1: Schizophrenia and Anxiety

Question 1

What percentage of the population have schizophrenia?

Answer 1

1%

Question 2

At what age does schizophrenia usually present?

Answer 2

Late teens to mid 20s

Question 3

What was dementia first described as?

Answer 3

Dementia praecox

Question 4

Who was the first person to use the word schizophrenia and in what year?

Answer 4

Bleuler in 1908

Question 5

What are some of the negative symptoms of schizophrenia?

Answer 5

Reduced speech
Difficulty with goal-orientated behaviour
Neglect of personal heigine
Flattened affect

Question 6

What is flattened affect?

Answer 6

Reduced expression of emotion

Question 7

What are some of the positive symptoms of schizophrenia?

Answer 7

Disorganised speech (A lack of logic and constantly changing topics)
Hallucinations (often auditory)
Delusions
Disorganised or catatonic behaviour

Question 8

What fraction of people with schizophrenia have delusions?

Answer 8

4/5

Question 9

What is the most common type of hallucination?

Answer 9

Auditory

Question 10

What are the cognitive symptoms of schizophrenia?

Answer 10

Poor attention
Impaired verbal working memory
Impaired executive function - inflexiable thinking style

Question 11

What are relapses and remissions in schizophrenia?

Answer 11

Symptoms go through cycles of improving and being more severe

Question 12

What is the DSM criteria for diagnosis of schizophrenia?

Answer 12

2 or more symptoms present for at least 1 month and 1 present for 3 months

Ongoing signs of illness for 6 months

Question 13

What disorders are often confused with schizophrenia?

Answer 13

Mood disorders (Depression or bipolar)
Substance abuse triggering an episode
brain damage
Huntington’s, parkinson’s and Alzheimer’s all have psychotic symptoms

Question 14

if one identical twin has schizophrenia, what is the chance the other twin will also have it?

Answer 14

48%

Question 15

What percentage of people with schizophrenia have no other relatives with it?

Answer 15

85%

Question 16

How is the age of the father linked to the development of schizophrenia?

Answer 16

The older the father is when the baby is conceived, the higher the chance of schizophrenia

Question 17

What is the interaction between genetics and environment?

Answer 17

They could trigger certain genes to be expressed

Question 18

What neurodevelopmental factors contribute to schizophrenia?

Answer 18

Infections during pregnancy
traumatic birth
low birthweight
cannabis in teenage years

Question 19

How is the brain structure of people with schizophreia different from others?

Answer 19

They have larger ventricles and less grey and white matter

Question 20

How is over-pruning linked to schizophrenia?

Answer 20

Too much pruning in the prefrontal cortex meaning communication between different areas of the brain is disrupted

Question 21

What neurotransmitters have been implicated in schizophrenia?

Answer 21

Dopamine

Glutamine

Question 22

What is the dopamine hypothesis?

Answer 22

That dopamine levels are linked with schizophrenia

Question 23

What evidence is there for the dopamine hypothesis?

Answer 23

Antipsychotic drugs work on dopamine receptors
PET scans show higher levels of dopamine synthesis in patients
High doses of drugs that increase dopamine cause psychotic symptoms
4/10 of the top associated genes are also linked to dopamine

Question 24

What are typical antipsychotic drugs?

Answer 24

They act on D2 receptors and have many side effects such as tardive dyskinesia

Question 25

What is tardive diskinesia?

Answer 25

Involuntary movements of the facial muscles

Question 26

What are atypical antipsychotics?

Answer 26

They act on several classes of receptors including serotonin

Less side effects which are less severe

Question 27

What are the limitations of the dopamine hypothesis?

Answer 27

1/3 of patients don’t respond to antipsychotics

The relationship between dopamine and negative symptoms is unclear

Question 28

What is the glutamate hypothesis?

Answer 28

It’s due to a dysfunction of the NMDA glutamate receptor

Question 29

What is the evidence for the glutamate hypothesis?

Answer 29

Ketamine was usedd as an anastetic and when patients came round, they had similar symptoms to schizophrenia
Mice bred with less receptrs have signs of schizophrenia

Question 30

How many people are affected by anxiety at some point in their lives?

Answer 30

30%

Question 31

What is generalised anxiety disorder?

Answer 31

Excessive worry, restlessness and trouble sleeping

Question 32

What is a panic disorder?

Answer 32

Reoccuring, unexpected panic attacks

Question 33

What is agoraphobia?

Answer 33

Where we excessively think our environment is unsafe

Such as not wanting to leave the house

Question 34

How long do panic attacks usually last?

Answer 34

Less than 30 minutes

Question 35

How is the sympathetic nervous system involved in panic attacks?

Answer 35

It triggers the fight or flight response

Question 36

How is the parasympathetic nervou system involved in panic attacks?

Answer 36

It slows down the body and dampens the fight or flight response

Question 37

How is the amygdala linked to anxiety?

Answer 37

It recieves sensory infomration from the cortex, thalamus and hippocampus and projects it to brain areas involved in emotional responses
Activated when we see fearful faces

Question 38

In what part of the amygdala is sensory information processed?

Answer 38

The basolateral nucleus

The information is then passed to the central nucleus

Question 39

How is the hippocampus linked to anxiety?

Answer 39

More concerned with factual information than emotion

Such as what the fear is paired with

Question 40

How is the ventromedial prefrontal cortex linked to anxiety?

Answer 40

Involved in the enxinction of fear

Question 41

How do benzodiazipines treat anxiety?

Answer 41

They enhance the activity of GABA