Schizophrenia Flashcards
Who classified the symptoms of schizophrenia based on the physical etiology, termed dementia praecox (course of delusions, hallucinations, and bazzare motor problems) which separated it from depression?
Emil Kraepelin (1856-1926)
Who indicated that emotions, perceptions, and cognitions split off from the others in schizophrenia?
Eugene Bleuler (1857-1939)
What were the 4 A’s that Bleuler used for schizophrenia?
Associations (loosened)
Affect (excited or withdrawn)
Ambivalence
Autism (living in an internal/unrealistic world)
Who characterized 1st and 2nd rank symptoms for schizophrenia, where you only need 1 1st rank for a Dx and 2nd rank were a little more vague for a Dx?
Kurt Schneider (1887-1967)
In the 1966 adoptive study, the 47 adoptees that had schizophrenia had what parental relation?
All schizophrenic children had schizophrenic mothers
Generally what is the correlation between the consinguinity and the incidence of schizophrenia?
Closer consanguinity = higher rates of schizophrenia.
MZ twins is 47%, where population is 1%
What was the drug that a surgeon designed to reduce the anxiety of pre-op patients?
Chlorpromazine (thorazine)
Chlorpromazine was then found that, in high doses, it acts on what receptors in the brain to chill out highly agitated and aggressive schizophrenic pts?
D2 receptors
Name the dopaminergic pathway:
Increased D will cause hallucinations and delusions, ↓ D will decrease the Sx.
Mesolimbic pathway
VTA –> limbic
Name the dopaminergic pathwau:
malfunction causes disordered thinking, like the negative Sx of schizophrenia.
Mesocortical pathway
VTA –> frontal lobe
Name the dopaminergic pathway:
↓ D causes muscular dyscontrol and trembling, and an ↑ D will cause extrapyramidal SE (tardive dyskinesia)
Nigrostriatal pathway
substrantia nigra –> striatum
Name the dopaminergic pathway:
blocking D causes ↑ PRL –> boob milk and sexual dysfunction
Tubuloinfundibular pathway
arcuate nucleus –> median emisence
What other NT in the brain (other than D) is throught to cause either + or - symptoms of schizophrenia when it’s in excess?
Serotonin
This is the condition where there is fixed and persistent delusions > 1 month, where there is no change in functioning.
Delusional disorder
note, the DSMIV says it’s nonbizarre delusions, but the DSM5 says they can be bizarre lol
What is the form of delusional disorder characterized by the central theme is that another person is in love with u?
Erotomanic type
What is the form of delusional disorder characterized by thinking u have some great talent or made some important discovery?
Grandiose type
What is the form of delusional disorder characterized by thinking your spouse in unfaithful?
Jealous type
What is the form of delusional disorder characterized by thinking ur consipired against or being harassed?
Persecutory type
What is the form of delusional disorder characterized by problems with body functions or sensations?
Somatic type
This is the condition where there is a sudden onset of delusions, hallucinations, disorganized speech, or disorganized/catatonic behavior LESS THAN 1 MONTH.
Brief psychotic disorder
This is the conditon where there is delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, or negative Sx from 1-6 months.
Schizophreniform disorder
What are “negative Sx” that we keep talking about?
Flat affect, social withdrawal, lack of motivation, lack of speech or thought.
This is the condition characterized by delusions, hallucinations, disorganized speech, disorganized/catatonic behavior, negative symptoms GREATER THAN 6 MONTHS.
Schizophrenia
In essence, how long to these conditons last?
Brief psychotic disorder
Schizophreniform disorder
Schizophrenia
Brief psychotic disorder: < 1mo
Schizophreniform disorder: 1-6mo
Schizophrenia: > 6 months
What must we rule out of schizophrenia to not fall to make a Dx of schizoaffective disorder?
Mood Sx
What defines “positive Sx” which may be seen in schizophrenia?
delusions or hallucinations
overactivity of the D2 receptors
This is the condition where there is an uninterrupted period of illness where there is a major MOOD episode (major depressive or manic) concurrent with the delusions/hallucinations/disorganized speech/catatonia/negative Sx of schizophrenia?
Schizoaffective disorder
How long must the Sx last in schizoaffective disorder to be diagnostic?
> 2 weeks
What is the subtype of schizoaffective disorder where there is manic episode and possible major depressive episodes?
Bipolar type
What is the subtype of schizoaffective disorder where there is only major depressive episodes?
Depressive type
5 or more of the following Sx describe what condition?
Stupor, catalepsy, waxy flexability, mutism, negativism, posturing, mannerism, stereotypy, agitation, grimacing, echolalia, and echopraxia
Catatonia
What is the LIFE THREATENING condition with antipsychotic medications due to abrupt withdrawal of D antagonists?
Neuroleptic Malignant Syndrome (NMS)
What are the PNS impairments seen with antipsychotics?
anti-DUMBELLSS
This is the condition where there is involuntary choreoathetoid movements of the face, trunk, or extremtities that typically occurs subsequent to prolonged exposure to D receptor blocking agents.
Tardive dyskinesia
This is the syndome caused by 2nd gen atypical antipsychotics, and the pts has 3 or more of the following risk factors:
abdominal obesity, high TGs, low HDL, HTN, elevated fasting glucose.
Metabolic syndrome
What are the 2 main reasons for higher relapse rates?
Discontinuation of the medication (usually due to SE) Substance abuse (interfering with drug action)
True or False: Schizophrenics have the same rate of suicide as the general population.
FALSE
Suicide rates are higher in schizophrenics than the general population.
