13-1 Flashcards
Psychotic symptom domains
Delusions Hallucinations Disorganized speech Disorganized behavior Negative symptoms
*first 3 are CORE
A fixed beliefs that is not amenable to change, even in light of conflicting evidence
Delusions
Belief that an outside action refers directly to the person or has special personal meaning to person
Delusion of reference
Thoughts being transmitted to others
Thought broadcasting delusion
Sensory perception without an external stimulus
Hallucinations
Speech (thinking) lacks the normal, logical connections b/n thoughts
Disorganized speech
Disorganized speech that shifts to a slightly-related topic
Tangentiality
Disorganized speech with rapid shift of thoughts with discernible links b/n ideas
Flight of ideas
Disorganized speech with no apparent connections b/n ideas
Derailment
Disorganized speech of word association based on rhyming
Clang Association
Disorganized speech of no meaningful relationship b/n words
Word salad
Presence of phonemic paraphasic errors with speech errors having addition/deletion of syllables
Disorganized speech in post-stroke aphasias
Pronunciation is good in psychotic patients but what is the problem?
With the logical connection b/n words
Non-goal oriented behavior (ex: unable to take care of daily activities)
Disorganized
Multiple motor/behavioral abnormalities that reflect diminished reactivity to the environment such as posturing or waxy flexibility
Catatonia
Negative symptoms of Psychotic Symptom Domains
Diminished emotional expression (verbal and non-verbal)
Avolition (decreased in purposeful activities)
Alogia (diminished speech)
Anhedonia
Asociality (disinterest social interactions)
Thoughts, behaviors or perceptions normally exist that are now absent or markedly diminished
Negative symptoms (domain 5)
Thoughts, behaviors or perceptions that are distorted or in excess of normal function
Positive symptoms (domains 1-4)
2 psychotic domain symptoms with at least one being a core symptom with an active-phase for >1 mos and at least 1 symptom persists for >6 mos
Schizophrenia
Dopamine Hypothesis of Schizophrenia
Overactivity of mesolimbic DA relates to positive symptoms (VTA to Basal forebrain)
Under activity of mesocortical DA relates to negative symptoms (VTA to prefrontal cortex)
Neurostructural changes of Schizophrenia
Enlarged lateral ventricles (Ventriculomegaly)
Cortical and hippocampal atrophy
Decreased volume of thalamus
Neurofunctional changes of schizophrenia
Hypofrontality: decrease prefrontal metabolism
Neurocognitive effects of Schizophrenia
Impairments in multiple ares including attention, memory, executive fxns, etc.
Neurodevelopmental theory of Schizophrenia
Lesion occurs during early brain development that lies dormant until brain maturation
Evidence of neurodevelopmental lesions of Schizophrenia
Hippocampal cellular disorganization
Increased neurological soft-signs
Increased minor physical anomalies
What causes the neurodevelopmental lesion of Schizophrenia
Genetic factors: multiple genes
Non-genetic factors: obstetric problem, maternal infection
Risk of developing Schizophrenia
Gen. pop: 1%
Relative: 15%
MZ co-twin: 50%
