Schizophrenia AO1 Flashcards
What are the positive symptoms of schizophrenia?
1) Hallucinations - sensory experience not reality/ distorted perception. Examples;
- single person talking or many
- hearing voices
- voices instructing to do harm to others or themselves
2) Delusion - belief that makes sense to them and not to others;
- of persecutions (others want to harm)
- of grandeur (important individual)
- of control (under someone elses control/manipulation)
What are the negative symptoms of schizophrenia?
1) Avolition - severe loss of motivation (unwillingness);
- not going out with friends
- no enthusiasm for hobbies
- doing nothing
2) Speech poverty - reduction in amount and quality of speech
- short empty replies to questions
What is reliability of Sz diagnosis?
When psychiatrists can agree on the same diagnosis when independently assessing patients (inter-rater reliability)
What is validity?
The extent to which we are measuring what we intend to measure. E.g. validity of diagnostic tools? For example do different assessment systems arrive at the same diagnosis?
What is symptom overlap?
Overlap between the symptoms of schizophrenia and other conditions.
- E.g. Sz & bipolar share + symptoms like delusions and - symptoms like avolition
- Validity?
- DID more Sz symptoms than Sz patients
What is comorbidity?
More than one disorder/disease that exists alongside a primary diagnosis.
- E.g. both Sz & personality disorder frequently diagnosed together (validity?)
- Can’t tell the difference?
- Actually just one condition?
What is culture bias?
- Research shows variation between countries in Sz diagnosis. Ethnic background impacts diagnosis
- Copeland, 134 US psychys & 194 UK psychys, 69% US diagnosed Sz and 2% UK diagnosed Sz
- same symtpoms, different diagnosis
What is gender bias?
- Boverman in US mentally healthy ‘adult’ behaviour = mentally healthy ‘male’ behaviour (androcentrism)
- Psychiatrist gender affects diagnosis (females overdiagnosed)
Family studies?
(genetic)
- strong relationship genetic similarity and shared risk
- Gottesman, aunt 2%, sibling 9%, identical twin 48%
Candidate genes?
(genetic)
- Sz is polygenic (several genes) and aetiologically heterogenous
- Ripke found 108 separate genes, increased risk of Sz
- Miyakawa PPP3CC - calcineurin production, regulates immune system
- Brown correlation paternal age and risk (sperm mutation)
Original dopamine hypothesis?
(neural correlates)
- Hyperdopaminergia of subcortex (associated with hallucinations and speech poverty
Updated dopamine hypothesis?
(neural correlates)
- Hypodopaminergic in prefrontal cortex (could explain negative thoughts)
Enlarged ventricles?
(neural correlates)
- fluid filled gaps between brain areas
- associated with damage (negative symptoms)
What is the cognitive explanation?
- Dysfunctional thought processing, lower info processing in areas suggests cognition impaired
- Frith
1) Metarepresentation - reflection on thoughts/behaviour, disrupts ability to ‘hearing voices’ (hallucination) and having thoughts placed in mind (delusion)
2) Central control , disorganised thinking, ability to suppress automatic responses, derailment of thought
Typical antipsychotics
- Combat positive symptoms
- E.g. Chlorprozamine
- Reduces/blocks effect of dopamine
- Called ‘dopamine antagonists’ as they bind to dopamine receptors (D2) reduce action
- Eliminate hallucinations & delusions
- Doesn’t stop negative symptoms & causes side effects (tardive dyskinesia)
