Final: Schizophrenia

Question 1

characteristics of schizophrenia

Answer 1

split mind
major disturbances in thought, emotion, movement, behavior

disordered thinking: ideas not logically related, faulty perception and attention
- perceptual distortions include hallucinations

lack of emotional expressiveness
- inappropriate or flat emotions

Question 2

prevalence of schizophrenia

Answer 2

1% - 2.6 million adults in US
- one of top 15 leading causes of disability
affects MEN more than women
age onset: late adolescence, early adulthood (men diagnoses at earlier age than women)

Question 3

what are some environmental risk factors

Answer 3

growining up in large cities
-air pollution - toxins
stress of the hustle and bustle
can lead to an immune rxn

Question 4

what % of patients attempt suicide

Answer 4

20-50% (10% are successful)

Question 5

association between immune dysfunction and schizophrenia

Answer 5

-birth season is a risk factor (late winter, early spring at inc risk, usually inc risk of getting sick then too)
-they are prone to infections
-autoimmune disorders inc risk
-proinflammatory cytokines inc and anti inflammatory cytokines reduced
antipsychotics restore levels

Question 6

perinatal complicatons associated with inc scz rates in offspring

Answer 6

inc maternal cytokines or exposure to viral infection in 2nd trimester - inc risk of Scz in offspring
malnutrition
fetal brain injury in pregnancy/delivery caused by oxygen deprivation or drug use

Question 7

behaviors in early infancy signal a potential risk

Answer 7

passive and apathy - no longer interested in new things
reduced responsiveness to verbal commands
difficult temperament (how well they respond to chanegs in environment)
poor sensorimotor performance

Question 8

genetic contribution

Answer 8

varies according to hw many genes one shares with someone that has the disorder
- monozygotic twins only 50% the other will get it

Question 9

multiple genes at different loci are effected

Answer 9

disruption of communication btw ionotropic and metabotroic families of receptors
ex: polymorphisms in DISC1gene assoiated with cognitive sypmtoms and pproper neural development

genetic vulnerability inc probability that the events during perinatal brain development will contribute to the occurence of Scz

Question 10

2 hit model of Scz development - first hit

Answer 10

genetic vulnerability inc the probability that events during perinatal brain development will contribute to the occurrence of Scz

Question 11

2 hit model of Scz - second hit

Answer 11

in adolescence neurodevelopmental errors and environmental events produce the diagnosable symptoms
stressors put someone over edge to develop symptoms

Question 12

diagnosis

Answer 12

difficult
no 2 individuals show sam pattern of symptoms - no single symptom occurs in every patient
symtoms inc and dec over time
type of symptoms also change over time

symptoms often seen in other disorders

Question 13

3 major clusters of symptoms

Answer 13

positive
negative
cognitive

Question 14

positive symptoms

Answer 14

delusions
hallucinations
adding behavior

Question 15

negative symptoms

Answer 15

avolition
alogia
anhedonia
blunted affect
asociality

Question 16

cognitive/disorganized symptoms

Answer 16

disorganized behavior

disorganized speehc

Question 17

delusions

Answer 17

+ symptoms

firmly held beliefs
contrary to reality
resistant to disconfirming evidence

Question 18

types of delusions

Answer 18

persecutory (the CIA [lanted a listening device in my head, 65% have these)

thought insertion
thought broadcasting
outside control 
grandiose delusions
ideas of reference

Question 19

hallucinations

Answer 19

+ symptom

sensory experiences in absence of sensory stimulation

Question 20

types of hallucinations (3)

Answer 20

auditory (74% have)
visual
hearing voices (inc activity in Brocas area in hallucinations)

Question 21

lack of interest, apathy, difficulty initiating/persisting in goal-directed behavior

Answer 21

avolition

Question 22

social withdrawal

inability to form close personal relationships

Answer 22

asociality

Question 23

inability to experience pleasure

Answer 23

anhedonia

Question 24

exhibits little or no emotion in face or voice

Answer 24

blunted/flat affect

Question 25

peculiar, rigid posture, inappropriate gestures, overt signs of tension, repetitive movement

Answer 25

motor disturbances

Question 26

reduction in speech

Answer 26

alogia

Question 27

cognitive symptoms

Answer 27

impaired working memory, executive functioning, attention

disorganized speech (incoherence - inability to organize ideas)
-loose associations (hard to stick to one topic)

disorganized behavior - silliness, agitation, unusul dress

Question 28

DSM-5 criteria for Scz

Answer 28

2 or more must be present for at least one month

hallucinations, delusions, disorganized speech, disorganized behavior, neg symptoms

Question 29

what brain region with positive symptoms

Answer 29

mesolimbic

Question 30

what brain region with affective symptoms

Answer 30

ventromedial PFC

Question 31

what brain region with aggressive symptoms

Answer 31

loss of orbitofrontal cortex

overactivity of amygdala

Question 32

what brain region with cognitive symptoms

Answer 32

dorsoloateral PFC

Question 33

what brain region with negative symptoms

Answer 33

mesocortical and Nacc

Question 34

structural abnormalities in Scz brain

Answer 34

atrophy of cerebral cortex

enlargement of ventricles

Question 35

what is the reduced brain volume due to

Answer 35

smaller neuronal cell bodies, reduced dendritic density, close packing of cells
poor connectivity btw brain regions

Question 36

where are cells dsorganized - what brain region

Answer 36

hippocampus

Question 37

loss of cortical ____

Answer 37

gray matter

Question 38

impaired integration for sensory and cognition

Answer 38

dec structural connectivity in white matter tracts btw frontal, temporal, parietal lobes

Question 39

hypofrontality hypothesis

Answer 39

dec activity in frontal lobe in Scz

Scz need to work hardr to get same executive control as healthy people

Question 40

what are the neurotransmitter systems involved in Scz

Answer 40

dopamine, glutamate, serotonin

Question 41

dopamine hypothesis

Answer 41

excess DA function results in + symptoms of Scz

hyperactivity at D2 receptors: dtrong correlation btw D2 receptor blockade and dec in Scz symptoms (inc in impulsivity, cognitive symptoms, agitation)

Question 42

what can produce psychotic reactions in healthy individuals reversable by DA antagonists

Answer 42

amphetamine

Question 43

DA imbalance hypothesis

Answer 43

neg symptoms and impaired thinking due to dec DA in mesocortical regions!

excess DA function in mesolimbic leads to + symptoms

Question 44

hypoglutamate model

Answer 44

dec glutamate activity in Scz

blocking NMDA recetors with PCP or ketamine produces psychosis similar to psychosis in Scz

Question 45

glutamate - DA interaction

Answer 45

insufficient NMDA, Glu can explain the inc in mesolimbic DA and dec in PFC activity

Question 46

hyperactivity/ imbalance of serotonin at what receptor can result in psychosis

Answer 46

5-HT2A

- always excitatory - depending on location can stimulate or inhibit glu release