10-30 Schizophrenia Flashcards
o Demonstrate knowledge of the epidemiology and risk factors for schizophrenia o Demonstrate knowledge of the neurobiology of schizophrenia o Demonstrate knowledge of the DSM-5 diagnostic criteria for schizophrenia o Identify 5 symptom domains in schizophrenia o Identify 3 treatment options for people with schizophrenia
epidemiology of schizophrenia
~1% population
risk factors for schizophrenia
- poor/childhood trauma
- enviro: First trimester exposure to famine, epidemic, summer (melatonin link?), perinatal trauma or anoxia, TBI
neurobiology of schizophrenia
+ sx: ↑ DA in meso-limbic sys
- sx: ↓ DA in meso-cortical sys
—glutamate/NDMA may be involved, too: inv in neuronal pruning/apop; may contrib to neuronal migration issues seen in SCZ
DSM-5 diagnostic criteria for schizophrenia
—MOST IMPORTANT
A. Characteristic Symptoms: 2 or more, each for significant portion of 1 month
——PARANOID SUBTYPE
—1. Delusions
—2. Hallucinations
——DISORGANIZED SUBTYPE
—3. Disorganized speech
—4. Grossly disorganized or catatonic behavior
—5. Negative sxs
B. Social/occupational dysfunction
C. 6mos continuous sx
D. Schizoaffective and Mood Disorder Exclusion: brief or no mood episodes
E. Substance/General Medical Exclusion
F. Relationship to Autism Spectrum Disorder: prominent hallucinations or delusions
identify 5 symptom domains in schizophrenia
- Positive symptoms
- Disorganization
- Negative symptoms
- Cognitive deficits
- Mood symptom
Identify 3 treatment options for people with schizophrenia
- meds
- hospitalization
- ACT (Assertive Community Treatment)
—smoking and caffeine improve cog sx
brief psychotic episode
—Only meets 1 criteria A —complete recovery —1 day to 1 mo of sx SPECIFIERS —W/ stressor —W/o stressor —Postpartum —W/ catatonia
Schizophreniform Disorder
—include prognosis?
—Meet the 2 categories requirement and not other things requirement —only have 1-6mos sx PROGNOSIS —Good if ing and no flattening of affect —Poor if w/ catatonia
Schizoaffective D/o
A. Major depressive, manic or mixed episodes concurrent with criterion A for SCZ
B. Delusions or hallucinations for 2+ weeks in the absence of mood symptoms
C. Mood symptoms present for majority of total duration
D. Substance/general medical exclusion
Subtypes: Bipolartype Depressive type
Delusional D/o
**shooters! dangerous because no fxnal impair
A. One or more delusions, 1+ month
B. Criterion A for SCZ never met
- If hallucinations, not prominent and related
C. Functioning, behavior not markedly impaired
D. Mood episodes brief relative to delusional periods
E. Substance/general medical exclusion
Schizotypal Personality D/o
A. Five of: 1. Ideas of reference 2. Odd beliefs that influence behavior 3. Unusual perceptual experience 4. Odd thinking and speech 5. Suspiciousness or paranoia 6. Inappropriate or constricted affect 7. Behavior or appearance odd or peculiar 8. Lack of close friends 9. Excessive social anxiety B. Not exclusively during psychotic, autistic disorder
Attenuated Psychosis Syndrome
A. 1+ in attenuated form, intact reality testing
—1. Delusions
—2. Hallucinations
—3. Disorganized speech
B. > once/week for past month
C. Begun or worsened past year
D. Sufficiently distressing and disabling
E. Not better explained by another disorder
F. Criteria for psychotic disorder never met
Antipsychotics 101
• First GenerationAntipsychotics(FGAs)
– D2 antagonists
– eg: chlorpromazine, haloperidol
• Second Generation Antipsychotics(SGAs)
– D2, 5HT2 antagonists
– eg: clozapine, “atypical antipsychotic”
– Gen 2.1, D2 partial agonist: aripiprazole
