Schizophrenia Flashcards
Neurophysiology in SCHIZOPHRENIA
reduced brain volume: enlarged lateral and third ventricles
limbic system decreases in size
prefrontal cortex is dyfunctional
shrinkage of the hypothalamus!
Elevated activity of D2 receptors is associated with _ symptoms in Schizophrenia
positive = better prognosis
what neurotransmitter levels have low activity in schizophrenia
GABA and NMDA (receptor hypo function)
what neurotransmitters are involved in the neurophysiology of schizophrenia
dopamine
serotonin
norepinephrine
GABA
NMDA
glutamate
PCP studies have been found to reduce _ function in schizophrenia
glutamate
what is the A category of the DSM-5 criteria for schizophrenia ?
two or more of the following for most of 1 month and at least one of the first three symptoms
delusions
hallucinations
disorganized speech
grossly disorganized or catatonic behavior
negative symptoms
what is the B category in the DSM5 criteria for Schizophrenia
marked social or occupational dysfunction
what is category C of the DSM 5 criteria of Schizophrenia
duration of at least 6 months of persistent symptoms such as attenuated forms of group A above or negative symptoms at least one moth must include a group A symptom
what is category D of the DSM-5 criteria for Schizophrenia
symptoms of schizoaffective and mood disorder are ruled out
what is category E of the DSM 5 criteria for Schizophrenia
substance abuse and medical conditions are ruled out as etiologic
risk factors for being violent with schizophrenia
antisocial/borderline personality disorder
history of violent acts
paranoid beliefs
content of auditory hallucinations
substance abuse
impulsivity
talking about violence
_ is the single leading cause of death in Schizophrenia patients
suicide
_ may reduce suicide rates in schizophrenia
clozapine
what are the 5 diagnostic criteria for Schizophrenia Catatonic Type (only need 2/5)
- motor immobility as evidenced by catalepsy or stupor
- excessive motor activity
- extreme negativism or mutism
- weird voluntary movement such as posturing, prominent mannerisms or prominent grimacing
- Echolalia or Echopraxia
how can we treat Schizophrenia ?
hospitalize them
group therapy
psychotherapy
community treatment
self-help programs
medication
Electroconvulsive therapy
Benzodiazepines for catatonic disorder
how do we treat acute psychosis in schizophrenia ?
IM injections of haloperidol, fluphenazine. olanzapine, choropromazine
how do you treat the stabilization phase of Schizophrenia ?
newer atypical antipsychotics
how do you treat the maintenance phase of schizophrenia ?
long acting depot injections
keep patients free from symptoms while avoiding incapacitating effects
poor responders are _ in patients whose SCHIZOPHRENIA was once under control but no longer responds
relapses
there is noncompliance with medication
first generation antipsychotics block _ receptors
dopamine
what are the first generation antipsychotics? (6)
Haloperidol
Loxapine
Pimozide
Chlopromazine
Perphenazine
Thiothixene
what are the side effects of first generation antipsychotics ?
extrapyramidal syndromes (EPSs)
neuroleptic malignant syndrome
what is extrapyramidal syndrome?
acute dystonic reactions - contractions of the mouth, eyes, and face
drug induced Parkinsonism- cogwheel rigidity, bradykinesia, tremor
antipsychotic induced catatonia- inability to speak
tardive dyskinesia- fasciculation’s of the tongue, lingual-facial hyperkinesis
akathisia- motor restlessness, inability to keep legs and feet still
what is neuroleptic malignant syndrome
muscular rigidity , fever, autonomic instability, altered level of consiousness
second generation antipsychotics. block ?
dopamine and serotonin activity
what are the side effects of clozapine
agranulocytosis and weight gain
what is the risk with taking risperidone ?
increased prolactin
what is the risk of taking olanzapine
weight gain, metabolic syndrome
what is the side effect of taking ziprasidone?
QT prolongation
what is brief psychotic disorder?
presence of either delusions, hallucinations, disorganized speech , (catatonic behavior) +/-
duration of an episode of a brief psychotic disorder is at least _ (duration) but no more than _ (duration)
1 day
1 month
what is Schizophreniform?
when a person meets criteria A,D,and E for schizophrenia
* A. Two (or more) of the following for most of 1 Month; at least one of the first 3 symptoms
* Delusions
* Hallucinations
* Disorganized Speech
* Grossly Disorganized or Catatonic Behavior
* Negative Symptoms
* D. Symptoms of schizoaffective and mood disorder ruled out.
* E. Substance abuse and medical conditions ruled out as etiologic.
duration is ony 1-6 months
what are some good prognostic features to schizophreniform (3)
onset of psychotic symptoms within 4 weeks of the first noticeable change
confusion or perplexity of height of episode
good premorbid social and occupational functioning
no flat affect
what is schizoaffective disorder?
uninterrupted period of illness with either a major depressive episode or manic episode along with Schizophrenia symptoms (criteria A)
what are the two types of schizoaffective disorder
bipolar type and depressive type
delusions that are not always non bizarre that could involve real life situations like being followed, poisoned or infected, having a disease, loving from a distance Etc. for at least 1 months duration
have never meet criteria A for Schizophrenia
functioning in intact
delusional disorder
types of delusional disorders
erotomania, grandiose, jealous, persecutor, somatic, mixed, unspecified
schizophrenia delusions are usually
bizarre
(more impairment in function too than delusional disorder)
