Chapter 3 pt 2 Flashcards
the negative symptoms of schizophrenia can be remembered by the “5 As” what are they
anhedonia affect (flat) alogia (poverty of speech) abolition (apathy) attention (poor)
what are examples of catatonia seen in schizophrenia
stereotyped movements, bizarre posturing, and muscle rigidity
what psychiatric exam findings are seen in patients with schizophrenia
disheveled appliance flat affect disorganized thought process intact procedural memory and orientation auditory hallucinations paranoid delusions ideas of reference lack of insight into their disease
what is echolalia
repeats works or phrases
what is echopraxia
mimics behaviors
PRActices behaviors
what is the timeline difference between brief psychotic disorder, schizophreniform, and schizophrenia
brief psychotic is less than 1 month
schizophreniform is 1-6 months
schizophrenia is over 6 months
people born when have higher incidence of schizophrenia
winter and late spring
men have what outcome in schizophrenia compared to women
more negative symptoms
worse prognosis
what is the most common substance used in patients with schizophrenia
nicotine
next is alcohol then cannabis then cocaine
what is the DOWNWARD DRIFT HYPOTHESIS
people suffering from schizophrenia are unable to function well in society and hence end up in lower socioeconomic groups
what is post-psychotic depression
major depressive episode after resolution of their psychotic symptoms
schizophrenia is thought to be partially due to increase what signaling
dopamine in certain neural areas
what are the theorized dopamine pathways affected in schizophrenia
prefrontal cortical: inadequate dopaminergic activity responsible for negative symptoms
mesolithic: excessive dopaminergic signaling responsible for positive symptoms
what other neurotransmitters are implicated in schizophrenia
serotonin- elevated
norepinephrine- elevated
GABA- decreased
glutamate- decreased
what is the lifetime prevalence of schizophrenia
0.3-0.7%
what evidence is there of genetic predisposition of schizoprhenia
50% twin concordance
40% risk of inheritance if both parents have it
12% risk if one first-degree relative has it
what is akathisia
an unpleasant, subjective sense of restlessness and need to move, often manifested by the inability to sit still
seen in disturbances to nigrostriatial pathway of dopamine
what is the risk of an identical twin having schizophrenia if the other does
50%
CT and MRI of schizophrenia may show what
enlargement of ventricles and defuse cortical atrophy and reduced brain volume
what factors are associated with a better outcome of schizophrenia
later onset good social support positive symptoms mood symptoms acute onset fame gender few relapses good premarin functioning
what factors are associated with a poor outcome of schizophrenia
early onset poor social support negative symptoms family history gradual onset male gender many relapses comorbid substance use poor premorbid functioning (social isolation)
what is the treatment of schizophrenia
multimodal approach is most affective
therapy tailored to patients needs
schizophrenia often inlaces NEOLOGISMS, what are those
newly coined word or expression that has meaning only to the person who uses it
what are the first-generation (TYPICAL) antipsychotics and how do they work
chlorpromazine, fluphenazine, haloperidol, perphenazine
dopamine (D2) antagonists
treat POSITIVE SYMPTOMS with minimal impact on negative
what are the side effects of first-generation (TYPICAL) antipsychotics
extrapyramidal symptoms
neuroleptic malignant syndrome
tardive dyskinesia
what are the second-generation (ATYPICAL) antipsychotics and how do they work
ariprazole, asenaphine, clozapine, iloperidone, lurasidone, alanzapine, quetiapine, risperidone, ziprasidone antagonize serotonin (5-HT2) and dopamine (D4>D2)
take for 4 weeks before determining efficacy
research has shown what difference in efficacy of 1st and 2nd generation antipsychotics
none (weight risks and benefits)
2nd generation less EPS side effects but more risk for metabolic issues
what is the role of behavioral therapy in schizophrenia
attempt to improve patients ability to function in society
family and group therapy are useful adjuncts
