Schizophrenia Flashcards
What are the different types of schizophrenia?
Paranoid, disorganised, catatonic, undifferentiated and residual
What are the positive symptoms of schizophrenia?
Hallucinations, delusions, agitation and disorganised thinking
What are the negative symptoms of schizophrenia?
Introversion, apathy and low-self esteem
What are the cognitive symptoms of schizophrenia?
Poor memory, attention deficit and executive dysfunction
How can you diagnose schizophrenia?
Two or more of the following (present for significant portion during one month): delusions, hallucinations, disorganised speech, grossly disorganised behaviour and negative symptoms (affective flattening)
How do you test for frontal cortical dysfunction?
Wisconsin card sorting test
What is the concordance rate of schizophrenia?
50% between identical twins
What genes are associated with schizophrenia?
BDNF (neurotrophic factor), COMT (dopaminergic transmission), DAOA (glutamatergic transmission), Neuregulin 1 (neuroplasticity), dysbindin (D2 receptors)
What structural changes may you see in an MRI of those with schizophrenia?
Slightly larger ventricles and smaller mesial temporal lobe
How does blood flow change in those with schizophrenia?
Decrease in blood flow to the prefrontal cortex and an increase in blood flow to the thalamus and cerebellum
What is Kraepilinian dichotomy?
A progressive, deteriorating course of schizophrenia where there is loss of brain matter, and is a form of neurodegeneration
Why do symptoms of schizophrenia tend to develop around the age of 20?
Due to abnormalities int he later stages of neural maturation when the prefrontal cortex is developing around the age of 20
How does schizophrenia affect the mesolimbic and mesocortiyal pathways?
Hyperactivity in the mesolithic and hyperactivity in the mesocortical pathways (dopaminergic pathways)
What is the major drug target for schizophrenia?
D2 receptor, but dopamine receptors broadly
What are the first line treatments for schizophrenia?
Atypical antipsychotics (antagonise 5-HT2)
Why is clozapine a particularly good atypical antipsychotic drug?
It can be used in drug resistance
How does clozapine work?
Blocks D4 receptors with high affinity to act as an atypical antipsychotic
What are the side-effects of typical antipsychotics?
Extrapyramidal effects (such as parkinsonism and tardive dyskinesia), QT interval prolongation, sudden death and hyperprolactinaemia
Why are atypical antipsychotics preferable to typical antipsychotics most of the time?
Less extrapyramidal effects (acute dystopias, parkinsonisms, tardive dyskinesias
What is the cause of the extrapyramidal effects of typical antipsychotics?
The drugs require 60% occupancy of D2 to work but if there is greater than 80% this causes side-effects (very narrow therapeutic window)
What are the side-effects of atypical antipsychotics?
Weight gain, hyperglycaemia, insulin resistance, dyslipidaemia and cardiovascular disease
What is neuroleptic malignant syndrome?
Potentially lethal complication with symptoms of hyperpyrexia, muscle rigidity, tremor and confusion
What is tardive dyskinesia?
Irreversible complication which involves the involuntary movement of the lips, jaw and face (grimacing), constant chewing or tongue thrusting
What is the most common cause of tardive dyskinesia?
Taking typical antipsychotics for longer than a few months or years
