10. Schizophrenia Flashcards
Psychosis
is a significant loss of contact with reality
When does schizophrenia usually occur?
Late adolescence or early adulthood
Criteria A
1) delusions 2) hallucinations 3) disorganised speech 4) grossly disorganised or catatonic behav. 5) negative symptoms (dim. emotional expression)
Criteria B
Level of functioning has decreased
Criteria C
Disturbance at least 6 months
Criteria D
Schizoaffective, depressive or bipolar disorder ruled out
Kraeplin -
Dementia praecox - mental deterioration at an early age
Major problem with dementia praecox
It is assumed that progressive deterioration of the brain is universal - wrong
When did the first clinical description of schizophrenia appear?
1810
The term Schizophrenia was first used in
1911 - Eugen Bleuler
Hallmark symptoms of schizophrenia
Hallucinations, delusions, disorganised speech
Delusions
- Erroneous beliefs
- Firmly held despite clear contradictory evidence
- disturbance in content of thought
Hallucinations
- Sensory experience…
- Seems real but occurs in absence of any external perceptual stimulus
- Most common is auditory
- Can occur in any sensory modality
Disorganised speech
- failure to make sense
- Disturbance in form of thought
When is disorganised speech more common?
In chronic schizophrenia
Disorganised behaviout
Impairment of goal-directed activity
catatonia (minimal movement)
catatonia stupor
Catatonia Stupor
Unusual position of body
Positive Symptoms
- Excess or distortion in normal repetoire of behaviour
Negative symptoms
- absence or deficit of normally present behavs
Other psychotic disorders (5)
- schizoaffective disorder
- schizophreniform
- delusional disorder
- brief psychotic disorder
- shared psychotic disorder
Genetic risks of developing schizophrenia
Having a first degree relative with schizophrenia increases chance of having disorder by 10 times
Prenatal exposures which can increase risk of schizophrenia
Infection, rhesus incompatibility, early nutritional deficiencies and maternal stress, pregnancy and birth complications
What is the current theory on the cause of schizophrenia
interactions - genes and environment
Brain areas abnormal in schizo
- decreased brain volume - enlarged ventricles - thalamus- frontal lobe - temporal lobe - amygdala
Neurocognitive deficits
attention and memory deficits - eyetracking issues
Diathesis Stress Model
- interplay between genes and environment
Psychosocial and cultural aspects in schizophrenia
- cannabis use - families - urban living - immigration
Schizoaffective Disorder
Major mood episode and criteria A of schizophrenia
Two subtypes schizoaffective
biopolar or depressive type
Pharmacological approaches to schizophrenia treatment
- first. gen. antipsychotics - 2nd gen antipsychotic -
Psychosocial approaches to treating schizophrenia (5)
- family therapy - case management - social-skills training - cognitive remediation - cognitive-behave therapy
Neurotransmitters implicated
- dopamine
- glutamate
Better outcomes male or female?
female, generally
