4.1 Schizophrenia Flashcards
Psychosis
- Mental condition with disorganization of personality, deterioration in social functioning and loss of contact with or distortion of reality
- Hallucinations - False sensory perceptions not associated with real external stimuli
- Delusions - Fixed, false beliefs
PSYCHOSIS CAN OCCUR WITH OR WITHOUT PRESENCE OF ORGANIC IMPAIRMENT
SCHIZOPHRENIA IS THE MOST COMMON FORM OF PSYCHOSIS
Schizophrenia
- Severe deterioration of social and occupational functioning
- Men are at greater risk and may develop the disorder earlier
- Suicide is the major contributor to the mortality statistic
- Symptoms usually appear late in adolescents or early adulthood
Phases of Schizophrenia
Phase 1 - Premorbid Phase
- Occurs before there is clear evidence of illness. May include traits such as being very shy and withdrawn, having poor peer relationships, doing poor in school, and being antisocial
Phase 2 - Prodromal Phase
- Symptoms are clearly manifest. Between premorbid and psychotic symptoms. Usually lasts 2-5 years. Usually experiences deterioration in function, social withdrawal, and cognitive impairment. 5% complain of depression. Adolescents have sudden onset of obsessive-compulsive behavior. Recognition during this phase provides opportunity for early intervention.
Phase 3 - Acute Schizophrenic Episode
- Chronic illness with acute episodes. Symptoms include delusions, hallucinations, and impairment in work, social-relations and self-care.
Phase 4 - Residual Phase
- Remission after active phase of illness. Symptoms of active schizophrenia are no longer present. Symptoms are similar to prodromal phase. Flat affect and impairment in role functioning are prominent.
Biological Factors of Schizophrenia
- Genetics
- Heritability
Biochemical Factors of Schizophrenia
- Dopamine (Overactive neurotransmitter of dopamine)
- Excess dopamine dependent neuronal activity in the brain
Other causes
- Abnormalities in neurotransmitters (norepinephrine, serotonin, acetylcholine, gamma-aminobutyric acid, and neuroregulatory prostaglandins, endorphins).
- Excess serotonin may cause positive/negative affects of schizophrenia (evidenced by effectiveness of clozapine)
Antipsychotic medications block dopamine activity to decrease hallucinations/delusions
- When 1 neurotransmitter is blocked, others increase which cause many side-effects.
Physiological Factors of Schizophrenia
- Autoimmune antibodies developed from infection of neurotoxic virus
- Structural brain abnormalities (ventricular enlargement is most common) and reduction in grey matter
- Reduced symmetry in several lobes of the brain
ADDITIONAL
- Viral infection
- Anatomical abnormalities
- Electrophysiology
- Epilepsy
- Huntington’s disease
- Birth trauma
Environmental Factors
- Possible link with low socioeconomic class (poverty)
Explanation
- Congested housing accommodations
- Inadequate nutrition
- Absence of prenatal care
- Few resources for dealing with stressful situations
- Feeling hopeless for changing ones lifestyle of poverty.
Downward Drift Hypothesis
- Symptoms of schizophrenia make it hard for these people to maintain employment. Poor social conditions is a consequence rather than cause of schizophrenia
Theory of Schizophrenia
- Schizophrenia is a biological disease influenced by environmental factors
Positive Symptoms of Schizophrenia
- What the patient is doing
- Agitated
- Delusions
- Paranoid
- Ideas of reference
- Hallucinations
- Illusions
- Associated disturbances
- Insomnia
- Disorganized speech
- Behavioral disturbances
Negative Symptoms of Schizophrenia
- What the patient is not doing
- Speaking (Alogia - Poverty of speech/Lack of conversation)
- Enjoying anything (Anhedonia - inability to feel pleasure)
- Expressing Emotion (blunted affect)
- Grooming
- Absence of normal cognition
- Avolition - Total lack of motivation
