory delusions and auditory hallucinations despite adequate trials of two different atypical antipsychotics (including olanzapine and risperidone), is considered for clozapine therapy. Which of the following baseline hematological investigations is mandatory before initiating clozapine treatment?

   1. A.Absolute Neutrophil Count (ANC) and total leukocyte count
   2. B.Erythrocyte Sedimentation Rate (ESR)
   3. C.Reticulocyte count
   4. D.Serum ferritin level
   See the answer and solution
3. Question 3Q-42F890

   A 28-year-old male is evaluated for prominent negative symptoms of schizophrenia, including avolition, alogia, and asociality, which have shown poor response to conventional dopamine D2 receptor antagonists. Which of the following atypical antipsychotics has the highest affinity for serotonin 5-HT2A receptors relative to dopamine D2 receptors, contributing to its efficacy on negative symptoms and lower extrapyramidal side effect profile?

   1. A.Haloperidol
   2. B.Aripiprazole
   3. C.Mirtazapine
   4. D.Pimavanserin
   See the answer and solution
4. Question 4Q-9919B6

   A 28-year-old male is evaluated for prominent negative symptoms of schizophrenia. Which of the following atypical antipsychotics is characterized by a high affinity for serotonin 5-HT2A receptors relative to dopamine D2 receptors, along with significant antagonism at 5-HT2C, alpha-1 adrenergic, and histamine H1 receptors?

   1. A.Haloperidol
   2. B.Olanzapine
   3. C.Pimozide
   4. D.Fluphenazine
   See the answer and solution
5. Question 5Q-22D43B

   A 25-year-old woman is brought to the emergency department in a catatonic state. She remains mute, assumes bizarre postures for hours despite being repositioned, and shows negativism and waxy flexibility. Her family notes she stopped speaking and moving normally 3 days ago. Which of the following is the most appropriate initial pharmacological treatment of choice for catatonia?

   1. A.Haloperidol
   2. B.Lorazepam
   3. C.Fluoxetine
   4. D.Lithium carbonate
   See the answer and solution