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Gurpal

Part 2 ISQ Club - Addiction/Psychosis

23 posts in this topic

Below are some ISQs from the autumn 2004 exam. The complete paper can be downloaded by clicking here.

1. Relatives of a patient with depression have increased genetic risk for alcoholism

2. One of CAGE questionnaire questions is “do you crave alcohol?”

3. Implicit memory is not impaired in Korsakov's psychosis

4. Somatisation is associated with amphetamine usage

5. In the treatment of substance abuse, detoxification starts in the action stage

6. Motivational interviewing aims to reduce primary gain

7. Use of naltrexone decreases the chance of relapse in the treatment of alcoholism

8. Medical professionals are associated with increased prevalence of alcohol liver cirrhosis

9. Having a relative with the disease is the major risk factor for schizophrenia

10. Low IQ is a recognised risk for schizophrenia

11. Schizophrenia is associated with perinatal complications

12. No association between late onset schizophrenia with paranoid personality disorder has been shown

13. In negative symptoms there are impaired prefrontal functions

14. Visual and auditory deficiencies are similarly distributed in old age patients with delusional disorder.

15. Persistent delusional disorder is more common in visual than hearing impairment

16. Admission to hospital is essential in an elderly person with delusional disorder

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one of the CAGE questionnaire questions is 'do you crave alcohol?'

FALSE

The questions are

Cutting down would be a good idea?

Angry at others for telling you to reduce intake?

Guilty at amount drunk?

Eye opener required?

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3, Implicit memory is not impaired in Korsakov's psychosis.

TRUE

loss in explicit tests, esp in retrieval tasks with temporal awareness of tasks.

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7. Use of naltrexone decreases the chance of relapse in the treatment of alcoholism.

TRUE

Kaplan & Sadocks pg 1085

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can't find anything to link motivational interviewing to primary gain

i think primary gain is a made up term

guess its false?

p.s i hate smileys

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No 8 as we already know

true

ref Chick 1992 quoted oxford textbook

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no 5 action stage and detox

true

oxford textbook- thats all I've got!

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6. Motivational interviewing aims to reduce primary gain

False I can't see how motivational interviewing has anything to do with primary gain.

Primary gain:

Alleviation of anxiety that results from conversion of emotional conflict into demonstrably organic illnesses

By contrast, secondary gain are benefits such as increased care, sympathy, and pity that one receives when suffering from psychologically induced physical symptoms.

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4. Somatisation is associated with amphetamine usage

?False

From Companion: withdrawal phase peaks at 2-4 days with depressive symptoms, hypersomnia, fatigue, anhedonia, sadness,suicidal ideation and general malaise (lago & kosten,1994)

no mention of somatisation tho'....

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13. In negative symptoms there are impaired prefrontal functions  

True

Prefrontal cortex, negative symptoms, and schizophrenia: an MRI study.

Wible CG, Anderson J, Shenton ME, Kricun A, Hirayasu Y, Tanaka S, Levitt JJ, O'Donnell BF, Kikinis R, Jolesz FA, McCarley RW.

and

Negative symptoms and hypofrontality in chronic schizophrenia

A. Wolkin, M. Sanfilipo, A. P. Wolf, B. Angrist, J. D. Brodie and J. Rotrosen

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10. Low IQ is a recognised risk for schizophrenia

True

IQ and risk for schizophrenia: a population-based cohort study.

David AS, Malmberg A, Brandt L, Allebeck P, Lewis G.

Psychol Med. 1997 Nov;27(6):1311-23.

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5. In the treatment of substance abuse, detoxification starts in the action stage

true

Management of alcohol detoxification

Duncan Raistrick APT2000

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up early Io?

thanks for the one on Primary Gain

I guess no1 is false but just too tired to look it up

any ideas no's 12,14,15,16?

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12. No association between late onset schizophrenia with paranoid personality disorder has been shown

FALSE

Check this out:

Schizophr Bull. 1993;19(4):701-7. Related Articles, Links

Clinical characteristics of late-onset schizophrenia and delusional disorder.

Yassa R, Suranyi-Cadotte B.

Douglas Hospital Centre, Verdun, Quebec, Canada.

We compared 20 patients with late-onset schizophrenia, 7 with delusional disorder with hallucinations (paraphrenia), and 13 with delusional disorder without hallucinations (late-onset paranoia). We found that these three categories could be distinguished from each other on some clinical parameters. Late-onset schizophrenia was characterized by bizarre delusions; auditory hallucinations; to a lesser degree, first-rank and negative symptoms; and premorbid personality of the paranoid or schizoid type. Paraphrenia was associated with predominantly nonbizarre delusions, auditory hallucinations, earlier onset of symptoms, and paranoid or schizoid personality. Paranoia (late-onset) was characterized by late onset of symptoms, nonbizarre delusions, relatively intact premorbid personality, and an underlying physical stratum.

PMID: 8303221 [PubMed - indexed for MEDLINE]

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14? possibly False

Really difficult to find any literature on that.. am I missing out on something?

Psychol Med. 1994 May;24(2):397-410. Related Articles, Links

Phenomenology, demography and diagnosis in late paraphrenia.

Howard R, Almeida O, Levy R.

Section of Old Age Psychiatry, Institute of Psychiatry, London.

One hundred and one patients with late paraphrenia were examined using the Present State Examination. The established high prevalence rates of female gender, the unmarried state and sensory impairment were confirmed. All of the symptoms of schizophrenia, with the exception of formal thought disorder, were found in the subjects with approximately the same prevalence as reported in schizophrenics with a symptom onset in younger life.

The presence of visual hallucinosis was significantly associated with visual impairment, but the same association was not found between auditory hallucinations and deafness.

Mean age at onset of symptoms was high at 74.1 years. Using ICD-10 diagnostic criteria the patients were categorized as schizophrenia (61.4%), delusional disorder (30.7%) and schizoaffective disorder (7.9%). Patients in these diagnostic categories differed in their pre-morbid IQ estimations, current cognitive state measured by the Mini-Mental State Examination and in the number of scored positive psychotic PSE symptoms and their systematization of and preoccupation with delusions and hallucinations. There were no significant differences between the patients in the ICD-10 schizophrenia and delusional disorder groups in terms of age at symptom onset, sex ratio, response to treatment, being unmarried, the presence of insight or sensory impairment. The high degree of clinical similarity between patients with late paraphrenia combined with the inability of ICD-10 to define diagnostic subgroups that correspond to patient clusters derived from clinical symptoms or which are meaningfully different from each other in terms of demographic and prognostic factors provide a strong argument for the retention of late paraphrenia as the most appropriate diagnosis for such patients.

PMID: 8084935 [PubMed - indexed for MEDLINE]

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16) FALSE

Just common sense. Admission always depends from a number of factors, never by simply a diagnosis.

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12 No association between late onset schizophrenia with paranoid personality disorder has been shown

false

there is an association

manchester notes

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4. Somatisation is associated with amphetamine usage

true

pubmed search

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1. Relatives of a patient with depression have increased genetic risk for alcoholism

True - I would say

Psychol Med. 2004 Nov;34(8):1519-30.

Genetic effects on alcohol dependence risk: re-evaluating the importance of psychiatric and other heritable risk factors.

Knopik VS et al.

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14. Visual and auditory deficiencies are similarly distributed in old age patients with delusional disorder.

true

15. Persistent delusional disorder is more common in visual than hearing impairment

false

16. Admission to hospital is essential in an elderly person with delusional disorder

false (all from synopsis of psychiatry)

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