Schizophrenia Flashcards
Schizophrenia
a psychotic disorder involving serious impairment of attention, thought, language, emotion, and behaviour
•Coined by Eugen Bleuler
•Affects 1% of people in Canada
What does a diagnosis of schizophrenia require?
Evidence that a person misinterprets reality, and exhibits disordered attention, thought or perception
Delusions
false beliefs, often involving themes of persecution or grandeur, that are sustained in the face of evidence that normally would be sufficient to destroy them
What are two types of dilution?
Dilution of persecution
Dilution of grandeur
Hallucinations
false perceptions that have a compelling sense of reality (typically voices speaking to the patient)
What are 3 types of affects related to schizophrenia?
- Blunted affect: manifesting less sadness, joy and anger than most people
- Flat affect: showing almost no emotion at all
- Inappropriate affect: wrong emotions for the situation
What are the 4 subtypes of schizophrenia in the old DSM-IV-TR ?
Paranoid
Disorganized
Catatonic
Undifferentiated
What is typical for patients in catatonic state (not just for schizophrenia) ?
Striking motor disturbances,
• From muscular rigidity to random or repetitive movements
Catatonics can alternate between stuporous states in which they seem oblivious to reality and agitated excitement during which they can be dangerous to others
What is waxy flexibility?
Catatonics in a stuporous state may exhibit a waxy flexibility in which their limbs can be moulded by another person into grotesque positions that they will then maintain for hours
Type 1 schizophrenia
subtype of schizophrenia characterized by a predominance of positive symptoms
•subtype of schizophrenia characterized by a predominance of positive symptoms
Positive symptoms
- Better prognosis for recovery
* schizophrenic symptoms such as delusions, hallucinations, and disordered speech and thinking
Type 2 Schizophrenia
subtype of schizophrenia characterized by negative symptoms
Negative symptoms
- associated with a long history of poor functioning prior to hospitalization and poor outcome following treatment
- schizophrenic symptoms that reflect a lack of normal reactions, such as emotions or social behaviours
Structural differences (in brain) are more common in what type of schizophrenia?
Negative-Symptom
Brain atrophy
A general loss of deterioration of neurons in the cerebral cortex and limbic systems, together with enlarged ventricles (cavities that contain cerebrospinal fluid)
What does the neurodegenerative hypothesis say?
Destruction of neural tissue can cause schizophrenia
What brain abnormalities are associated with schizophrenia?
- Brain atrophy
- Abnormalities in the thalamus which sends bad information to the cerebral cortex accounts for disordered attention and perception
Dopamine Hypothesis
view that the symptoms of schizophrenia (particularly positive) are produced by overactivity of the dopamine system in areas of the brain that regulate emotional expression, motivated behaviour, and cognitive functioning
•People diagnosed with schizophrenia have more dopamine receptors on neuron membranes, and the receptors are overreactive
How do antipsychotic drugs work?
Reduce dopamine -produces synaptic activity
What are some biochemical factors to schizophrenia?
Dopamine overactivity
Deficiency of neural input from cortical areas play a role
Regression
a psychoanalytic defence mechanism in which a person retreats back to an earlier stage of development in response to stress
The Social Causation Hypothesis
The higher prevalence of schizophrenia to the higher levels of stress that low-income people experience, particularly within urban environments
The Social Drift Hypothesis
As people develop schizophrenia, their personal and occupational functioning deteriorates, so that they drift down the socioeconomic ladder into poverty and migrate to low-cost urban environments
Where is the likelihood of recovery of schizophrenia greater, developed or developing countries? Why?
Developing countries
•Stronger community orientation and greater social support extended to disturbed people in developing countries
What is the psychoanalyst perspective of schizophrenia?
What is the psychodynamic?
Cognitive?
Psychoanalyst: Regression
Psychodynamic: Focusing on the interpersonal withdrawal, view the disorder as a retreat from an interpersonal world that has become too stressful to deal with
Cognitive: A defect in the attentional mechanism that filters out irrelevant stimuli. The stimulus overload produces distractibility, thought disorganization and the sense of being overwhelmed by disconnected thoughts and ideas
What did PET scans reveal at times when schizophrenics were hearing voices?
The auditory and visual areas of the cortex were highly active, but there was no activity in the prefrontal cortex (prefrontal function to distinguish reality from fantasy)
Expressed emotion
a family interaction pattern involving criticism, hostility, and overinvolvement that is associated with relapse when formerly hospitalized schizophrenic patients return home
What is a theory of family dynamics on biological vulnerability?
Biological vulnerability factor must be present if stressful familial events are to cause their damage
