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Schizophrenia Flashcards

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1
Q

What is schizophrenia

A

Disorder of thought and mind

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2
Q

What is the incidence of schizophrenia

A

About 1%

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3
Q

What are the three types of symptoms of schizophrenia

A

Negative
Cognitive
Positive

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4
Q

What are negative symptoms of schizophrenia?

A

Poverty of speech [alogia], Low initiative [avolition], Apathy
Social withdrawal, Anhedonia

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5
Q

What are cognitive symptoms of schizophrenia?

A

difficulty with sustained attention
low psychomotor speed
Deficits in learning and memory
Poor abstract thinking and problem solving

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6
Q

What are positive symptoms of schizophrenia?

A

Delusions [beliefs that are contrary to reality]
Hallucinations [perceptions that occur in the absence of stimuli]
Thought disorder [disorganised and irrational]

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7
Q

What have adoption studies shown about schizophrenia

A

Adopted adult schizophrenics are likely to have schizophrenic biological relates

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8
Q

What have twin studies shown about schizoophrenia?

A

Concordance rates are higher for identical than fraternal twins

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9
Q

What is believed to be the role of genes in schizophrenia

A

May pass on susceptibility to develop schizophrenia

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10
Q

What are the two major hypotheses as to etiology of schizophrenia?

A
  1. Dopamine hypothesis [positive symptoms are consequence of over activity of brain dopaminergic synapses]
  2. Atrophy of brain [explain negative symptoms]
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11
Q

What was originally identified as effective antipsychotic agent?

A

Chlorpromazine

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12
Q

What does chlorpromazine do?

A

blocks DA receptors [D2]

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13
Q

What do drugs that block DA receptors do?

A

reverse schizophrenia

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14
Q

What do amphetamines do

A

release DA - produce positive symptoms of schizophrenia

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15
Q

Where is dopamine overactivity likely to be located in schizophrenia?

A

in mesolimbic pathway

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16
Q

What is the pathway in mesolimbic pathway that’s essential for reinforcement?

A

Ventral tegmental to nucleus accumbens

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17
Q

What are possible causes of increased DA transmission in schizophrenics?

A

Increased DA release
Increased postsynaptic response to DA release
Prolonged activation of postsynaptic receptors

18
Q

What are the three ways that DA release can be increased in transmission?

A

More excitatory input to DA neurones
Less inhibitory input to DA neurones
Fewer or defective autoreceptors on DA neurones

19
Q

What are the two ways that postsynaptic response to DA release in transmission can be increased?

A

More postsynaptic DA receptors

Greater response in postsynaptic neurones to activation of DA receptors

20
Q

How can DA postsynaptic receptors be activated longer?

A

Decrease reuptake of DA by DA terminal button

21
Q

Why is it difficult to discover the cause of increased DA transmission in schizophrenia?

A

Probably different for different patients

22
Q

What does chlorpromazine do to postsynaptic receptor?

A

Biologically inert - doesn’t open a channel, blocks it instead tf reducing dopamine pathways

23
Q

What does amphetamine do to neurotransmitters?

A

promotes release and inhibits uptake

24
Q

What was effect of amphetamine dose on striatum of schizophrenics?

A

Greater release of dopamine [shown in PET studies], related to the increase in positive schizophrenia symptoms

25
Q

What have studies of dopamine receptors in schizophrenic brains shown?

A

Postmortem studies suggest increased D2 receptors in striatum

  • may be due to exposure of anti-psychotic drugs
  • could be wrong site
  • schizophrenia may be related to D4 or D3 sites
26
Q

What do antipsychotic medications do for schizophrenia?

A

diminish the thought disorder

27
Q

What causes the negative symptoms of schizophrenia?

A

Brain damage

28
Q

What are neurological signs evidence in schizophrenia

A

eye tracking problems
catatonia
problems with blinking, eye focusing and visual pursuit

29
Q

Describe brain ventricles in schizophrenics?

A

Enlarged

30
Q

What do enlarged brain ventricles indicate?

A

loss of brain cells

31
Q

What are the abnormal regions of schizophrenic brain?

A

Prefrontal cortex
Medial temporal lobes
Medial diencephalon

32
Q

What prenatal events might cause brain damage in schizophrenia?

A

Birth trauma
Viral infections that impair neural development during second trimester
Nutritional issues
Maternal stress [compromising immune system of mother]
Shared placenta vs separate placenta

33
Q

When are people with schizophrenia more likely to be born

A

late winter or early spring

34
Q

WHat is hypofrontality?

A

decreased activity of dorsolateral prefrontal cortex [behavioural flexibility - card sorting tasks]

35
Q

What relationship does PCP have with NMDA receptors

A

indirect antagonist [in dlpfc]

36
Q

What are NMDA receptors?

A

most common glutamate receptors

37
Q

What does PCP to do excitatory glutamate receptors?

A

Antagonises them, particularly in dorsolateral prefrontal cortex, and reduces dopamine usage in the area [decreased capacity]
[different in mesolimbic area]

38
Q

What are the negative and positive symptoms produced by PCP?

A

underactivity in prefrontal cortex

overactivity in nucleus accumbens

39
Q

What does PCP do to nucleus accumbens?

A

results in positive symptoms of schizoprenia [increased activity]

40
Q

What do new antipsychotic drugs like clozapine and aripiprazole do as treatment for schizophrenia?

A

improve both positive and negative symptoms
reduce dopamine release in mesolimbic system
increase it in the PFC

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