Schizophrenia Flashcards
What are the three significant categories of schizophrenia symptoms?
- positive symptoms
- negative symptoms
- cognitive symptoms
What are positive symptoms
- hallucinations
- delusions
- disorganized thoughts and behaviour
What are negative symptoms
- reduced emotional experience
- avolition
- alogia
- Diminished emotional expressiveness
- anhedonia
What are cognitive symptoms
- problems with attention
- problems with working memory
- impaired longer-term verbal memory
- difficulties in social cognition
What are common comorbid disorders of schizophrenia
- depression
- anxiety
- OCD
- neurodevelopmental and learning disorders
- substance abuse
how to differentiate schizophrenia from mood disorder with psychotic features
MDD with psychotic features has psychotic symptoms that only occur during the major depressive episode
how to differentiate schizophrenia and schizoaffective disorder
the schizoaffective disorder requires mood episodes that occur for the majority of the illness
how to differentiate schizophrenia from cluster A personality disorder
cluster A personality disorder have psychotic symptoms that tend not to rise to the severity of full-blown delusions or hallucinations
how to differentiate schizophrenia from delusional disorder
the psychotic symptoms of delusional disorder are usually restricted to one or more delusions
how to differentiate schizophrenia from a brief psychotic disorder
psychotic symptoms only occur for a brief amount of time (less than one month) and they resolve on their own
how to differentiate schizophrenia from schizophreniform disorder
schizophreniform is only diagnosed when a person has had symptoms of schizophrenia that has last longer than 1 month but less than 6 months
if it exceeds 6 months diagnosis changes to schizophrenia
What are the premorbid features of schizophrenia
- lower intelligence and school achievement
- poorer social functioning
- lower positive emotionality
- greater negative emotionality
- motor abnormalities and late developmental milestones
What factors are associated with a worse prognosis
- longer psychotic symptoms go without treatment
- being male
- early age of onset
- poor premorbid functioning
- more severe negative symptoms
- family history
What is the lifetime prevalence rate for schizophrenia
0.5% - 1 %
What is the age of onset for schizophrenia
early 20s
What factors predict psychosis
- genetic risk
- deterioration in functioning
- higher levels of unusual thought content
- higher levels of suspicion and paranoia
- greater social impairment
- history of substance abuse
What are endocannabinoids
plays an important role in regulating the balance between GABA and Glutamate
high concentration in the hippocampus thus helps with regulation of memory acquisition, consolidation and retrival
What are exogenous cannabinoids
THC binds to receptors and inhibits the release of GABA and Glutamate in the hippocampus
what can long-term cannabis use cause
- down regulation of cannabinoid receptors
- inhibition of the synaptic changes that are required for the formation and consolidation of memories
What are the cognitive deficits associated with schizophrenia
- impaired visual processing
- impaired sensory gating
- deficits in verbal and spatial memory
- deficits in abstract reasoning
- deficits in executive functioning
- deficits in social cognition
environmental and sociocultural factors related to schizophrenia
- stress
- peristent social stress
- families with highly negatively expressed emotions
- childhood and proximal stress triggers
is schizophrenia heritable
yes
What obstetrical complications are related to schizophrenia
- preeclampsia
- fetal hypoxia
- cannabis and nicotine exposure
- maternal viral infection
- second-trimester fetal insult
- prenatal maternal stress
What are the ethnic disparities involved in schizophrenia
Prescription drug use is lower among black and Hispanic patients with psychosis due to societal barriers such as unequal access to care, language barriers, health care shortages
What are the implications of the ethnic disparities for schizophrenia
- black and Hispanic patients may have reduced opportunities for timely detection of psychotic symptoms and early interventions
- this may contribute to higher rates of diagnosis of schizophrenia and poorer long-term outcomes in these patients
What are the three phases of treatment for schizophrenia
- acute
- stabilization
- maintenance
When were typical antipsychotics used, and how do they work
was used in the past and worked by blocking dopamine receptors
What are the side effects of typical antipsychotics
- extrapyramidal symptoms
- tardive dyskinesia
What are extrapyramidal symptoms
- tremor
- akathisia
- facial masking
- some resemblance of Parkinson’s disease
What is tardive dyskinesia
response to motor areas not receiving the expected amount of dopamine signaling the brain tries to generate extra dopamine receptors
extra receptors lead to misfiring of neurons in motor areas of the brain and causes abnormal movements
How do atypical antipsychotics work
Work by blocking dopamine receptors are also other neurotransmitters like serotonin
What are the side effects of atypical antipsychotics
- anticholinergic effects
- adrenergic effects
- substantial risk of metabolic syndrome
What are anticholinergic effects
- blurred vision
- dry mouth
- confusion
- constipation
- urinary retention
What are adrenergic effects
- orthostatic hypotension
- light-headedness
What is the substantial risk of metabolic syndrome
- substantial weight gain
- onset or worsening of diabetes mellitus
- lipid abnormalities
What is family psychoeducation therapy
reduced patient relapse and rehospitalization rates by 50%
What is assertive community treatment
the multi-disciplinary team helps patients re-integrate into the community
What is social skills training
teaches necessary skills to perform daily living activities, function in the workplace, and develop interpersonal relationships
What is CBT for schizophrenia
teaches coping strategies for dealing with delusions with the primary goal of reducing symptom severity and distress but helping them develop effective coping strategies
What is cognitive remediation
practice tasks that require attention, short-term memory, and other cognitive abilities with the hope to improve those abilities in everyday settings
