Schizophrenia Flashcards
What is schizophrenia co-morbid with?
depression, excessive nicotine, alcohol and substance use, and an increased risk of cardiovascular disease.
How many commit suicide?
5-10%
What are positive symptoms of schizophrenia?
delusions, hallucinations, thought disorders
What are negative symptoms of schizophrenia?
decreased motivation, diminished emotional expression
What are cognitive deficits of schizophrenia?
impairments in attention, executive function, certain types of memory
What are sensory abnormalities of schizophrenia?
gating disturbances
What are sensorimotor abnormalities of schizophrenia?
eye tracking disturbances
What are motor abnormalities of schizophrenia?
impaire posturing
What was schizophrenia once called?
dementia praecox
What are the 4 A’s of schizophrenia according to Bleuler?
Loosening associations
Autistic/ideosyncratic though and behavior
Ambivalence
Disturbance in affect
What is true about early views of schizophrenia?
positive symptoms were view as accessory or secondary
How do schizophrenics score against controls for cognitive deficits?
1.5-2 SD below the healthy controls and 73% rate as impaired vs 15% of general pop.
98% perform more poorly than predicted by parental educational level. Useful as an at risk predictor.
What happens to cognitive impairments prior to first break?
It gets worse. Ability declines in high school. This could be progressive, sudden shift, or they could start behind and just remain behind.
IQ also drops off from childhood to post diagnosis unlike with others.
What do monozygotic twin studies show about cognitive deficits?
affected twin is poorer than unaffected twin who is poorer than control twins.
Also, high risk children with two affected parents have attention deficits during childhood
How are psychotic features different from cognitive deficits?
They’re not persistent and they can burn out.
What is true about early vs late onset of first episode?
Early (youth) onset have larger deficits on most cognitive measures, but late onset have relatively preserved functions.
They both have deficits in attention, global cognition and IQ, but executive function and psychomotor speed and verbal memory are more affected in youth-onset.
Age of onset predicts severity.
What do measures of cognitive function predict?
Social functioning, employment, treatment adherence, relapse prevention, medical comorbidity.
They do not predict psychotic features.
What cognitive domains are most affected (or best studied) in schizophrenia?
vigilance and attention
verbal memory worse than visual memory
verbal fluency (list of words begins with letter A)
social cognition
working memory (verbal and non-verbal material, also mental rearranging of material)
What is shown about improvement of working memory with age in schizophrenia?
It declines on the same curve as other cognitive problems (or not declines, but fails to improve linearly) from 6-22
What is true about working memory and rewards in schizophrenia?
They have lower WM capacity and faster decay, but normal reinforcement learning so it’s not a reward system disturbance.
ie. they aren’t bad at the task because they don’t care about the reward. Their deficit is due to failure to learn outcomes which is a result of WM.
What area is associated with schizophrenia as a focus of this lecture? How do they know?
Dosrolateral prefrontal cortex as seen in fMRI, network oscillations by EEG, and GABA neurotransmission assessment postmortemly
How was decreased working memory shown in fMRI?
Lack of BOLD response in DLPFC for items present 2 back, but not 1 back.
What increases with working memory load in humans? What is true about schizophrenic patients?
DLPFC Gamma Band Power but these are practically nonexistant in fMRI studies of DLPFC.
I think this means more neurons are firing
What is critical for gamma oscillations and working memory?
Pyramidal neuron-parvalbumin GABA neuron circuitry in the DLPFC layer 3