Schizophrenia

Question 1

What is schizophrenia?

Answer 1

1. Positive symptoms:
   - Lack of insight
   - Hallucinations
   - Delusions
   - Suspiciousness
   - Flatness of affect
   - Delusional mood
   - Thought alienation
   - Thoughts spoken aloud
2. Negative symptoms:
   - Social withdrawal
   - Self-neglect
   - Loss of motivation and initiative
   - Emotional blunting
   - Scarcity of speech
3. Disorganised thoughts

Question 2

How can schizophrenia be treated?

Answer 2

1. Pharmacologically  Typical or atypical antipsychotics
2. Cognitive behavioural therapy
3. Family therapy
4. Psycho-education
5. Cognitive remediation therapy
6. Social skills training

Question 3

Neurobiology of schizophrenia

Answer 3

1. Orbitofrontal dysfunction = Responsible for violent behaviour
2. Frontal hypometabolism
3. Disturbances in temporal lobe (hippocampus and para-hippocampal gyrus)
4. Subcortical dopaminergic system = Hyperactive = Could be responsible for positive symptoms
5. Cortical dopaminergic system = Hypoactive = Could be responsible for negative symptoms
6. COMT gene = Enzyme breaking down dopamine = Dysfunction could lead to higher doses of dopamine
7. Dopamine receptor D4 = Associated with novelty-seeking

OVERALL = They don’t know, there is no clear or consistent neurobiological theory

Question 4

Schizophrenia and violence

Answer 4

1. No clear correlation

2. A very small percentage of schizophrenics are violent