Behav. Sci. L2.

Question 1

schizophrenia definition

Answer 1

“split mind” irrational divergence between behavior and thought content - chronic, debilitating illness associated with deterioration in mental function and behavior

Question 2

when does schizophrenia begin?

Answer 2

young adulthood (1/100)

Question 3

what is the hallmark symptom of schizophrenia

Answer 3

psychosis - hallucinations, delusions, abnormalities in thought process/organization

Question 4

illusion

Answer 4

misperception of REAL external stimuli (distortion)

Question 5

hallucination

Answer 5

sensory perceptions not generated by external stimuli

Question 6

ideas of reference

Answer 6

false conviction that one is subject of attention by other people (crowds, TV, radio, internet) - feeling as though people are referring to you in their conversations - common

Question 7

delusion

Answer 7

false beliefs not correctable by logic or reason - no based on simple ignorance and not shared by culture

Question 8

loss of ego boundaries

Answer 8

not knowing where one’s mind and body end and those of others begin

Question 9

alogia

Answer 9

lack of informative content in speech, lacking/poverty of speech

Question 10

echolalia

Answer 10

repeating statements of others/associating words by their sounds, not by their meaning (I’m very sure i’ve got the cure and i’m not pure”

Question 11

though blocking

Answer 11

abrupt hult in the train of thinking, often bc of hallucination

Question 12

neologisms

Answer 12

inventing new words

Question 13

circumstantiality

Answer 13

in responding to questions, one presents unnecessary and voluminous details ultimately arriving at an answer to the question posed

Question 14

tangentiality

Answer 14

beginning a response in a logical fashion but then getting further and further away from the point an fail to answer the questions initially posed

Question 15

loose associations

Answer 15

loss of logical meaning btw words or thoughts

Question 16

characteristics of schizophrenia

Answer 16

at least one episode of psychosis with persistent disturbances of thought, behavior, appearance, speech and affect (emotion) as well as impairment in occupational and social functioning

Question 17

how does schizophrenia contrast with delirium or substance abuse

Answer 17

schizos do not have clouding of consciousness

Question 18

what are the DSM-5 diagnostic criteria?

Answer 18

1. characteristic symptoms (2+); 2. social/occupational dysfunction; 3. duration of AT LEAST 6 MONTHS; 4. cannot be due to another illness 5. cannot be due to substance use

Question 19

what are the characteristic symptoms of schizophrenia

Answer 19

delusions, hallucinations, grossly disorganized or catatonic behavior, negative symptoms (flat affect, alogia, avolition), disorganized speech

Question 20

what are the positive symptoms of schizophrenia

Answer 20

symptoms that are additional to expected behavior: delusions, hallucination, agitation, talkativeness, thought disorder - respond well to most tradition and atypical antipsychotic agents

Question 21

what are the negative symptoms of schizophrenia

Answer 21

symptoms that are missing from expected behavior: lack of motivation, social withdrawal, flattened affect/emotion, cognitive disturbances, poor grooming, poor/impoverished speech

Question 22

prodromal schizophrenia

Answer 22

prior to first psychotic break: avoidance of social activities, quiet and passive or irritable, sudden interest in religion or philosophy, physical complaints, anxiety and depression common

Question 23

psychotic/active schizo

Answer 23

loss of touch with reality - positive symptoms

Question 24

residual schizo

Answer 24

period between psychotic episodes, in touch with reality but doesn’t behave normally - negative symptoms (peculiar thinking, eccentric behavior and withdrawal from social interactions)

Question 25

men vs women with schizo

Answer 25

occurs equally in men and women but earlier in men (15-25; women 25-35) and women respond better to antipsychotic meds but have a greater risk of tardive dyskinesia

Question 26

neurological abnormalities in schizo

Answer 26

abnormalities in front lobes (decreased use of glucose); lateral and third ventricle enlargement; abnormal cerebral symmetry; changes in brain density (decreased volume of hippocampus, amygdala, and parahippocampal gyrus); EEG abnormal; abnormal eye movements

Question 27

which part of the brain is hyperactive while hallucinations occur?

Answer 27

auditory cortex

Question 28

when shown a scary face, which areas of the brain are hot/cold in schizo?

Answer 28

hot: limbic system esp amygdala. cold: cortex

Question 29

dopamine hypothesis schizo

Answer 29

excessive dopaminergic activity in mesolimbic tract and hypoactivity of mesocortical tract (negative symptoms)

Question 30

how do stimulant drugs cause psychotic symptoms?

Answer 30

amplifying mesolimbic tract

Question 31

homovanillic acid

Answer 31

metabolite of DA in bodily fluids of schizo - suggests more DA activity and use of CNS

Question 32

which drug has anti-5HT2A receptor activity?

Answer 32

clozpine - serotonin symptoms

Question 33

glutamate

Answer 33

major excitatory neurotransmitter in CNS

Question 34

glutamate hypothesis

Answer 34

antagonists of NMDA subtype of GLU receptors aggravate and create psychosis, while agonists of NMDA receptors may relieve symptoms - NMDA (receptor) hypoactivity

Question 35

normal pathway of glutamate activity

Answer 35

glutamate excites, GABA interneuron inhibitory, 2nd glutamate excites, dopamine release

Question 36

psychosis (positive symptoms) pathway of glutamate activity

Answer 36

glutamate tries to excite, but no receptor, so no GABA inhibitory signal, so too much excitement of glutamate causing too much dopamine release

Question 37

negative symptoms pathway of glutamate activity

Answer 37

normal is GLU-GABA-GLU-GABA-DA; abnormal is the same, but problem with NMDA receptors that Glu binds to, causing too much inhibition since the second glutamate is not inhibited

Question 38

What is the differential diagnosis when it comes to schizo

Answer 38

psychotic disorder caused by a general medical condition (B12/folate deficiency, temporal lobe epilepsy), manic phase of bipolar, substance-induced psychotic disorder, other psychotic disorders

Question 39

what other psychotic disorders are similar to schizophrenia

Answer 39

brief psychotic disorder, schizophreniform disorder, scizoaffective disorder, delusional disorder, shared psychotic disorder

Question 40

brief psychotic disorder

Answer 40

1-29 days of schizophrenia symptoms

Question 41

schizophreniform disorder

Answer 41

1-6mo of symptoms

Question 42

schizoaffective disorder

Answer 42

schizophrenia + mania and/or depression

Question 43

delusional disorder

Answer 43

delusions, but no other schizophrenia symptoms

Question 44

shared psychotic disorder

Answer 44

one person is delusional and a second person develops same delusion

Question 45

How do effective antipsychotics work?

Answer 45

block D2 receptors in the mesolimbic DA pathway (blocks neurons from excessively firing even in the face of high DA concentrations)

Question 46

What does 5HT2a blockade by atypical SGAs allow?

Answer 46

allows dopamine to more freely flow in the nigrostriatal pathway (less side effects)

Question 47

Why is compliance low for antipsychotic drugs?

Answer 47

unpleasant side effects of fatigue, grogginess, sedation and poor patient insight

Question 48

What is an option for noncompliant patients

Answer 48

long acting injectable forms of drugs (haloperidol decanoate, fluphenzine decanoate, resperidone, paliperidone, aripiprazole)