L1 Schizophrenia - 30/9

Question 1

What is the incidence of schizophrenia?

Answer 1

Effects 1% of the population

Question 2

What does schizophrenia mean?

Answer 2

Splitting of psychic functions

Question 3

What was schizophrenia originally thought to be?

Answer 3

A breakdown of integration between emotion, thought and action.

Question 4

List symptoms of schizophrenia

Answer 4

Bizarre delusions
Hallucinations (visual and auditory)
Incoherent thought
Delusions of grandeur
Paranoid delusions
Feeling disconnected from emotion
Disorganised speech

Question 5

What was RD Laing’s view of schizophrenia?

Answer 5

Argues that many people labelled as “sane” are still alienated but blend in because they act like everyone else. On the other hand, individuals who show forms of alienation that don’t fit the societal norm are often labelled as “mad” or “bad.”

Question 6

What is Freud’s theory of schizophrenia?

Answer 6

Paranoid delusions result from repressed sexual urges which are striving for expression.

Question 7

What are the concordance rates for schizophrenia in monozygotic twins and dizygotic twins?

Answer 7

MZ - 45%
DZ - 10%

Question 8

What does a 45% MZ concordance rate show?

Answer 8

That there must be other factors than genes such as: infections, autoimmune reactions, toxins, traumatic injury, and stress.

Question 9

Give an example of a specific environmental stressor.

Answer 9

Bullying - linear increase in severity and frequency of psychotic symptoms with increase in severity and frequency of bullying.

Question 10

How did the use of chlorpromazine to treat schizophrenia?

Answer 10

It was originally marketed as an anti-histamine. French surgeon noticed it calmed normal patients when used as an anti-inflammatory. Decided it might calm schizophrenics

Question 11

Discuss reserpine?

Answer 11

Taken from snake root plant
Used to treat mental illness in India
Also effective in treating schizophrenia

Question 12

What are the similarities of Reserpine and Chlorpormazine?

Answer 12

Both take 2-3 weeks of medication to work.
Symptoms like those in Parkinson’s disease start to emerge - it was then discovered that Parkinson’s disease was due to a loss of DOPAMINE da in the nigro-striatal pathway.

Question 13

What is the mode of action for Reserpine against dopamine?

Answer 13

Reserpine depletes vesicles so reduce amount of DA that can be released by popping the vesicles so dopamine floats in the cell and can’t go anywhere.

Question 14

What is the mode of action for chlorpromazapine?

Answer 14

Blocks DA receptors so stops the DA working. Dopamine antagonist (false transmitter) so DA can’t get to the receptors itself.

Question 15

What is the other evidence for DA hypothesis?

Answer 15

Cocaine psychosis + amphetamine psychosis (Caused by prolonged use) block the reuptake of dopamine so leaves more in the synapse.

Question 16

What is the efficacy of an anti-psychotic drug correlated with?

Answer 16

It’s ability to bind to DA receptors

Question 17

What is the exception in this case?

Answer 17

Initially haliperidol appears that it doesn’t bind to the dopamine receptors but upon a closer look you can see it does bind to D2.

Question 18

What is haliperidol?

Answer 18

A very potent anti-psychotic medication.

Question 19

What do typical antipsychotics bind to?

Answer 19

Just bind to D2

Question 20

What do atypical antipsychotics bind to?

Answer 20

Other receptors like D4

Question 21

What are DA receptors?

Answer 21

Metabotropic receptors (a cell surface receptor that activates a secondary messenger system when a transmitter binds to it).

Question 22

Describe the groups of DA receptors.

Answer 22

2 families. D1 which includes D1 and D5, and D2 which includes D2, D3, D4.

Question 23

Describe the relationship of the D1 family of DA receptors to adenlyate cyclase.

Answer 23

Positively coupled to adenlyate cyclase

Question 24

Describe the relationship of the D2 family to adenlyate cyclase

Answer 24

Negatively coupled.

Question 25

What is adenylate cyclase?

Answer 25

An enzyme that helps send messages inside the cell

Question 26

Which receptor does clozapine bind to?

Answer 26

D4 receptor

Question 27

Which receptor is involved in treating schizophrenia?

Answer 27

D2

Question 28

Pharamacoligcal fallacy

Answer 28

The wrong idea that schizophrenia is only caused by a chemical imbalance in the brain and can be fully fixed with medication. Ie think knee injury and aspirin

Question 29

Discuss Abi Dargham et al’s method and findings on schizophrenia?

Answer 29

Does dopamine cause schizophrenia or other way around?
Green - IBZM, a radioactive chemical to measure dopamine receptors. Pink - natural dopamine.
The solution is to deplete the natural dopamine with a reserpine type drug and see how many greenies we get.
Higher number of receptors seen in schizophrenia after depletion of dopamine.