Neuro23 - Psychotic Disorders

Question 1

6 type of symptoms of schizophrenia

Auditory Hallucinations
Somatic Hallucinations
Passivity Experiences
Thought Withdrawal, Broadcast, or Insertion
Delusional Perception
Negative Symptoms x5

Answer 1

1. ) Auditory Hallucinations - hearing thoughts out loud
   - though echo, running commentary, third person
2. ) Somatic Hallucinations - mimics feelings from inside the body
3. ) Passivity Experiences - patient believes an action is caused by an external force e.g. ‘MI5 is moving my leg’
4. ) Thought Withdrawal, Broadcast, or Insertion
   - withdrawal: thoughts taken out of the mind
   - broadcast: everyone knows what you’re thinking
   - insertion: thoughts implanted by others

5.) Delusional Perception - new meaning given to normally perceived objects e.g. ‘the traffic lights went red, showing that aliens were going to land soon’

6. ) Negative Symptoms - after treating +ve symptoms
   - underactivity, low motivation, social withdrawal, emotional flattening, self neglect

Question 2

3 pathological features of schizophrenia

Dopamine Pathways
Brain Changes x8
Neuropathology x3

Answer 2

1. ) Dopamine Pathways - dopamine induces psychosis
   - mesolimbic pathway is overactive –> delusions
   - mesocortical pathway is underactive-> -ve symptoms
2. ) Brain Changes - enlarged ventricles
   - ↓grey matter and ↓brain weight, ↓amygdala,
   - ↓temporal lobe volume, ↓prefrontal cortex
   - ↓hippocampal formation, ↓parahippocampal gyrus
3. ) Neuropathology - ‘aberrant connectivity’
   - ↓pre-synpatic markers, ↓oligodendroglia
   - fewer thalamic neurones

Question 3

Treatment of schizophrenia

Typical Antipsychotics
Atypical Antipsychotics
Hyperprolactinaemia

Answer 3

1. ) Typical Antipsychotics - dopamine antagonists
   - block D2 receptors in all CNS dopamine pathways
   - removes +ve symptoms, leaving -ve symptoms
   - side effects are parkinsonian symptoms (↓dopamine)
2. ) Atypical Antipsychotics - newer generation
   - ↓affinity for D2 receptors –> ↓side effects
   - also block serotonin (5HT2) receptors
   - other side effects: prolonged QT syndrome, affects glucose tolerance, hypercholesterolaemia
3. ) Hyperprolactinaemia - common side effect
   - dopamine inhibits prolactin release from pituitary
   - dopamine antagonists therefore ↑prolactin levels:
   - amenorrhea, galactorrhoea, ↓fertility, ↓libido
   - long term can lead to osteopenia/osteoporosis