physiological Disorders 4 - schizophrenia

Question 1

Define Schizophrenia?

Answer 1

class of disorders marked by delusions, hallucinations, disorganized thinking, disorganized motor behaviour and negative symptoms -

prevalence is in 0.7% of population

Question 2

when do the psychotic features of schizophrenia normally emerge?

Answer 2

between late teens and mid-30s - onset before adolescence is rare

Question 3

why is life expectancy reduced in individuals with schizophrenia?

Answer 3

b/c of associated medical conditions

• weight gain from medications
• diabetes
• metabolic syndrome
• cardiovascular and pulmonary disease
• poor engagment in primary reduction of disease i.e. cancer screening or exercise

Question 4

what are the symptoms of schizophrenia?

Answer 4

• delusions/irrational thought- false beliefs maintained even though they are clearly out of touch with reality -
• distorted perception - hallcuinations are sensory perceptions that occur in the absence of a real external stimulus or are gross distortions of perceptual input (hearing voices)
• Disorganized thinking - usually inferred from a person’s speech - person may switch from one topic ot another, answers to questions may be unrelated or incomprehensible
• Disorganized or abnormal motor behaviour - decreased reactivity to environment, staring, grimacing and echoing of speech
• nagative symptoms - diminished emotional expression - reductions in expression of emeotion in face, eye contact, intonation of speech/movements - so it’s the absence of something you would expect to be there in a normal person
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Question 5

what is negative syndrome?

Answer 5

a syndrome associated with schizophrenia where there is no psychotic symptoms - but there is a lack of a a lot of physical/emotional factors that are normal to social expresison

Question 6

what are the positive vs. negative symptoms of schizophrenia?

Answer 6

positive = adding something - so behavioural excesses or peculiarities, delusions, hallucinations etc

negative = loss of something - behavioural deficits such as flattened emotions, withdrawal, apathy, impaired attention etc.

Question 7

What is the DSM V criteria for schizophrenia?

Answer 7

Question 8

Describe the cognitive impairment in schizophrenia

Answer 8

broad range cognitive deficits (attention, working memory, executive functions etc)

• cognitive impairments are independent of the postiive symptoms

negative symptoms and cognitive deficets are important b/c they strongly determine functional outcome of the patient

Question 9

what is the prevailing theory of schizophrenia?

Answer 9

schizophrenia as a disorder of faulty brain development

Question 10

what is the percent heritability of schizophrenia ?

Answer 10

64%

Question 11

how is cannabis related to schizophrenia?

Answer 11

evidence that adolescence use of marijuana has a causative role in schizophrenia

Question 12

what are some brain abnormalities in schizophrenia?

Answer 12

smaller cortex, less grey matter than white, enlarged ventricles, smaller thalamus, temporal lobes etc

Question 13

what is our evidence for the neurodevelopment hypothesis of schizophrenia?

Answer 13

• brain images on diagnosis
• gene abnormalities - especially among those that code for brain development
• obstetric complciations (hypoxia)
• prenatal infections - malnutrition and prenatal anaemia and prenatal vitamin D deficiency
• presence of minor anomalies indicating brain maldevelopment
• abnormalities of motor and language milestones, cognition and social performance

Question 14

Treatment is more effective on which symptoms of schizophrenia?

Answer 14

the positive symptoms - though they have little effect on the negative or cognitive symptoms -

this is particularly problematic b/c the negative/cognitive effects are more disabling in the long term

Question 15

What non-medication treatment can we give for schizophrenia?

Answer 15

CBT

social skills training

family therapy

cognitive remediation - computerized training modules