schizophrenia

Question 1

what are the general characteristics of schizophrenia?

Answer 1

split-mind -there is an irrational divergence from between behavior and thought content. it is a chronic debilitating illness with deterioration in mental function and behavior that clearly involves a genetic and environmental component. it is exacerbated by social stress.

Question 2

epidemiological facts

Answer 2

rare in children. starts in young adulthood. one of the most debilitating illnesses that shows a downward drift in social aspects. as the disease progresses the person will become more and more socially inept falling behind in income, stature, relationships, etc.

Question 3

what is the hallmark in schizophrenia?/

Answer 3

psychosis. the impairment in reality testing presents as alteration in sensory perceptions, abnormalities in thought content and processing and organization.

Question 4

other common symptoms in schizo

Answer 4

loss of ego boundaries. not knowing where ones body and mind end and those others begin. ideas of reference, such as persecution and that one is subject of attention by others. false beliefs that do not correlate with logic or reason -delusions.

Question 5

there is a linear progression of symptoms that goes from bad to worse

Answer 5

circumstantial (one gives unnecessary voluminous details when asked a question), tangential, thought blocking and lose associations.

Question 6

diagnosing schizophrenia

Answer 6

at least one episode of psychosis and two or more of the associated symptoms each present for a significant amount of time throughout a month. continuous signs of disturbance must last for 6 months. it may include periods of prodromal or residual symptoms.

Question 7

do schizos have a loss of consciousness or clouding

Answer 7

no. this is characteristic of delirium or substance abuse. schizos are typically intact memory and attention.

Question 8

associated schizo symptoms

Answer 8

delusions, hallucinations, grossly disorganized or catatonic behavior, negative symptoms, disorganized speech, social occupational dysfunction.

Question 9

positive symptoms

Answer 9

are additional to expected behavior and include, delusion, hallucinations, agitation, talkativeness, thought disorder

Question 10

negative symptoms

Answer 10

missing from expected behavior such as lack of motivation, socially withdrawn, flattened affect/emotion, cognitive disturbances, poor grooming, poor speech.

Question 11

treatment of positive symptoms? negatives?

Answer 11

positives respond to both typicals and atypicals. negatives respond to atypicals.

Question 12

undifferentiated schizophrenia

Answer 12

most common subtype. characteristics of more than one subtype

Question 13

paranoid schizop

Answer 13

delusions of persecution. tend to be older age of onset. better functioning than the other types.

Question 14

residual schizo

Answer 14

all negative symptoms. at least one psychotic episode and then all the rest are negative symptoms.

Question 15

disorganized

Answer 15

onset before age 25. incoherent speech, bizarre behavior. poor grooming, inappropriate emotional response. facial grimacing.

Question 16

catatonic

Answer 16

rare since the onset of antipsychotics. stupor or extreme agitation, incoherent speech, blank facial expression, bizarre posturing and waxy flexibility.

Question 17

course of disease

Answer 17

three phases prodromal, psychotic/active, residual.f

Question 18

prodromal phase

Answer 18

prior to first attack. avoidance of social activities, quiet and passive or irritable, sudden interest in religion or philosophy, may have physical complaints. anxiety and depression are common.

Question 19

psychotic/active phase

Answer 19

loss of touch with reality. associated with positive symptoms.

Question 20

residual

Answer 20

period between psychotic events, in touch with reality but doesn’t behave normally. negative symptoms such as peculiar thinking, eccentric behavior, and withdrawal from social events.

Question 21

further etiology

Answer 21

men and women equal, but men earlier onset (15-25). advanced paternal age, increased incidence when born in colder months. possible viral etiology. maternal use of diuretics.

Question 22

neuronal abnormalities

Answer 22

hypofrontality (decreased glucose usage in the frontal cortex). lateral and third ventricle enlargement. abnormal cerebral symmetry (loss of asymmetry). changes in brain density, such as hippocampus, amygdala, parahippocampal gyrus. decreased alpha waves, increased theta and delta. there are also abnormalities in the eye movements.

Question 23

positive symptoms and DA

Answer 23

hyperdopaminergic (think that hyper dopamine such as stimulants can cause psychosis.)

Question 24

negative symptoms and DA

Answer 24

hypodopaminergic.

Question 25

dopamine hypothesis

Answer 25

excessive dopamine activity in the mesolimbic tract. negative symptoms caused by hypodopaminergic ailment of the mesocortical tract.

Question 26

common finding in many psychiatric illnesses regarding dopamine

Answer 26

frontal dopamine system is cold and the inner is hot.

Question 27

when the mesolimbic system is hyperactive what happens? when the mesocortical system is hypoactive what happens?

Answer 27

1. ) you get the positive symptoms. this comes from the hyperactivity of the dopamine system in the mesolimbic path.
2. ) you get the negative symptoms. this comes from the hypoactivity of the dopamine system of the mesocortical tract.

Question 28

other neurotransmitters

Answer 28

serotonin hyperactivity is associated with the delusion and hallucinations

Question 29

glutamate hypothesis of schizophrenia

Answer 29

that the NMDAR are underactive or ineffective. perhaps the glutamate ineffectiveness causes the dopamine systems malfunction.

Question 30

normal functioning of the mesolimbic system involves what neuronal path?

Answer 30

glu-GABA-glu-DA

Question 31

mesolimbic dysfunction in schizophrenia

Answer 31

the second glutamatergic neuron has a loss of proper function. there is a loss of inhibition in the glutamatergic neuron and thus excessive firing to the DA neuron. this causes the positive symptoms of the disorder.

Question 32

mesocortical normal circuits

Answer 32

glu-GABA-glu-GABA-DA

Question 33

mesocortical circuit dysfunction in schizophrenia

Answer 33

the loss is still within the second glutamatergic neuron. thus there is loss of inhibition from the previous GABA, causing excessive signaling to the GABAnergic neuron downstream and thus excessive inhibition of the DAnergic neuron. this causes hypodopamanergic state in the cortical path.

Question 34

brief psychotic disorder

Answer 34

1-29 days of schizophrenia symptoms

Question 35

schizophreniform

Answer 35

1-6 months of symptoms

Question 36

schizoaffective disorder

Answer 36

schizophrenia with mania or depression

Question 37

delusional disorder

Answer 37

delusions, but no other symptoms of schizophrenia

Question 38

shared psychotic disorder

Answer 38

one person with delusions and a second person shares the same delusion.

Question 39

antipsychotics general function

Answer 39

all block dopamine D2 receptors in the mesolimbic path. this does not decrease the availability of DA but blocks it action

Question 40

first generation typicals

Answer 40

haloperidol, chlorpromazine D2 receptor blockers. high and low potency respectively.

Question 41

atypical 2nd generation antipsychotics

Answer 41

also block histamine 5HT2a receptors. Pines and dones. these are first line agents because they have less negative effects such as TD, and parkinsonism from the antagonism of the nirgostriatal path.

Question 42

which neurotransmitters are excessive in schizo

Answer 42

DA, glutamate, serotonin, norepinephrine