Chapter 9 Schizophrenia Flashcards
Schizophrenia creates Major disturbances in what?
thought, emotion, and behavior
Disordered thinking is characterized as..?
Ideas not logically related
Faulty perception and attention
Emotions are displayed as?
Inappropriate or flat emotions
describe how movement or behavior are affected?
Disheveled appearance, erratic body movement
Schizophrenia dramatically increases the rates of what?
Suicide
Does schizophrenia affect men or women more?
Men
Life time prevalence is?
1% of the population
When is the onset of Schizophrenia typically
late adolescence or early adulthood
men slightly earlier
In what area is schizophrenia Diagnosed more frequently?
different ethnicity’s
May reflect diagnostic bias
How many symptoms should be present and for how long must they last before the diagnosis can be made?
Two or more of the following symptoms for at least 1 month; one symptom should be
either Hallucinations, delusions, disorganized speech:
One symptom must be either?
(1) delusions
(2) hallucinations
(3) disorganized speech
Name all symtoms
(1) delusions
(2) hallucinations
(3) disorganized speech
(4) disorganized (catatonic) behavior
(5) negative symptoms (diminished motivation or emotional expression)
6) positive symptoms (hallucin and delusion)
Positive symptoms are defined as?
excesses (increases movement, talking)
Negative symptoms are defined as?
deficits (lacking emotional expression is a deficit, the lack it)
Prodromal phase means
early signs and symptoms, it’s the time span leading up to the first obvious psychotic episode. when the first change in a person occurs until he or she develops full-blown psychosis
Active phase means?
The active phase, also called the acute phase, is characterized by hallucinations, paranoid delusions, and extremely disorganized speech and behaviors. During this stage, patients appear obviously psychotic.
What are the three phases of schizophrenia?
prodromal, acute or active, and residual.
Acute or active means?
is what people can see in a person…hallucinations, paranoid delusions, and extremely disorganized speech and behaviors.
Identifying prodromal period: if recognized and treated early on, the person may
may not always continue on to develop full-blown schizophrenia.
The residual stage of schizophrenia resembles?
Obvious psychosis has subsided, but the patient may exhibit negative symptoms of schizophrenia, such as social withdrawal, a lack of emotion,
What are some negative symptoms?
social withdrawal, a lack of emotion, and uncharacteristically low energy levels.
Three major clusters of symptoms are?
Positive
Negative
Disorganized
Positive Symptoms are?
Hallucinations (sensory disorder, hearing things) and delusions (thought disorder)
Negative symptoms are?
Avolition….Alogia..Anhedonia…blunted affect…asociality
Avolition means?
lack of motivation or ability to do tasks or activities that have an end goal,
Alogia means?
Reduction in speech
inability to speak because of mental defect, mental confusion, or aphasia.
Anhedonia means?
inability to feel pleasure. Consummatory pleasure
Anticipatory pleasure
blunted affect means?
difficulty in expressing their emotions [1], characterized by diminished facial expression, expressive gestures and vocal expressions in reaction to emotion provoking stimuli
asociality means?
Inability to form close personal
relationships. lack of desire to form relationships, social withdrawal
Disorganised symptoms are?
disorganized speech and behaviour
(Positive) Delusions are displayed as?
Firmly held beliefs
Contrary to reality
Resistant to disconfirming
evidence
(Positive) Hallucinations are displayed as
Sensory experiences in the
absence of sensory stimulation
65% of schizophrenics have what time of delusions (thoughts)?
thoughts of persecution
74% have what types of hallucinations (sensory)
Auditory (hearing voices)
when hearing voices (hallucinating) what area of the brain has increased activity?
Increased levels of activity in Broca’s
area during hallucinations
Disorganized behavior shows itself as?
Silliness, agitation, unusual dress
e.g., wearing several heavy coats in hot weather
with Disorganized speech, Loose associations (derailment) shows itself as what behaviour?
Rambles, difficulty sticking to one topic
with Disorganized speech, Incoherence shows up as?
Inability to organize ideas
what are the three Movement Symptoms?
