Behavioral Science - Schizophrenia Flashcards
Psychosis is a hallmark symptom of what psychiatric disorder?
Schizophrenia
–Hallucinations, delusions, abnormalities in thought process/organization
Psychosis CAN occur in other disorders is bipolar disorder, substance abuse, delirium, depression
What are the symptoms of psychosis?
Illusion Hallucinations Ideas of reference Delusions Loss of ego boundaries
What is echolalia?
Repeating the statements of others, associating words by sound
Symptom of psychosis
Alogia Echolalia Thought Blocking Neologisms Circumstantiality Tangentiality Loose associations
These are characteristics of:
Psychosis
The diagnostic symptoms for schizophrenia are:
Part A symptoms:
- Delusions
- Hallucinations
- Grossly disorganized or catatonic behavior
- Negative symptoms (flat affect, alogia, avolition
- Disorganized speech
**2 or more, each present for a significant portion of time during a 1-month period
What is the DSM criteria for schizophrenia?
Characteristic symptoms;
Social and occupational dysfunction (symptoms are affecting your life);
Continuous signs of disturbance present for 6 months with at least 1 month of active symptoms;
Can’t be due to other mood disorder or medical condition
Positive symptoms of schizophrenia are:
Delusions Hallucinations Agitation Talkativeness Thought disorder
respond well to antipsychotics
Negative symptoms of schizophrenia are often mistaken for:
Depression
Lack of motivation Social withdrawal Flattened affect/emotion Cognitive disturbances Poor grooming Impoverished speech
sometimes a better response with atypical antipsychotics
What is the residual phase of schizophrenia?
Period between psychotic episodes, in touch with reality but does not behave normally
What is the prodromal phase of schizophrenia?
Prior to first psychotic break - several months to a year or two
Anxiety and depression are common; Avoiding social activities; Quiet and passive or irritable; Sudden interest in religion; Physical complaints
What is the age of onset of schizophrenia?
15-25 in men
25-35 in women
1:1 incidence in men and women
Women with schizophrenia have a greater risk of what complication?
Tardive dyskinesia (bc of D2 receptor drug blockage)
Third trimester maternal use of diuretics is associated with what greater risk?
Schizophrenia
Negative symptoms in schizophrenia are from
Hypofrontal frontal lobes
Cold dorsolateral PFC;
Decreased use of glucose
Lateral and third ventricle enlargement is seen in what psychiatric disorder?
Schizophrenia
Along with changes in brain density, decreased volume of hippocampus, amygdala and parahippocampal gyri
What happens if dopamine is blocked in the brain, for example, in the mesolimbic pathway, and then there is subsequently less dopamine in the tuberoinfundibular pathway?
Increase in prolactin secretion when DA is low
What are the BRAIN goals of schizophrenia treatment?
SLOW mesolimbic pathway (positive symptoms);
INCREASE mesocortical pathway (negative symptoms);
HAVE NO EFFECT ON tuberoinfundibular pathway and nigrostriatal pathway
What metabolite of dopamine is found in elevated levels in patients with schizophrenia?
Homovanillic acid
What is the leading hypothesis behind schizophrenia?
Glumate –> dopamine
What is GLU-GABA-GLU-DA ?
Normal functioning
What is GLU-GABA-GLU-GABA-DA?
Normal functioning
Hyperactivate second GLU - hypofunctioning –> negative symptoms
What is schizophreniform disorder?
1-6 months of symptoms
What is schizoaffective disorder?
Schizophrenia + mania/depression
What is brief psychotic disorder?
1-29 days of schizophrenia symptoms
All effective antipsychotics block _____ in the mesolimbic dopamine path.
D2
Haloperidol and Chlorpromazine are what kinds of drugs?
Traditional, typical first generation antipsychotics
–more side effects in nigrostriatal and tuberoinfundibular pathways
Use: Clozapine
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path
Use: Risperidone
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Paliperidone
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Olanzapine
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Quietapine
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Ziprasidone
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Aripiprazole
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Asenapine
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Iloperidone
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
Use: Lurasidone
Atypical antipsychotic;
first line for schizophrenia;
5HT2a blockade allows dopamine to move more freely in the nigrostriatal path –> less neurological side effects
What second generation antipsychotics are available as shots?
Risperidone
Paliperidone
Aripiprazole
decrease relapse
What psychotherapy is helpful in schizophrenia treatment?
CBT
Family therapy
Peer and mentor groups
Neurotransmitter abnormalities in schizophrenia include:
Excess dopamine, serotonin, glutamate, norepinephrine
