Schizophrenia Flashcards
What is epidemiology of schizophrenia?
- 20 per 100 000 per year
- 0.5-1% population
- Occurs in all cultures
- Males age onset 28
- Females age onset 32
What is aetiology of schizophrenia?
- Winter births
- Left handed
- Obstetric complications
- Urban birth
- 2nd generation immigration(Africa and Caribbean)
- South Asian
- Cannabis
What is the most prominent risk factor?
-Genetic heritability
What is the dopamine hypothesis?
- Anti psychotics bind to dopamine receptors
- Varied results
- Some respond better than others
- Shows that more to schizo than just dopamine
How is neuroimaging used to detect schizophrenia?
- Brain scans show enlarged lateral ventricles
- Lateral temporal lobe abnormalities
What is seen when patient put into fMRI?
- Broca’s area become illuminated in hallucinations
- Part of the brain responsible for speech
Does neuroimaging help diagnosis of schizophrenia?
- No
- hasn’t helped in diagnosis of treatment
- only scanned if patient has unusual presentation
- to exclude organic causes
How is brain volume, grey matter affected in schizophrenia?
- Brain volume reduction 3%
- grey matter loss up to 25%
What 3 parts of brain lose function?
-Parietal, temporal, frontal loss
What factor can predict relapse?
-Expressed emotion
What can show why there is a relapse?
-Life events
When do psychological conflicts arise?
- During childhood
- as a result of problems
What is family systems theory?
- the influence of the family on abnormal behaviour
- looking at family relationships to understand their conditions
What is noticed in individuals with chronic negative schizophrenia?
–Low IQ
What can be said about the attention of schizophrenia patients?
-poor information processing
What can be said about perception in schizophrenia patients?
-impairment in picture and face recognition
What is the filter theory?
- unable to “filter out”
- They perceive voice in their head as external voices
What is over inclusive thinking?
-Overblow even small things
What is theory of mind?
-understanding of other people perspective is difficult
What is social learning theory?
- children who do not receive reinforcement early in their lives will put larger attention into irrelevant environmental cues.
- children who do not receive reinforcement early in their lives will put larger attention into irrelevant environmental cues.
What is neurodevelopmental?
-means that the primary brain insult or pathology occurs during brain development, long before the illness is clinically manifest
Is schizophrenia neurodevelopmental disorder?
-Yes and No
What can be seen in people who developed schizophrenia as a neurodevelopmental disorder?
-brain abnormalities: increased ventricular size decreased frontal and temporal volume are present -family history -birth complications -socially distanced -not many friends
Possible causes for neurodevelopmental schizophrenia?
- pregnancy and birth complications
- prenatal viral exposure
What procedures are done to rule out organic causes?
- CT Head
- Bloods (infection, metabolic abnormalities)
- Auto-immune screen
- EEG
What baselines are obtained before treatment?
- Glucose
- Cholesterol
- ECG
- Prolactin
What is used as predictor outcome?
-Duration of untreated psychosis (DUP)
What are the increased rates noticed in people with schizophrenia?
-Higher rate of MI, stroke, diabetes and smoking
What are good prognostic factors?
- Abrupt onset
- Marked mood component
- Any family history or disorders than can explain
- Later onset, better treatment because more knowledge for later onset schizophrenia
What are poor prognostic factors?
- Male
- Slow onset
- Negative syndrome
- Cognitive impairment
- Early onset
What is outcome of schizophrenia?
- 1/5 people of diagnosed with schizophrenia are fine,
- 1/3 of people do badly, stay in hospital for long periods and can’t live independently
- 35% live high functioning lives with occasional episodes