Schizophrenia Flashcards
Three types of schizophrenic disorders that were included in DSM-IV-TR
Schizophrenia Spectrum Disorders
● Schizotypal Personality Disorder
● Delusional Disorder
● Brief Psychotic Disorder
● Schizophreniform Disorder
● Schizophrenia
● Schizoaffective Disorder
● Substance/Medication Induced Psychotic Disorder
● Psychotic Disorder Due to Another Medical Condition
● Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
Schizophrenic Episode
Acute episodes feature delusions, hallucinations, illogical thinking,
incoherent speech, flat or inappropriate affect & bizarre behaviour
- Between episodes, people may be unable to think clearly and lack
appropriate emotional responses
Phases of Schizophrenia
- Prodromal Phase- when symptoms start to show up
- Acute Phase- symptoms are most noticeable, presence of positive, negative and affective symptoms
- Residual Phase- mildest, a person experiences fewer or less severe symptoms
- typically, people in this stage do not experience positive symptoms like hallucinations and delusions
3 types of schizophrenic disorders that were included in DSM-IV TR:
- Disorganized (hebephrenic)- shallow and inappropriate emotional responses, foolish or bizarre behaviour, false beliefs (delusions), and false perceptions (hallucinations)
-Catatonic- affects the way they move, catatonia or hyperactivity
- Paranoid- predominantly positive symptoms of schizophrenia, including delusions and hallucinations
Dopamine and Schizophrenia
Excess dopamine activity in schizophrenia
Effective medications reduce dopamine activity
Medications cause side effects similar to Parkinson’s Disease which results from reduced dopamine
- Amphetamines (that can cause psychotic symptoms) release norepinephrine
and dopamine - Increased dopamine activity may be due to oversensitivity of dopamine receptors rather than excess dopamine per see
- Dopamine may be only one piece of the puzzle with other neurotransmitters
also playing a role (e.g., serotonin)
Dopamine and Schizophrenia
Excess dopamine activity in schizophrenia
Effective medications reduce dopamine activity
Medications cause side effects similar to Parkinson’s Disease which results from reduced dopamine
- Amphetamines (that can cause psychotic symptoms) release norepinephrine
and dopamine - Increased dopamine activity may be due to oversensitivity of dopamine receptors rather than excess dopamine per see
- Dopamine may be only one piece of the puzzle with other neurotransmitters
also playing a role (e.g., serotonin)
Other Possible Causes/Contributors
- Pregnancy/birth complications more common
- Structural brain problems (e.g., enlarged ventricles implying loss of brain cells)
- Sociogenic vs. social selection theories
- Early theories of the “schizophrenogenic mother” (not supported)
- Expressed emotion (EE)-High EE involves emotional overinvolvement, criticism, hostility, and low warmth
Management
Signs of schizophrenia often appear in childhood although the condition usually does not manifest itself until later
- Schizophrenia is a treatable condition that is usually managed in the community
- Symptoms are less severe between acute episodes
- Sometimes hospitalization is necessary
- Remission can occur in approximately 1/3 of the cases (usually cases with milder symptoms)
Biological Treatments
- Repetitive Transcranial Magnetic Stimulation
- Initial promise
- First-generation antipsychotics
- More effective for positive symptoms
- Many patients don’t respond
- Side effects (e.g., tardive dyskinesia- repetitive movements)
- Second-generation antipsychotics (e.g., clozapine)
- Fewer side effects
- Improved effectiveness (e.g., negative symptoms)
- Mechanisms not fully understood but appear to be acting on serotonergic
neurotransmitters
Psychological Treatments
Earlier Treatments
* Token Economies
* Social Skills Training
Cognitive Behavioural Therapy
* Significant but small effects (Jauhar et al., 2014)
- Expressed Emotion Interventions
