PSYCHOTIC DISORDERS: SCHIZOPHRENIA Flashcards
primarily affects thought and behaviour and may
cause people to hear voices, see imaginary things (hallucinations) or
believe that others are controlling their thoughts
(delusions/paranoia)
• Schizophrenia
SK onset occurs primarily between the ages of _____ and tends to be earlier in men than in women.
18-25
s/s of SK
delusions/paranoia
hallucinations
Negative symptoms
Absence of normal behavior
SK socially withdrawn, apathy, etc
SK likely has?
Genetic component
Incidence increases if you have a sibling with schizophrenia, 8%; one
parent, 12%, both parents 39% and 60-80% for monozygotic twins
SK diagnosis
Delusions Halluc Catatonic Behavior Disorg speech Negative symptoms
Requires 2+ of above w/ 1 positive symptom for at least 6 months
SK has ↑ size of
Lateral Ventricle
Brain regions functionally and/or structurally affected in
schizophrenia MRI study
↓ Gray/ white matter/ brain volume
↓ Hippocampus, thalamus, amygdala, accumbens
↑ Ventricular volume
*MRI: possible other causes, maybe not SK etiology
Neurocognitive dysfunction in schizophrenia
- Episodic memory
- Reward and Salience
- Emotional regulation
- Social cognition
DLPFC Neurocognitive dysfunction constantly observed
Changes in Dorso-Lateral- Prefrontal cortex
Neuropathological Findings of SK
*↓ size and packing density of pyramidal neurons in the prefrontal cortex
- ↓ GABA interneuron proteins and neuronal function in layer III DLPFC
- ↓ dendritic spines and presynaptic axonal inputs
Genes in all three paths contributes to the disorder
Neuropathological Findings of SK
↓ dendritic spines and ______ inputs
presynaptic axonal
Neuropathological Findings of SK
↓ GABA interneuron proteins and neuronal function in ______
layer III DLPFC
Neuropathological Findings of SK
↓ size and packing density of ________ in the prefrontal cortex
pyramidal neurons
Hyperactivity of dopamine in the Mesolimbic system and Hypoactivity dopamine in the
Mesocortical system.
Dopamine Theory
Hypoactivity of cortical
glutamatergic system
Glutamate Model:
Reduced parvalbumin positive
interneurons in laminar III of prefrontal cortex
GABAergic Model:
Dopamine Theory
Hyperactivity of dopamine in the Mesolimbic system and Hypoactivity dopamine in the
Mesocortical system.\
↑ VTa- NA and ↓ VTA- Cortex paths
________ exacerbates SK and makes normal people act similar to SK
Meth, which has explosive ↑ DA
______ effects are important risk factors for the disorder
Genetic
Schizophrenia is not ___________, it is a multifactorial trait, with non-genetic (or environmental) factors
completely caused by genes
Patterns of transmission in families are_____________, complex trait influenced by a large number of genes, which produce a modest individual increase in risk
inconsistent with single gene of large effect
SK= polygenic
_______________ and interactions appear necessary for pattern of risk
Environmental factors
Environmental risk factors
- Season of birth
- Prenatal nutrition
- Prenatal infection
- Pregnancy/ birth complications
- Social biology (migration, urbanicity etc.)
- Drug abuse, marijuana use
Chlorpromazine
a dopamine antagonist of the typical anti-psychotic class of medications possessing additional antiadrenergic, anti-serotonergic, anticholinergic and antihistaminergic properties used to treat schizophrenia
Chlorpromazine ADR
dry mouth, muscle
stiffness, muscle cramping, tremors, EPS and
weight-gain. EPS is a cluster of symptoms
consisting of akathisia, parkinsonism, dystonias.
• EPS more common with typical (1st gen drugs)
