Schizophrenia Flashcards
psychosis
loss of reality
Kraeplin
- 1st to recognize schizophrenia
- Dementia Praecox: conditions that featured mental deterioration beginning early in life
- hallucinations, apathy, indifference, withdrawn, incapacity to work
Bleuler
- 1st to coin schizophrenia
- Schizophrenia: disorganization of thought, lack of coherence btwn thought & emotion, orientation away from reality
- thought there to be differnt types of schizophrenia
Onset
- late adolescence, early adult
- earlier and more severe in men than women
Delusions
- belief that is fixed and held despite contradictory evidence
- thoughts are being controlled
- inserted
- robbed
- delusions of reference
- delusions of body changes
Hallucinations
- Sensory experience that seems real but in absence of external stimulus
- sometimes incorporated in delusions
- worse when alone
- rude and vulgar
- misinterpretation on inner speech
- auditory (most common)
- visual
- olfactory
- tactile
- sound
Disorganized Speech
- fails to make sense
- words are communicative but no understanding of a point
- sometimes using neologism (fake words)
Disorganized, Catatonic Behavior
- incapable of personal upkeep
- disorganized behavior
- impairment in prefrontal region
- Catatonia: absence of movement and speech, unusual posture
Positive Symptoms
exces or distortion in normal behavior
- delusions
- hallucinations
Negative Symptom
Absence or deficit in behavior. Worse prognosis.
- flat emotion
- alogia (little speech)
- avolition (inability to have goal-directed activity)
- asociality
- anhedonia
Disorganized Symptoms
- bizarre behavior
- disorganized speech
Paranoid Schizophrenia
suspiciousness and difficulty with relationships
- illogical
- being watched, followed, poisoned, talked about, influenced
- delusions of grandeur
Disorganized Schizophrenia
disorganized speech, behavior, flat affect. Poor prognosis.
- gradually more reclusive
- preoccupied with fantasies
- emotional indifference
- infantile behavior
- speech incomprehensible
- inability to perform daily activities
Catatonic Schizophrenia
excitement (like mania) or stupor
- Echopraxia: imitate actions of others
- Echolalia: mimic phrases
- violent moments
- suggestible
Undifferentiated Schizophrenia
doesnt fit into other types but has diagnostic criteria
Residual Schizophrenia
Has suffered an episode of schizophrenia but do not show any positive symptoms. Only negative ones.
Schizoaffective Disorder
Has features of schizophrenia and severe mood disorder
- psychotic symptoms
- changes in mood over itme
Schizophreniform Disorder
Psychoses for a month
Delusional Disorder
hold beliefs that are false and absurd
- normal behavior
- erotomania: love for someone (of higher status)
Brief Psychotic Disorder
sudden onset of psychotic symptoms, disorganized, or catatonic behavior
- only lasts days
Shared Psychotic Disorder
develops in someone who has close relationshp with another delusional person
- adopts delusions of another
Genetic causes
- If mother is schizophrenic, child more likely to develop schizo
Environmental Causes
- If child at high-risk for schizo, and placed in dysfunctional family with high communication deviance-more likely to develop schizo
Prenatal Causes
- prenatal viral infection
- rhesus
- nutritional deficiency
- birth complications
Early Indicators
- abnormal facial expressions, motor skills
- more deviant during attention tasks
Brain Differences
- enlarged ventricles- smaller brain volume
- low frontal lobe activation
- comprimised temporal (connects frontal lobe), hippocampus (memory) and amygdala (emotion)
- thalamus smaller (sensory input)
Differences in Neurochemistry
Dopamine
too much causes
- psychosis
- Aberrant Salience = attention to unimportant stimuli
- heightened senses
Differences in Neurochemistry
Glutamate
blockage of glutamate receptors cause
- triggers schizo symptoms
- degeneration of neurons
Expressed Emotion Measure
Measure of family environment. Predicts relapse.
- criticism
- hostility
- emotional overinvolvement
Risk Factors
- high expressed emotion in familly
- urban living
- immigration
- cannabic abuse
Meds
Typical
Antipsychotics (neuroleptics):
- Thorazine
- dopamine antagonists (block dopamine)
- best for positive symptoms
Side Effects of 1st gen antipsychotics
- Drowsiness
- dry mouth
- weight gain
- EPS (spasms)
- Tardive Dyskinesia: involuntary movement of lips, tongue, neck
2nd Gen Antipsychotics
- fewer side effects
- work on positive and negative symptoms
- block multiple neurotransmitters
Therapy Tx
- family therapy
- case manage
- social skills training
- cognitive remediation
- cog-behavioral therapy
