Schizophrenia Flashcards
What are diagnostic criteria of schizophrenia?
- 2 or more characteristic sx for 6 months: delusions, a/vh, disorg speech, grossly disorg or catatonic behavior, negative sx
- social/occupational/interpersonal dysfunction
- not attributed to another condition or medication
What characteristics of schizophrenia are associated with real-world outcomes?
- Cognitive disturbance and negative sx more though than positive sx
- Early detection and treatment initiation soon after onset
- social support, good premorbid adjustment, precipitating events, co-occurring mood disturbance, minimal residual sx
What were the different variants of schizophrenia in prev. versions of dsm?
- paranoid
- disorganized
- catatonic
- undifferentiated
- residual
How do neurodevelopmental models hypothesize development of schizophrenia?
- Heritable risk when genes underlie neurodevel. and brain maturation, along with others involved in signal transduction
- Disrupted signaling pathways in embryogenesis lead to faulty neurocircuitry during maturation
- environmental stressors + genetic vulnerability results in d/o
What neuropathological abnormalities might be implicated in schizophrenia?
- reduced dendritic complexity
- lower spine and synapse density of cortical pyramidal neurons
- cortical and subcortical reductions in gray matter volume
- decreased gray matter integrity
- premorbid behavioral and neurological signs
- irregularities in amygdala, hippocampus, limbic sys, BG,
What’s the estimated heritability of schizophrenia and rate of concurrent dx in twins?
- 80 to 85% overall
- Risk of developing schizophrenia increases in severity with the degree of genetic relationship
- Dizygotic twins, 10-19%
- Monozygotic twins, 40-50%
What obstetric complications increase risk for schizophrenia?
- maternal infection during pregnancy
- malnutrition
- labor and delivery complications
- prematurity
- LBW
What’s the typical age of onset of schizophrenia and gender trends?
- Late adolescence to young adulthood (15-35)
- early onset associated with poorer prognosis
- females have later illness onset, lower negative sx severity, greater affective sx, and better social, cognitive, premorbid functioning than men
Common medical comorbid dxs with schizophrenia?
- cardiovascular disease
- obesity
- DM
- HTN
- hyperlipidemia
What’s the rationale behind the dopamine hypothesis of schizophrenia?
- Excessive dopamine; neuroleptics block dopamine receptors can be effective in tx of schizophrenia
- Amphetamines can block reuptake; individuals taking amphetamines can display sxs of schizophrenia
What are common premorbid features before dx of schizophrenia?
- Poorer social adjustment and intelligence
- Behavioral signs shyness, learning difficulties, withdrawn, clumsiness, depressed mood
What are common features of prodromal stage in schizophrenia?
- Attenuated positive sxs or brief intermittent psychotic sxs
- Functional impairments
- Cognitive deficits in verbal memory, attn, emotion regulation, olfactory processing
What are features of acute/first-episode psychosis in schizophrenia?
- full threshold psychotic sxs
- prominent cognitive impairments in memory, attn, EF
- Problems with social, academic, occupational functioning
- Psychotic sxs can last weeks to months if untreated and can fluctuate from exacerbation to relative stability or remission
What are common features of schizophrenia not included in DSM criteria?
- Inappropriate affect, laughing
- disturbed sleep pattern
- dysphoric mood
- anxiety and phobias
- depersonalization
- derealization
- cognitive deficits
- lack of insight into d/o
- hostility and aggression
What’s a residual phase in schizophrenia?
-Psychotic sxs are largely remitted but negative sxs may continue, odd beliefs, poor social functioning, persistent cognitive impairment
