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IDAP > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Schizophrenia

A
  • Disorder of thought, split from reality.
  • Heterogenous.
  • Many symptoms
  • Not a split personality disorder
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2
Q

Describe the prevalence of schizophrenia and who is most affected

A
  • Under 1% of population
  • Late teens or early adulthood
  • Earlier in men than women
  • Women have better long term outcomes and less severe symptoms.
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3
Q

Describe the history of Schizophrenia

A
  • Krapelin was the first to classify as dementia praeco in 1898. Viewed it as an early onset form of dementia which had a progressive intellectual deterioration. Not a decline in all.
  • Bleuler renamed the disorder in 1908 to dissociate it from dementia. Characterised by disorganisation of thought processes, split from reality.
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4
Q

What are the three clusters of symptoms in Schizophrenia?

A

Positive
Negative
Disorganised

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5
Q

Positive Symptoms

A

Excesses and distortions of perception and thought. Something added to experience e.g. delusions and hallucinations

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6
Q

Delusions

A
  • Beliefs held contrary to reality and firmly held in spite of disconfirming evidence
  • Paranoid in nature - Feel like being spied on.
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7
Q

Thought insertion

A
  • Form of delusion
  • Believe thoughts belong to someone else
  • Placed by external source
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8
Q

Thought broadcasting

A
  • Form of delusion

- Believe others can read thoughts

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9
Q

Grandiose Delusions

A
  • Exaggerated sense of own importance

- Believe have power over others

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10
Q

How do those with schizophrenia have abnormal perceptions

A

De-realization - World has changed and no longer feels real.

Have heightened perception. Busy spaces are overwhelming.

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11
Q

Describe the hallucinations experienced by those with schizophrenia

A
  • They are sensory experiences. Auditory most common.
  • 75% report hearing voices
  • Voices telling them things, threatening to do things, violence.
  • Allen et al. (2004) - Those with these likely to misattribute recordings of their own speech to a different source.
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12
Q

Negative Symptoms (Schizophrenia)

A
  • Deficit e.g. in motivation, mood
  • Usually in chronic cases
  • Strong predictor that may not respond well to treatment
  • Poor quality of life
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13
Q

Provide examples of negative symptoms (schizophrenia)

A

Avolition: Lack of motivation and absence in interest

Asociality: Social withdrawal

Anhedonia: Inability to experience pleasure. Deficit in anticipatory pleasure, don’t see hope in future activities.

Blunted Affect: Lack of outward expression of emotion (66%)

Alogia: Reduction in amount of speech

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14
Q

Disorganized Symptoms (Schizophrenia)

A
  • Fragmentation of cognitive function
  • Problem maintaining thought and speech, attention.

Loose Associations - Able to communicate, but can’t stick to one topic

Catatonia: Abnormality of movement. Overactivity e.g. gesture repeatedly or may not move for hours. Seen less now.

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15
Q

Identify the symptoms of schizophrenia as described in DSM-5

A
  1. Delusions
  2. Hallucinations
  3. Disorganised speech
  4. Disorganized behaviour
  5. Negative symptoms
  • Impair life, work etc.
  • Has to be present for longer than 6m.
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16
Q

State some of the differential diagnoses from schizophrenia and how they differ

A

Schizoaffective Disorder - Mixture of schizophrenia symptoms and mood disorders.

Schizophreniform Disorder - Schizophrenic lasting 1-6m

Brief Psychotic Disorder - 1 day to 1 month. Brief

Delusional Disorder - Delusions in absence of other schizophrenia symptoms. Less bizarre e.g. think have disease

Substance Abuse: Alcohol, meth

Medical: Tumours, fever

17
Q

Explain the genetic risk factors associated with schizophrenia

A
  • Negative symptoms have stronger genetic component
  • DZ Twins: 12%
  • MZ Twins: 44.30%
  • Gottesman et al. (2010) - 2million ppl, Denmark. Higher rates of it in those with 2 parents who have it (27.3%)
  • No single gene predicts it.
  • Some suggestion that genes can predict other disorders, but difficult to find one specific.
18
Q

Explain the dopamine hypothesis in regards to schizophrenia

A
  • Suggest its due to excess activity of dopamine.
  • Parkinson’s - Treatment incs dopamine, patients show psychotic symptoms like schizophrenia. Evidence that due to overreation of dopamine.
  • Effective drugs reduce dopamine activity
  • Excess numb of dopamine receptors or oversensitive dopamine receptors
  • Not complete - medications take weeks to show effects. Physiological instant. Why is this?
19
Q

Explain the role of serotonin in regards to schizophrenia

A
  • Newer anti-psychotic medications more effective than old as they block the serotonin receptor 5HT2.
  • Regulates dopamine transmission in the mesolimbic pathway.
20
Q

Explain the role of GABA in schizophrenia

A
  • Inhibitory function
  • Deficits led to inhibition problems
  • Said to be disrupted in the prefrontal cortex of those with schizophrenia
21
Q

Explain the role of glutamate in schizophrenia

A
  • Low levels found in the cerebrospinal fluid of those with disorder
  • Low levels of enzyme needed to produce glutamate
  • NDMA part of glutamate system
22
Q

How are the ventricles impacted in schizophrenia?

A
  • Are fluid filled sacs with cerebral spinal fluid
  • Size increases over course of illness, making brain matter decrease
  • Impaired perf on neuropsychological tests
23
Q

How is the prefrontal cortex impacted in schizophrenia?

A
  • Role in speech, decision-making, emotion which are all disrputed in schiz.
  • MRI show reduction in gray mater.
  • Fewer dendritic spines - Communication among neurons disrupted
  • Reduced metabolic activity which place demands on area
24
Q

How is the temporal cortex impacted in schizophrenia?

A
  • Reduced volume of hippocampus - Memory deficits and brain areas associated with language processing
  • Abnormal amygdala activity - Heightened activity of emotion processing, hallucinations?
25
Q

How can socio-economic status play a role in schizophrenia?

A
  • Highest rates in poor urban areas
  • Sociogenic Hypothesis - Stress from social status can increase onset of disorder?
  • Social Selection Hypothesis - Having the disorder can make it more likely to fall into poverty. Favoured.
26
Q

How can family factors play a role in schizophrenia?

A
  • Expressed Emotion - Communication patterns of families with schizophrenia different to healthy. More hostile. More likely to relapse.
  • Brown et al. (1966) - Interviews with parents. 10% of those low in EE families relapsed compared to 58% in high EE families.

Environment important.

27
Q

Explain the biological treatments to schizophrenia

A

1st gen neuroleptic medications - Reduce dopamine activity

2nd gen antipsychotics - Better response rate. Dopaminergic and serotonergic effects. 70% respond to treatment.

Extrapyramidal Effects - Serious side-effects like Parkinson’s

Electroconvulsive Therapy - Seizures induced. Low usage.

Psychosurgery - Prefrontal lobotomies - Can reduce some symptoms, but cognitive deficits

28
Q

Explain the psychological treatments to schizophrenia

A
  • Only beneficial when combined with medication.
  • Many lack insight - don’t believe have disorder
  • Social Skills training - Deal with probs integrating into society.
  • Psychoanalysis
  • Family therapy - Improve EE
  • CBT - Can reduce negative symptoms
  • Psychoeducation - Teach about their disorder and symptoms. More likely to take medication

IDAP (5 decks)

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