Final: Schizophrenia Flashcards

1
Q

characteristics of schizophrenia

A

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

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2
Q

prevalence of schizophrenia

A

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)

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3
Q

what are some environmental risk factors

A

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

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4
Q

what % of patients attempt suicide

A

20-50% (10% are successful)

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5
Q

association between immune dysfunction and schizophrenia

A

-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

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6
Q

perinatal complicatons associated with inc scz rates in offspring

A

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

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7
Q

behaviors in early infancy signal a potential risk

A

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

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8
Q

genetic contribution

A

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

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9
Q

multiple genes at different loci are effected

A

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

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10
Q

2 hit model of Scz development - first hit

A

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

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11
Q

2 hit model of Scz - second hit

A

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

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12
Q

diagnosis

A

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

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13
Q

3 major clusters of symptoms

A

positive
negative
cognitive

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14
Q

positive symptoms

A

delusions
hallucinations
adding behavior

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15
Q

negative symptoms

A
avolition
alogia
anhedonia
blunted affect
asociality
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16
Q

cognitive/disorganized symptoms

A

disorganized behavior

disorganized speehc

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17
Q

delusions

A

+ symptoms

firmly held beliefs
contrary to reality
resistant to disconfirming evidence

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18
Q

types of delusions

A

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

thought insertion
thought broadcasting
outside control 
grandiose delusions
ideas of reference
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19
Q

hallucinations

A

+ symptom

sensory experiences in absence of sensory stimulation

20
Q

types of hallucinations (3)

A

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

21
Q

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

22
Q

social withdrawal

inability to form close personal relationships

A

asociality

23
Q

inability to experience pleasure

24
Q

exhibits little or no emotion in face or voice

A

blunted/flat affect

25
peculiar, rigid posture, inappropriate gestures, overt signs of tension, repetitive movement
motor disturbances
26
reduction in speech
alogia
27
cognitive symptoms
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
28
DSM-5 criteria for Scz
2 or more must be present for at least one month | hallucinations, delusions, disorganized speech, disorganized behavior, neg symptoms
29
what brain region with positive symptoms
mesolimbic
30
what brain region with affective symptoms
ventromedial PFC
31
what brain region with aggressive symptoms
loss of orbitofrontal cortex | overactivity of amygdala
32
what brain region with cognitive symptoms
dorsoloateral PFC
33
what brain region with negative symptoms
mesocortical and Nacc
34
structural abnormalities in Scz brain
atrophy of cerebral cortex | enlargement of ventricles
35
what is the reduced brain volume due to
smaller neuronal cell bodies, reduced dendritic density, close packing of cells poor connectivity btw brain regions
36
where are cells dsorganized - what brain region
hippocampus
37
loss of cortical ____
gray matter
38
impaired integration for sensory and cognition
dec structural connectivity in white matter tracts btw frontal, temporal, parietal lobes
39
hypofrontality hypothesis
dec activity in frontal lobe in Scz | Scz need to work hardr to get same executive control as healthy people
40
what are the neurotransmitter systems involved in Scz
dopamine, glutamate, serotonin
41
dopamine hypothesis
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)
42
what can produce psychotic reactions in healthy individuals reversable by DA antagonists
amphetamine
43
DA imbalance hypothesis
neg symptoms and impaired thinking due to dec DA in mesocortical regions! excess DA function in mesolimbic leads to + symptoms
44
hypoglutamate model
dec glutamate activity in Scz | blocking NMDA recetors with PCP or ketamine produces psychosis similar to psychosis in Scz
45
glutamate - DA interaction
insufficient NMDA, Glu can explain the inc in mesolimbic DA and dec in PFC activity
46
hyperactivity/ imbalance of serotonin at what receptor can result in psychosis
5-HT2A | - always excitatory - depending on location can stimulate or inhibit glu release