Schizophrenia

Question 1

What are the subtypes of Schizophrenia?

Answer 1

Paranoid, disorganized, catatonic, undifferentiated, and residual.

Question 2

Explain the splitting of psychic functions.

Answer 2

People with Schizophrenia have a breakdown of integration of emotion, thought, and action. ACT happy, THINK sad, FEEL mad.

Question 3

Who is Schizophrenia more common in?

Answer 3

Men. 7 to 5.

Question 4

What are the symptoms of Schizophrenia?

Answer 4

Positive (Hallucinations, Delusions), Negative (social withdrawal, poor speech), Cognitive, (poor attention, low IQ), and Affective (inappropriate, odd).

Question 5

Which symptoms are more common in men and women respectively?

Answer 5

Affective symptoms in Women. Cognitive symptoms in Men.

Question 6

Why do men have onset of Schizophrenia at age 20?

Answer 6

Because myelination is complete. Why are women’s onset later then when they myelinate first? Nobody knows..

Question 7

What are the environmental factors in Neurodevelopmental Disorder?

Answer 7

Maternal malnutrition, season of birth (higher in winter), cytokine exposure (fighting off fever), obstetric complications (forceps to extract baby), urban birth and upbringing, social stress, drug abuse, migration, childhood adversity.

Question 8

How many genes are involved with Schizophrenia?

Answer 8

1000 genes.

Question 9

What is the Dopamine Hypothesis?

Answer 9

Blockade of D2 receptors associated with improvement of positive symptoms. SUBCORTICAL INCREASE in dopamine levels and CORTICAL DECREASE in DA levels. No metabolic evidence of dopamine abnormalities.

Question 10

What is the Glutamate Hypothesis?

Answer 10

PCP and ketamine antagonize NMDA glutamate receptors; induce positive and negative symptoms. NMDA glutamate receptors found throughout brain. NMDA agonists (glycine analogs, glycine transporter inhibitors) show clinical benefit. Higher glutamate = lower DA = cytotoxic (influx of + ions).

Question 11

What is the COMT?

Answer 11

Common Genetic Findings gene. Catechol-O-methyltransferase. Degrades DA. Val -> Met SNP decreases activity significantly.

Question 12

What is DISC1?

Answer 12

Disrupted in Schizophrenia 1. Important in brain development and polymorphisms affect hippocampal function and connectivity.

Question 13

What is NRG1?

Answer 13

Neruegulin-1. Important in brain development and axon guidance. Activity-dependent plasticity at glutamate synapse.

Question 14

What are some structural abnormalities?

Answer 14

Ventricles, MTL, frontal lobe, basal ganglia, corpus callosum, thalamus, cerebellum

Question 15

What was found in brain imaging?

Answer 15

White matter connections between frontal and temporal lobes abnormal. Oligodendrocytes implicated in schizophrenia.

Question 16

What are the abnormalities in activation paradigms?

Answer 16

Motor tasks, working memory, attention, word fluency, emotional processing, and decision making.

Question 17

Describe the relationship between patients and emotional task.

Answer 17

Lack of amygdala activation during sad mood. Decreased activity and accuracy identifying emotions. Negative faces hyperactivated left amygdala.

Question 18

Describe the neurochemical therapy of the typical antipsychotic.

Answer 18

Blocks D2 receptors, treats for positive symptoms in the mesolimocortical system, and blocks DA in mesostriatal system(tardive dyskinesia tremors and involuntary movements).

Question 19

Describe the neurochemical therapy of atypical antipsychotics.

Answer 19

Seldom produce movement problems, more effective at treating negative symptoms and are now more widely used. Less effective on DA D2 receptors. More strongly antagonize serotonin type 5-HT2 receptors.

Question 20

How are the lateral ventricles different in patients with Schizophrenia?

Answer 20

Larger than normal Lateral ventricles.

Question 21

What are other common brain differences?

Answer 21

Reduced hippocampus, increased basal ganglia, abnormalities in prefrontal cortex.

Question 22

What is found in catatonic schizophrenia?

Answer 22

Motor immobility, extreme negativism, echolalia or echopraxia.

Question 23

What is found in paranoid schizophrenia?

Answer 23

Delusions and Hallucinations. Not present, disorganized speech. Inappropriate behavior

Question 24

What is found in disorganized schizophrenia?

Answer 24

Disorganzied thought, speech, flat/inappropriate affect, and no catatonic symptoms.

Question 25

What is dissociative identity disorder?

Answer 25

The myth that schizophrenia gives you multiple disorders.

Question 26

What is the alpha7-nicotinic cholinergic receptor?

Answer 26

Auditory sensory gating. Release of GABA stimulates GABAb receptors and decreases release of glutamate. Muscarinic antagonists DO NOT affect inhibitory gating. p50 gating, smoking helps return baseline to normal. CHRNA-7 = gene of cause.

Question 27

What two genes are a cause of high risk?

Answer 27

Dysbindin DTNBP1 and neuregulin NRG1

Question 28

What does dysbindin do?

Answer 28

Alterations in glutamate and DA signaling. Decreased levels in hippocampus and prefrontal cortex.

Question 29

What does Neuregulin (NRG1) do?

Answer 29

(Family of genes) encode proteins that act on epidermal growth factor receptors (EGFRs). Induces growth and differentiation of epithelial, neuronal, glial, and other types of cells. Important in neural functioning and plasticity. Increased levels lead to hyperactivity, memory difficulties, and inability to focus or pay attention.

Question 30

What can’t schizophrenics do considering visual illusions?

Answer 30

They can’t associate context.