Chapter_11_Schizophrenia Flashcards
What is the definition of schizophrenia?
A chronic mental disorder characterized by psychosis, thought disturbances, behavioral abnormalities, and social dysfunction.
At what age does schizophrenia typically onset in men and women?
Men: 15–25 years; Women: 25–35 years.
What is the lifetime prevalence of schizophrenia?
Approximately 1% across cultures and ethnic groups.
Name four positive symptoms of schizophrenia.
- Delusions
- Hallucinations
- Disorganized speech
- Agitation
Name four negative symptoms of schizophrenia.
1.Anhedonia
2. Affect (flat)
3. Alogia (poverty of speech)
4. Avolition (apathy)
5. Asociality
6.Attention (poor)
What are the three phases of schizophrenia?
- Prodromal
- Active
- Residual
Describe the prodromal phase of schizophrenia.
Characterized by social withdrawal, unusual thoughts, and odd behavior. Usually join cult or new religion
What factors are associated with a better prognosis in schizophrenia?
- Later onset
- Female gender
- Presence of mood symptoms
- Good social support
- Few relapses
What is the duration criterion for diagnosing brief psychotic disorder?
Symptoms lasting more than 1 day but less than 1 month.
What percentage of individuals with brief psychotic disorder recover completely?
50–80%.
How long must symptoms persist for a diagnosis of schizophreniform disorder?
1–6 months.
What is schizoaffective disorder?
A disorder featuring symptoms of schizophrenia along with a mood disorder (major depression or mania).
For a diagnosis of schizoaffective disorder, how long must psychotic symptoms persist without mood symptoms?
At least 2 weeks.
What is delusional disorder?
A condition with fixed, persistent delusions and minimal other thought disturbances.
Name three types of delusions in delusional disorder.
- Persecutory
- Grandiose
- Erotomanic
What is shared psychotic disorder (Folie à Deux)?
The development of identical delusions in a person in close relationship with someone with a primary delusional disorder.
Which neurotransmitter is implicated in the positive symptoms of schizophrenia?
Dopamine (excess in the mesolimbic pathway).
What structural brain abnormalities are associated with schizophrenia?
- Enlarged lateral ventricles
- Decreased frontal lobe activity
- Reduced volume of limbic structures
What are typical antipsychotics, and what symptoms do they primarily target?
Drugs like haloperidol and fluphenazine that block D2 receptors, effective for positive symptoms.
What are atypical antipsychotics, and what symptoms do they target?
Drugs like clozapine, risperidone, and olanzapine that block D2 and 5-HT2A receptors, treating both positive and negative symptoms.
Which antipsychotic is associated with a risk of agranulocytosis?
Clozapine.
What are extrapyramidal symptoms (EPS), and which class of antipsychotics are they more common with?
Mnemonic for EPS Onset Timeline
“ADAPT”
• A = Acute Dystonia (hours to days)
• A = Akathisia (days to weeks)
• P = Parkinsonism (weeks to months)
• T = Tardive Dyskinesia (months to years)
Medications (Most Common Cause)
• Typical Antipsychotics (Haloperidol, Fluphenazine) – High risk
What is the role of cognitive-behavioral therapy (CBT) in schizophrenia?
To help manage delusions and hallucinations.
What is the significance of family therapy in schizophrenia treatment?
It reduces the risk of relapse.
What is the diagnostic criterion for schizophrenia regarding symptom duration?
Symptoms must persist for more than 6 months.
How does schizoaffective disorder differ from schizophrenia?
Schizoaffective disorder includes mood disorder symptoms along with psychotic symptoms.
What is the dopamine hypothesis of schizophrenia?
The theory that excess dopamine activity in certain brain pathways contributes to schizophrenia symptoms.
What role does glutamate play in schizophrenia?
Glutamate dysfunction, particularly reduced NMDA receptor activity, is implicated in schizophrenia, contributing to cognitive deficits and negative symptoms.
What is the significance of enlarged lateral ventricles in schizophrenia?
Enlarged lateral ventricles are a structural brain abnormality often observed in individuals with schizophrenia, indicating potential brain volume loss.
How does decreased frontal lobe activity manifest in schizophrenia?
Decreased frontal lobe activity is associated with impaired executive functions, such as planning, decision-making, and social behavior.
What is the function of the mesolimbic pathway in schizophrenia?
The mesolimbic pathway, associated with reward and emotion, is implicated in the positive symptoms of schizophrenia due to dopamine hyperactivity.
What is the function of the mesocortical pathway in schizophrenia?
The mesocortical pathway, associated with cognition and emotion, is implicated in the negative and cognitive symptoms of schizophrenia due to dopamine hypoactivity.
