Schizophrenia I & II Flashcards
What part of the brain gets bigger in schizophrenia?
Ventricles
What is schizophrenia?
Irrational divergence between behavior and thought content. Debilitating disease associated with genetics, and exacerbated by stress.
What is the schizophrenic “downward drift”?
The average patient becomes worse over time
What is schizophrenic psychosis?
Impairment in reality testing that may present as hallucinations, delusions, abnormalities in thought processes
What is “loss of ego boundaries”?
Not knowing where one’s mind and body and and those of others begin
What is Echolalia (Clanging)?
Repeating statements of others/rhyming words
What is alogia?
Speaking few or no words
What is a neologism?
Creating new words
What are the major characteristics of schizophrenia?
At least one episode of psychosis with persistent disturbances of thought, behavior, appearance, speech and affect (emotion) as well as impairment in occupational and social functioning
What are the criteria for schizophrenia Dx?
A. At least two of following Syx present of significant portion of time during 1-month period:
Delusions, Hallucinations, Grossly disorganized or catatonic behavior, negative Syx, Disorganized speech
B. Social/occupation dysfunction
C. Duration >= 6 months with at least 1 moth of Syx that meet “A”
D. Schzoaffective and Mood Disorder Exclusion: Syx can’t be due to another illness
What are positive Syx of schizophrenia?
Delusions, Hallucinations, Agitation, Talkativness, Thought Disorders (Respond well to drugs)
What are negative Syx of schizophrenia?
Lack of motivation, social withdrawal, flattened affect/emotion, cognitive disturbances, poor grooming, poor speech
What are the 5 subtypes of Schizophrenia?
Undifferentiated (most common), Paranoid (delusions of persecution), Residual (At least one psychotic episode with subsequent negative Syx, mild positive Syx), Disorganized (Incoherent speech, bizarre behavior, poor grooming, inappropriate emotional responses
What are the three phases of the course of schizophrenia?
Prodromal, Psychotic/Active, Residual
What is the prodromal stage of schiz?
Prior to first psychotic break, avoidance of social activities, quiet/passive or irritable, sudden interest in religion/philosophy, physical complaints, anxiety/depression
What is the psychotic/active stage of schiz?
Loss of touch with reality (positive Syx)
What is the residual stage of schiz?
period betwixt psychotic episodes in touch with reality but doesn’t behave normally (negative Syx)
What are neurologic abnormalities found in a schizophrenic brain?
Decreased use of glucose in frontal lobe, lateral and third ventricle enlargement, loss of symmetry, change in brain density, decreased alpha waves, increased theta and delta waves, abnormal eye movements
What is the Dopamine Hypothesis of Schizophrenia?
Excessive dopaminergic activity in mesolimbic tract; Too much dopamine from the ventral tegmental area activates the mesolimbic pathway and causes positive symptoms
What does serotonin hyperactivity cause?
Hallucinations and delusions
What is the major excitatory neurotransmitter in the CNS?
Glutamate
Describe the Glutamate Hypothesis (Positive Symptoms)
NMDARs that normally sit on GABA interneurons become abnormal. GABA inhibitiory interneurons are not stimulated by Glutamate and therefore do not inhibit Glutamate neurons going to the VTA. There is overstimulation of the VTA which produces Dopamine. Excess dopamine is pumped into the mesolimbic system causing positive psychotic events.
Describe Glutamate Hypothesis for (Negative Symptoms)
Within the prefrontal cortex pathway, a glutamatergic neuron is unable to bind to the NMDA receptor on the GABA interneuron. The interneuron no longer puts the brake on a glutamate neuron which over stimulates a further downstream inhibitory neuron. This inhibitory neuron stops dopamine from going to frontal lobe!
What is considered a brief psychotic disorder?
1-29 days of schizophrenia symptoms
