Schizophrenia

Question 1

symptoms?

Answer 1

• Delusions
• Hallucinations—hearing voices most common
• Grossly disorganized behavior
• Disordered thought/speech
• Negative symptoms

Question 2

prognosis?

Answer 2

rule of thirds:
1/3 only have one episode
1/3 have reoccurring episodes
1/3 are chronic with unremitting symptoms

Question 3

better (higher chance of survival) prognostic signs?

Answer 3

• Acute onset
• Female
• No family history of schizophrenia
• Older age at onset
• Prompt treatment
• Fewer negative symptoms
• Good support system
• Premorbid stable personality/relationships

Question 4

poor (lower chance of survival) prognostic signs?

Answer 4

• Early and insidious onset
• Male
• Prominent negative symptoms
• Family history of schizophrenia
• Prominent cognitive symptoms
• Poor medical care
• Poor support system
• History of substance abuse

Question 5

treatment?

Answer 5

• Traditional antipsychotics have been available since the mid-1950’s
  (EX: Haldol, Thorazine)
• Mostly medication and supportive therapy

Question 6

known environmental risk factors?

Answer 6

• Abuse and maltreatment
• Social adversity
• Urbanization/migration
• Season/latitude of birth
• Prenatal infection/severe prenatal maternal stress
• Obstetric complications
• Paternal age

Question 7

family studies?

Answer 7

HERETABLE
.65% risk in population
4% risk 2nd degree relatives
9% risk 1st degree relatives
46% risk if both parents have schizophrenia

Question 8

adoption studies?

Answer 8

Schizophrenia in genetic but (not adoptive) relatives predicts schizo in adopted children

Question 9

twin studies?

Answer 9

• Average concordance about 50% suggests environmental contribution
• Concordances for MZ range from 48%-64%

Question 10

what heritability coefficients do twin/adoption studies show?

Answer 10

consistently show heritability coefficients range from .65 - .80 (only ASD has higher heritability)

Question 11

dopamine hypothesis?

Answer 11

Positive sx’s likely caused by overactivation of dopamine systems via faulty dopamine receptor molecules

Question 12

glutamate hypothesis?

Answer 12

• Excessive glutamate in certain parts of the brain may cause overstimulation of some dopamine circuits
• Dysfunction of glutamatergic neurotransmission — on its own or as mediator of dopamine

Question 13

neurodegenerative changes?

Answer 13

often see some abnormal neural pruning during adolescence- unsure why

Question 14

big picture of schizophrenia?

Answer 14

• Almost certainly there are many genes involved, each of which individually may have a small effect, but their combined effects are additive
• And, in many (nearly all) cases, also need an environmental stressor.