Schizophrenia Flashcards
What is schizophrenia?
A severe psychiatric disorder characterized by distortion of thoughts, perceptions, and mood, along with cognitive impairment. It affects approximately 1% of the population and exists on a spectrum with identifiable subtypes
What is the normal onset of schizophrenia?
Onset typically occurs in adolescence or early adulthood.
In which gender is schizophrenia more prevalent?
Schizophrenia affects males and females equally.
What are the two types of disease progression for schizophrenia?
- Repeated episodes (psychotic break, recovery, repeat)
- Chronic progression leading to a decline in function.
What are the clinical symptoms of schizophrenia according to DSM-5?
- Positive symptoms (Type I): Presence of abnormal thoughts and behaviors, including delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior.
- Negative symptoms (Type II): Absence of normal responses/behaviors, such as reduced expression of emotion and social withdrawal.
Which symptoms are more likely to be picked up by clinicians?
Positive symptoms are more likely to attract the attention of clinicians.
Is schizophrenia genetic?
Yes, there is a hereditary component to schizophrenia. The risk increases with the amount of genetic material shared with a relative who has schizophrenia.
What other factors can affect the risk of schizophrenia?
Environmental factors may include slow viral infections, autoimmune processes, poor maternal nutrition, and developmental abnormalities.
How can the aetiology of schizophrenia be described?
Genetic predisposition combined with environmental triggers.
What is the dopamine hypothesis of schizophrenia?
It states that dopaminergic hyperactivity underlies schizophrenia, supported by the effects of various dopaminergic agents.
What evidence supports the dopamine hypothesis of schizophrenia?
- Amphetamine abuse increases dopamine release, leading to symptoms similar to schizophrenia.
- Dopamine D2 receptor agonists can produce Type I-like symptoms.
- Excessive L-DOPA can cause Type I symptoms.
Which type of schizophrenia does the dopamine hypothesis account for?
It accounts for Type 1 positive symptoms.
How to differentiate between amphetamine abuse and a psychotic break?
Visual hallucinations are likely in amphetamine abuse but unlikely in schizophrenia.
What is an antipsychotic drug used for schizophrenia?
Chlorpromazine.
What is Chlorpromazine?
Originally developed as an antihistamine, it attenuates positive symptoms of schizophrenia without excessive sedation but is not effective for negative symptoms.
What are neuroleptics?
Neuroleptics are antipsychotic drugs used to treat schizophrenia.
What are the three classes of typical neuroleptics?
- Phenothiazines (e.g., chlorpromazine)
- Butyrophenones (e.g., haloperidol)
- Thioxanthines (e.g., flupenthixol).
What is the mechanism of action of typical neuroleptics?
They act as receptor antagonists, blocking various receptor sites including dopamine, ACh, histamine, noradrenaline, and 5-HT.
Which receptor do typical neuroleptics target for their antipsychotic effects?
They primarily target dopamine D2 receptors.
What is the potency of typical neuroleptics?
Greater affinity to the D2 receptor results in a lower required dose to produce an antipsychotic effect.
What are atypical neuroleptics?
They differ from typical neuroleptics by having a different pharmacological profile, fewer motor side effects, and being more effective against negative symptoms and treatment-resistant schizophrenia.
What are some examples of atypical neuroleptics?
Sulpiride, Amisulpride, Clozapine, Olanzapine, Risperidone, Quetiapine.
Which receptor do atypical neuroleptics target?
D2 receptor antagonism is key to treating schizophrenia.
What are the indications for typical and atypical neuroleptics?
Typical neuroleptics control positive symptoms but are less effective for negative symptoms and have problematic side effects. Atypical drugs are better for negative symptoms and have fewer side effects.
