Schizophrenia - Biological explanations & treatments Flashcards

genetics, family studies, twin studies, adoption studies, other studies, neural - dopamine, brain structures, typical & atypical antipsychotics, evaluations

1
Q

Genetics

A

Genes passed on through family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Family studies

A

Compare concordance rates between different degree relatives -> higher concordance rates = genetic basis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Twin studies

A

Compare concordance rates of monozygotic and dizygotic twins to find similar correlations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Adoption studies

A

Is environment or genetics the cause -> compare adopted children to their biological & adoptive parents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Candidates genes

A

Particular genes focused on to study development of features

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Polygenic

A

Multiple genes involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Aetiologically heterogenous

A

Different combinations of factors/genes lead to disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lifetime risk of schz

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Genetic study: Riley & Kendler

A

First degree relative w/disorder -> 10x greater risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Genetic study: Gottesman (family study)

A

2% blood aunt, 9% sibling, 48% identical twin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Genetic study: Tienari et al (adoption study)

A

7.5% when biological parents have schz, even if they grow up in adoptive family

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Genetic study: Hilker et al (twin study)

A

33% identical, 7% non-identical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Genetic study: Ripke et al (candidate genes)

A

108 separate genetic variations associated with risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Genetic counselling

A

Discussions about physiological & mental health and how it will impact individual’s family/children, understand their own genetics & family’s genes/risks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other factors: Di Forti et al

A

Increased risk associated with high level THC smoking in teenagers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Other factors: Morgan et al

A

Complication during birth increase the risk

17
Q

Other factors: Mokved et al

A

67% of their participants had at least 1 childhood trauma (compared to 38% in control group)

18
Q

Dopamine hypothesis (original)

A

Hyperdopaminergia on subcortical level (higher levels of dopamine) -> increased positive symptoms

19
Q

Dopamine hypothesis (updated)

A

Hypodopaminergia on cortical level (lower levels of dopamine) -> increased negative symptoms (+increased stress in early experiences -> more sensitive)

20
Q

Studies on dopamine: Falkai

A

Schizophrenic patients post-mortem -> increased dopamine in left amygdala

21
Q

Studies on dopamine: Tenn et al

A

Amphetamines induced schizophrenic-like symptoms in rats and reduced with other drugs

22
Q

Drug use & psychosis

A

Abuse of opioids
- experience psychotic-like symptoms (hallucinations)
- increases release of dopamine
- deficiency of endorphins increases dopamine release & result in psychosis (withdrawal)

23
Q

Other: Garson

A

Refutes ideas of drug-related psychosis imitating schizophrenia

24
Q

Other: McCutcheon et al

A

Glutamate (responsible for learning, attention & memory) differs for each schizophrenic patient (candidate genes impact)

25
Brain abnormalities
- Enlarged ventricles & reduced grey matter - 2.6% smaller brains (Haijma et al) - 6% lighter (Brown et al)
26
BA: Allen
Patients with auditory hallucinations -> lower activation levels in superior temporal gyrus & anterior cingulate gyrus
27
BA: Juckel et al
Negative correlation between avolition & activity in ventral striatum
28
Treatment: typical antipsychotics
Dopamine antagonists developed in 1950s -> block D2 receptors
29
Typical: Chlorpromazine
- Reduce action of dopamine - Makes dopamine build up initially - Production then decreases - Decreases positive symptoms - Indiscriminately blocks all dopamine activity - Side effects: tardive dyskinesia, sedative effect (histamine receptor impacted), agitation
30
Treatment: Atypical antipsychotics
Dopamine antagonists & other neurotransmitters developed in 1970s to act on both symptoms
31
Atypical: Clozapine
- Weak binding to inhibit D2 & D5 receptors - Inhibits S2, norepinephrine and histamine receptors - Mood-enhancing effects - Initially led to agranulocytosis (deaths) - Only given when others fail - Must have regular blood tests
32
Atypical: Risperidone
- Developed in 90s - Stronger binding to dopamine & serotonin receptors - Fewer side effects
33
Positive of biological treatments
+ Cost-effective (only £15 for 28 x 10mg chlorpromazine compared to £60 therapy) + Economic impact (fewer hospitalisations & people able to function/work) + Ethical (independent living without need for institutionalisation and sedatives mean they are calm enough to engage in additional treatments)
34
Effectiveness of biological treatments (+)
+ Bagnall & atypicals (more effective - fewer movement disorders, fewer leave treatment early, Clozapine effective in 30-50% resistant cases [Meltzer]) + Leucht et al (more effective than placebos) + Thornly et al (chlorpromazine reduced severity of symptoms & improved functioning)
35
Negatives of biological treatments
- Ethics (severe side effects cause harm, reduce adherence) - Outdated research i.e. dopamine hypothesis (drug treatments may not be appropriate, typical only help pos. symptoms, treatment fallacy)
36
Effectiveness of biological treatments (-)
- Tarrier et al (improved severity of symptoms better paired with CBT than alone) - Healy (only focus on short-term effects rather than long-term and could just be because of the powerful calming effect) - Moncrieff (easier for staff to manage than help patient [chemical cosh] which misleads patients)