Schizophrenia (2 & 3) Flashcards by Erin Allmer

What is schizophrenia?

chronic, debilitating illness associated with deterioration in mental function and behavior

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What is the hallmark symptom of schizophrenia?

psychosis

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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

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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

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What are illusions?

Misperception of real external stimuli

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What are hallucinations?

Sensory perceptions not generated by external stimuli

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What are ideas of reference?

False convictions that one is subject of attention by other people

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What are delusions?

False beliefs not correctable by logic or region

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What is loos of ego boundaries

Not knowing where one’s mind and body end and those of another begin

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What is alogia?

Lack of informative content in speech

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What is echolalia?

Repeated statements of others. associating words by their sound

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What is thought blocking?

Abrupt halt in the train of thrinking (often b/c of hallucinations)

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What is neogiasms?

Invention of new words

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What is circumstantiality?

In responding to a question one responds unnecessarily with voluminous information

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What is tangentiality?

Begins with proper response and get further and further away from the point

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What are loose associations?

Loss of logical meaning between words and thoughts

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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

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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

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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