-Catatonia, Repetitive, complex gestures
Usually of the fingers or hands
Excitable, wild flailing of limbs
-Catatonic immobility, Maintain unusual posture for long periods of time
e.g., stand on one leg,
-Waxy flexibility, Limbs can be manipulated and posed by another person
what are the symptoms for Schizophreniform Disorder
Same symptoms as schizophrenia
what is the time frame for Schizophreniform Disorder diagnosis? how long or short have the symptoms been present
Symptom duration greater than 1 month but less than 6 months
Schizophreniform Disorder symptoms MUST include at least one of what three things?
either hallucinations, delusions, or disorganized speech
Brief Psychotic Disorder symptom time frame is? (symptom duration)
Symptom duration of 1 day to 1 month
Brief Psychotic Disorder is often triggered by
extreme stress, such as bereavement
Brief Psychotic Disorder must include either?
either hallucinations, delusions, or disorganized speech
Schizoaffective Disorder diagnostic symptoms are what?
schizo = schizophrenia
affective = mood
both schizophrenia and either a depressive or manic episode
the mood disorder must be present for how long in Schizoaffective Disorder?
major mood episode are present for a majority of the duration the illness
Delusional disorder (thoughts) may include what symptoms?
Persecution Jealousy Being followed Erotomania (Loved by a famous person) Somatic delusions (thinking that your body is diseased in some way) but no other symptoms of schizophrenia
what is Erotomania?
Loved by a famous person
what are Somatic delusions?
thinking that your body is diseased in some way, missing an imaginary limb, your arms not really yours, body is infested with maggots
what disorder may include somatic delusions and/ or erotomania?
delusion (thoughts) disorder
what disorder must have both schizophrenia and either a depressive or manic episode?
Schizoaffective Disorder
Schizo = schizophrenia
affective = mood
If symptoms of schizopheniform last longer than six months the diagnosis is changed to?
schizophrenia or, in some cases, bipolar or schizoaffective disorder.
incidence of schizophrenia occur mostly with people who’s parents had?
both parents with schizophrenia 27.3%
if one parent has bipolar 15.6%
Etiology: what does Genetically heterogeneous
mean?
Not likely that disorder caused by single gene
Etiology: family studies show that?
Relatives at increased risk
Negative symptoms have stronger genetic component
Etiology: Twin studies showed that MZ twins were at a?
44% higher risk for MZ twins vs. 12% risk for DZ twins
for developing schizophrenia
Etiology: Twins- Children of non-schizophrenic MZ twin were?
more likely to develop
schizophrenia (9.4% vs. 1% in general population)
Etiology: what are the two genes associated with schizophrenia
DTNGP1
and NGR1
Etiology: what are the two genes associated with cognitive deficits
COMT
and BDNF
Neurotransmitters: what is the Dopamine Theory?
Disorder due to excess levels of dopamine, Excess numbers of dopamine receptors or oversensitive
dopamine receptors
Neurotransmitters: what drug can induce psychosis?
Amphetamines because it reduces dopamine activity
Neurotransmitter: what neurotransmitter alleviate symptoms of schizophrenia?
drugs that reduce dopamine
To be effective, antipsychotics must?
reduce dopamine
activity to below normal levels
Other neurotransmitters involved are?
Serotonin
GABA
Glutamate
In brain structure scans that show Enlarged ventricles indicate?
Implies loss of brain cells Correlate with Poor performance on cognitive tests Poor premorbid adjustment Poor response to treatment
Brain structure: Structural and functional abnormalities have been found in these regions
Temporal Cortex, Temporal gyrus Hippocampus Amygdala Anterior cingulate
Brain structure: Reduced _______ and ____ evident
Grey matter and volumn
Environmental Factors: what are the environmental factors that may cause schizophrenia?
Damage during gestation or birth (lack of oxygen at birth)
or Viral damage to fetal brain from toxins, parasite or higher rates in mothers who had the flu during pregnancy
What axis system triggers cortisol and increases dopamine?
Stress activates HPA system, which triggers cortisol
secretion, Cortisol increases dopamine activity
What does the HPA system do?
Manages reactivity to stress
Triggers release of cortisol and is
Affected by early life stress
Psychological Stress: schizophrenics are more _________ to stress and have _______ positive moods and _______ negative moods
more reactive to stress, lower positive feelings, higher levels of negative moods
Family environment: what may increase relapse rates?
expressed emotion from family, criticism, emotional over involvement, Hostility
studies found Second-generation drugs were _____ effective than the older, first-generation drug
2nd generation were not more effective then 1st generation
second generation drugs have what serious side effects
Weight gain, diabetes, pancreatitis
