Schizophrenia Flashcards
what are the four key symptoms of schizophrenia
thought insertion, hallucinations, delusions, disorganised thinking
thought insertion
believing one’s thoughts have been implanted by an external source
hallucinations
perceptual experiences which do not correspond with reality
delusions
fixed beliefs that are resistant to change and implausible to people of the same cultural background
disordered thinking
jumbled and unrelated thoughts leading to incoherent speech
lifetime prevalence of schizophrenia
0.3-0.7%
how does lifetime prevalence vary
varies with ethnicity, nationality and geographic origin in immigrants
the onset of schizophrenia, males vs. females
earlier in males (early to mid-20s)
females (late-20s)
features of schizophrenia
minority may recover completely
but most experience chronic, episodic impairment and some show progressive deterioration, with increasingly brief periods of remission and severe cognitive deficits.
positive symptoms reduce over time but delibating negative symptoms often remain
strength of schizophrenia diagnosis
high degree of consistency with DSM-5 and ICD-10
hyperdopaminergia
excess dopamine
chlorpromazine and reserpine, helpful in alleviating the symptoms of schizophrenia
schizophrenic symptoms may be linked to high levels of dopamine
positive symptoms of dopamine
hypodopaminergia
dopamine deficiency
negative symptoms of schizophrenia derived from lack of dopaminergic activity
positive schizophrenic symptoms
delusions and hallucinations
from hyperdopaminergia
negative schizophrenic symptoms
flat effect and mutism
from hypodopamingeria
strength of neurotransmitters as an explanation
supported by research on rats treated with amphetamines.
rats given nine amphetamine injections. showed schizophrenia-like symptoms
weakness of neurotransmitters as an explanation
cannot explain social causations like second-generation immigrants
how is schizophrenia a heritable condition
estimate for the heritability of schizophrenia 79%
identify responsible. genes that are present in family members who have schizophrenia
gene mutations
schizophrenia can appear in the absence of a family history.
DNA code in genes may mutate
which will lead to schizophrenia
what are the two candidate genes that are linked to the presence of schizophrenia
COMT gene and DISC1 gene
COMT gene
provides instructions for the creation of catechol-O-menthyltransferase
DISC1 gene
those with an abormality to that gene are more likely to develop schizophrenia
Diathesis-stress model
one may posess schiophrenic genes but it will only be triggered by other biological or environmental effects
strength of genes as an explanation
research support – schizophrenia runs in family. clear similarity in MZ twins than DZ twins
weakness of genes as an explanation
social causation
those exposed to city life are more likely to get schizophrenia
factors for social causation
social adversity, urbanicity, social isolation and immigration/ minority status
social adversity
basic human needs: physical and emotional
and people from lower socioeconomic groups may be more vulnerable, further exacerbating their problems
urbanicity
urban living and schizophrenia… city life is more stressful than rural life
many stressors linked to city life
social isolation
people with schizophrenia withdraw from contact with people because they find it stressful
immigration and minority status
those in minority or outgroup status may leave them marginalised or have a weaker ethnic or cultural identity
strength of social causation
significant correlation between urban dwelling and schizophrenia
FGA
first-generation antipsychotics
chlorpromazine – first antipsychotic medication
reduces positive symptoms
Features of FGA
effective in reducing positive symptoms
as many as 40% gain no relief at all, many people may still experience negative symptoms
side effects of FGA
tardive dyskinesia = stiff or slow, wirthing movements of your face and body that you can’t control
SGAs
clozapine – blocks dopamine, serotonin and glutamate receptors
reduces positive and negative effects
side effects of SGAs
fatal blood condition, agranulocytosis
features of SGAs
provides relief for up to 60% of people
drug treatment protocols
start medication use as quickly as possible to be effective
objective is to decrease hostility and to return the client back to normal functioning
once symptoms subside, manitenence dose will be prescribed, maintained for 12 months after remission
factors disrupting the effectiveness of antipsychotic medications
amphetamines, alcohol, caffeine and nicotine
strength of drug treatments
supported by empirical evidence
Zhao et al. meta-analysis comparing 18 antipsychotics
found out that antipsychotics had lower relapse rates
weakness of drug treatment
conducted on animals
can’t be generalised
CBT structures
5-20 sessions
in groups or individually
CBT - irrational thoughts
helps clients identify irrational thoughts and tries to change them
builds self-awareness by helping the individual understand more about their condition
CBT - delusions
CBT helps patients explain the delusions they see, therefore reducing anxiety
CBT - behavioural experiments
‘reality testing’
patients asked to collect evidence of percieved reality.
debunked with the clinician to prove that it is not real
CBT - behavioural action
awarding positive behaviours (being more sociailly active, etc) to reduce motivational deficits
strength of CBT
support by NICE
analysis done
showed that CBT was effective in reducing rehospitalisation rates for up to 18 months
weakness of CBT
may not reduce all symptoms or prevent relapse
CBT found to be only superior in 2/9 trials
CBT is better than drug treatments because…
some might not respond well to medication
study found drug resistant clients improved when given CBT which targeted their delusions and hallucinations
