Schizophrenia (2 & 3) Flashcards
What is schizophrenia?
chronic, debilitating illness associated with deterioration in mental function and behavior
What is the hallmark symptom of schizophrenia?
psychosis
What is psychosis?
Impairment in reality testing that may present as:
1- alteration in sensory perceptions (hallucinations)
2- abnormalities in thought content (delusions)
3- abnormalities in thought process organization
What are the symptoms of psychosis?
1- Illusion 2- Hallucinations 3- Idea of Reference 4- Delusions 5- Loss of ego boundaries 6- Alogia 7- Echolalia 8- Thought blocking 9- Neologisms 10- Circumstantiality 11- Tangentiality 12- Loose associations
What are illusions?
Misperception of real external stimuli
What are hallucinations?
Sensory perceptions not generated by external stimuli
What are ideas of reference?
False convictions that one is subject of attention by other people
What are delusions?
False beliefs not correctable by logic or region
What is loos of ego boundaries
Not knowing where one’s mind and body end and those of another begin
What is alogia?
Lack of informative content in speech
What is echolalia?
Repeated statements of others. associating words by their sound
What is thought blocking?
Abrupt halt in the train of thrinking (often b/c of hallucinations)
What is neogiasms?
Invention of new words
What is circumstantiality?
In responding to a question one responds unnecessarily with voluminous information
What is tangentiality?
Begins with proper response and get further and further away from the point
What are loose associations?
Loss of logical meaning between words and thoughts
What are the characteristic symptoms needed to diagnose schizophrenia?
2 or more for 1 month:
Delusions, hallucination, grossly disorganized or catatonic behavior, negative symtoms, disorganized speech
What are the social/ occupational dysfunctions needed to diagnose schizophrienia?
One or more major areas of functioning are markedly below the level achieved prior to onset
What is the duration of time needed to make a diagnosis of schizophrenia?
6 months, with at least 1 month of constant symptoms
What are the positive symptoms of schizophrenia? (5)
Delusions, hallucinations, agitation, talkativeness, thought disorder
What are the negative symptoms of schizophrenia? (6)
Lack of motivation, social withdrawal, flattened affect, cognitive disturbances, poor grooming, poor specch
Why were the schizophrenia subtypes eliminated in the DSM-5?
B/c limited diagnostic stability, low reliability and poor validity
What is the course of schizophrenia? (3 stages)
1- Prodrome
2- Psychotic/ active
3- Residual (period between psychotic breaks)
What are some etiologic factors associated with the development of schizophrenia?
1- advanced paternal age
2- genetic links
3- viral infection/ exposure to drugs in development
4- 3rd trimester maternal use of diuretics
Explain the neuro abnormality seen in the frontal lobes of people with schizophrenia?
Decreased glucose in the PFC –> hypofunctionality
What happens to the ventricles in schizophrenia?
Lateral and 3rd ventricles are enlarged
What changes are seen on EEG in schizophrenia?
Decreaesd alpha waves and increased theta and delta waves
What are positive symptoms due to?
Excessive DA in mesolimbic tract
What are negative symptoms due to?
hypoactivity of mesocortical DA tract
What symptoms are seen in serotonin hyperactivity?
hallucinations
What symptoms are seen in NE hyperactivity?
Paranoid subtype of schizophrenia
What is the major excitatory neurotransmitter i the CNS?
Glutamate
Explain the NMDA receptor hypoactivity hypothesis?
Mutated NMDA receptr can become inactive or underactive.
If these mutated NMDA receptors are on GABA interneurons, the GABA neurons lose their inhibitory function.
What happens when GABA neurons lose their inhibitory function?
Allows for excessive firing and ultimately an increase in firing in the VTA which sends extra DA into the limbic system–> psychosis
GLU-GABA-GLU-GAMA-DA
hypofunctioning–> negative symptoms
GLU-GABA-GLU-DA
hyperfunctioning–> positive symptoms
What is brief psychotic disorder?
1-29 days of schizophrenia symptoms
What is schizophreniform disorder?
1-6 months of symptoms
What is schizoeffective disorder?
Schizophrenia + mania or depression
What is delusional disorder?
Delusions only
What is shared psychotic disorder?
One person is delusional and a second person develops same delusion
How is schizophrenia medicinally managed?
Antipsychotics–> block D2 receptors
Typical antipsychotics only block D2 receptors
Atypical antipsychotics also block 5HT2 receptos
What are the typical antipsychotics used?
Haloperidol and chlorpromazine
What are the atypical antipsychotics used?
‘pines and ‘dones
Does psychotherapy work for schizophrenia?
Yes, fosters treatment compliance and CBT works
What is the prognosis of an individual with schizophrenia?
Lifelong impairment with chronic downhill course
Negative symptoms increase with time.
Increased suicide risk
