Schizophrenia

Question 1

Recongnize the main criteria that go into a diagnosis of schizo

Answer 1

1. 2+ for 1 mont at least from DSM
   - delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour, negative symptoms
2. work, relationship, or self-care suffer
3. continuous signs of disturbance, prodomal symptoms persist for 6 months with at least 1 month of symptoms from 1.
4. Schizoaffective disorders have been ruled out (bipolar 1, depression)
5. disturbance is not affected by drugs.

Question 2

Distinguish between positive, negative, and cognitive symptoms of schizo

Answer 2

1. Positive Symptoms: mental phenomena that does not occur in healthy people
   - hallucinations
   - delusions of culture etc.
2. Negative Symptoms resulting from an impairment of normal function
   - blunted emotional resposnses
   - impoverished content through speech
   - reduced social motivation.
3. Cognitive abnormalities
   - impaired working memory
   - impaired source monitoring

Question 3

name some risk factors of schizo

Answer 3

-genetics
- urban enviro
- maturnal infection/malnurished
- perinatal complications
- cannabis or stimulant use
- paternal age > 35

Question 4

Identify common brain changes

Answer 4

Structural:
- Decreased grey matter (cell bodies) in frontal and temporal cortices
- thinning of dorsolateral prefrontal cortex (working memory)
- volume loss is not due to cell dealth but rather a reduction in cell processes (axons/dendrites) in prefrontal cortex
- hippocampus can have atypical neuron layering and shape.

Functional:
- Abnormal/ hypoactive frontal and temporal lobes including hippocampus

Question 5

Compare the efficacy of the various nonpharmacologicl and pharmacological treatments for schizo

Answer 5

Non-pharmacological:
- Cognitive behavioural therapy (CBT) has been shown to help positive and negative sympotms COMBINED with medication.

Pharma
- The most common treatments (for positive symptoms) are antipsychotics. Typical can cause movement disorder, atypical can cause metabolic problems
- usually no luck treating the negative symptoms.

Question 6

Compare and contrast the dopamine and glutamate theories of schizo

Answer 6

Dopamine Theory: Too much dopamine activity at the dopamine receptors.
- PD has dopa depletion and antipsychotic produces of parkinsons symptoms
- drugs that increase dopamine levels produce schizo symptoms
- takes 2-3 weeks to start but dopamine changes right away.

Glutamate Hypofunction Theory: PCP and ketamine can induce negative symptoms and psychosis. they act antagonistically to the glutatmate neurotransmitter.
- some interneurons receive excitatory glutatmate signals and then send inhibitory GABA signals onto other neurons.
- if glutamate signals become abnormal it can lead to: lss gaba transmission (decreased inhibition) leading to too much activity.