Cognition- Schizophrenia Flashcards
Definition
Schizophrenia
profound neurobiological disorder characterized by psychotic symptoms, diminished capacity to relate to others, odd or bizzare behaviors
Involuntary commitment
person is unable to care for self or deemed a danger to self or others
Criteria: danger to self and/or others
Emergency vs. Civil/Judicial commitments
Emergency- risk of harm to self or others
Civil- protects the community from person posing a threat
short term & long term
DE’s commitment Process
Complaint
Arrest/Custody
ED physician exam determines danger
Taken to psych facility
Psychiatrist certifies as mentally ill (hold for 2 days)
Court determines involuntary commitment
Structural anatomic alterations
-decreased matter of gray matter
-enlarged ventricles/sulci
Neuro
Neurotransmitter abnormalities
-dopamine system
-nicotine acetylcholine receptors
-dysregulation of NMDA subclass of glutamine receptors
Etiology
mylenation and reorganization of neuronal structures that typically occur in adolescence
Risk factors
- Genetic
- Epigenic
- Psychological
- Developmental
- Genetic: first degree relatives have 50% risk
- Epigenic: birth complications, poor prenatal care, weed use
- Psychological: early life adversities
- Developmental: stress during developmental periods
Symotomatology
Positive vs. Negative
Positive: Hallucinations, delusions, alterations in speech, bizarre behavior, manifestations of things that are not normally present
Negative: Affect, alogia, anergia, anhedonia, avolition
Phases of Schizophrenia
- phase I- premorbid
- phase II- prodromal
- phase III- acute
- phase IV- residual
phase I- nonspecific emotional, cognitive and motor delays
phase II- symptomatic period with shift from premorbid functioning. sleep disturbances, poor concentration, social withdrawal, weak/mild symptoms of psychosis
phase III- onset of florid psychotic positive symptoms, causes significant distress, if untreated if may be difficult to treat
phase IV- stabilization and maintenance
Dopamine pathways
- mesolimbic
- mesocortical
- tuberoindunfibular
- nigrostriatal
- responsible for positive symptoms
- responsible for negative symptoms
- responsible for increased prolactin levels
- responsible for movement disorders from medications
too much or too little dopamine
Role of typical antipsychotics in the dopamine pathways
- block all 4 pathways
- good for positive symptoms not good for treating negative symptoms
- movement disorders increase due to lack of dopamine into nigrostriatal
DSM-5 criteria for schizophrenia
must be present >6 months
must have caused significant impairment of functioning in one or more areas
* home
* work
* self-care
generic names
typical antipsychotics
- chlorpromazine
- haloperidol
- loxapine
adverse effects
typical antipsychotics
- anticholinergic effects
- sexual effects
- endocrine effects
- EPS
- NMS