What is the role of the nigrostriatal pathway in antipsychotic treatment?
The nigrostriatal pathway is involved in movement regulation; dopamine blockade in this pathway by antipsychotics can lead to extrapyramidal symptoms.
What is the role of the tuberoinfundibular pathway in antipsychotic treatment?
The tuberoinfundibular pathway regulates prolactin secretion; dopamine blockade here can result in elevated prolactin levels, causing side effects like galactorrhea.
What is the significance of the dopamine hypothesis in schizophrenia?
The dopamine hypothesis suggests that schizophrenia symptoms are related to dysregulated dopamine activity, with hyperactivity in certain brain regions leading to positive symptoms and hypoactivity in others contributing to negative symptoms.
How do typical and atypical antipsychotics differ in their mechanism of action?
Typical antipsychotics primarily block D2 dopamine receptors, effectively reducing positive symptoms, while atypical antipsychotics block both D2 and 5-HT2A serotonin receptors, addressing both positive and negative symptoms.
What is the significance of NMDA receptor hypofunction in schizophrenia?
NMDA receptor hypofunction is thought to contribute to the pathophysiology of schizophrenia, leading to cognitive deficits and negative symptoms.
What is the role of serotonin in schizophrenia?
Serotonin modulates dopamine activity in schizophrenia, mainly via 5-HT2A receptors.
• Overactivity of 5-HT2A contributes to negative symptoms and cognitive deficits.
• Blocking 5-HT2A (as atypical antipsychotics do) improves negative symptoms and reduces EPS.
• Atypical antipsychotics target serotonin and dopamine to provide better symptom control than typical antipsychotics.
What is the significance of the glutamate hypothesis in schizophrenia?
The glutamate hypothesis suggests that schizophrenia is partly due to NMDA receptor hypofunction.
• NMDA receptor dysfunction leads to dysregulated dopamine and impaired cortical function, contributing to all symptom domains (positive, negative, cognitive). • Unlike the dopamine hypothesis, which mainly explains positive symptoms, the glutamate hypothesis better accounts for negative symptoms and cognitive deficits
What is the role of astrocytes in glutamate regulation in schizophrenia?
Astrocytes regulate glutamate transmission, and their dysfunction may contribute to glutamatergic dysregulation observed in schizophrenia.
How do NMDA receptor antagonists like ketamine relate to schizophrenia?
NMDA receptor antagonists such as ketamine can produce symptoms that mimic psychosis, supporting the role of NMDA receptor hypofunction in schizophrenia.
What is the impact of NMDA receptor hypofunction on cortical microcircuitry in schizophrenia?
NMDA receptor hypofunction disrupts cortical microcircuitry, potentially leading to cognitive deficits and impaired information processing.
How do typical and atypical antipsychotics differ in their mechanism of action?
Typical antipsychotics primarily block D2 dopamine receptors, while atypical antipsychotics block both D2 and 5-HT2A serotonin receptors.
This difference allows atypical antipsychotics to address both positive and negative symptoms.
What is the significance of NMDA receptor hypofunction in schizophrenia?
NMDA receptor hypofunction is thought to contribute to cognitive deficits and negative symptoms in schizophrenia.
This dysfunction plays a crucial role in the pathophysiology of the disorder.
What is the role of serotonin in schizophrenia?
Serotonin dysregulation, particularly involving 5-HT2A receptors, is implicated in schizophrenia.
This dysregulation is targeted by atypical antipsychotics to help manage symptoms.
What is the impact of NMDA receptor hypofunction on cortical microcircuitry in schizophrenia?
NMDA receptor hypofunction may affect synaptic plasticity and cortical microcircuitry, contributing to the cognitive deficits observed in schizophrenia.
What is the relationship between dopamine and glutamate in schizophrenia?
Dopamine and glutamate are interconnected in schizophrenia.
• NMDA receptor hypofunction leads to mesolimbic dopamine excess (positive symptoms) and mesocortical dopamine deficiency (negative & cognitive symptoms). • Current treatments mainly target dopamine, but glutamate-based therapies may offer better symptom control.
How does NMDA receptor hypofunction contribute to negative symptoms in schizophrenia?
NMDA receptor hypofunction may lead to reduced activation of inhibitory interneurons, resulting in negative symptoms such as social withdrawal and flat affect.
What is the role of metabotropic glutamate receptors in schizophrenia?
Alterations in metabotropic glutamate receptor function have been implicated in schizophrenia, affecting glutamatergic signaling and associated with cognitive deficits.
How does glutamate dysregulation affect synaptic plasticity in schizophrenia?
Glutamate dysregulation, particularly involving NMDA receptors, can impair synaptic plasticity, contributing to cognitive deficits in schizophrenia.
