schizophrenia + psychosis Flashcards
what is schizophrenia ?
mental illness impacting thought processes, emotions and behaviour
what is needed to classify them under that category ?
at least 2 symptoms in 6 months such as:
delusions
hallucinations
disorganised speech
catatonic behaviour
negative symptoms
what is psychosis ?
an episode where on is detached from reality
can be a symptom of slip deprivation, substance use, mental illness
give examples of positive, negative and cognitive symptoms
positive: hallucinations, delusions
negative: anhedonia, anergia, apathy, avolition
cognitive:cog impairment, poor memory, processing speed
what is the prevalence of schizophrenia ?
affects 20 million people worldwide
top 10 most debilitating disorders (global burden of diseases review)
economic burden of 3.7 billion by 2026
Explain genetic vulnerability
person can be put into stressful situation which can lead to expression of illness
stress can increase cortisol and increase development risk
living in a city can increase risk due to increased stress compared to living in the countryside (Faris & Dunham 1939)
when is schizophrenia most likely to develop?
late teens and early adulthood
how does exposure to peripheral and central stressors effect development of schizophrenia ?
they can elicit a maladaptive response ti stress in immune cells
stress activates astrocytes, increasing reactivity of body , increasing inflammation in the brain
how does maladaptive response to stress effect neurotransmitters and immune system ?
neurotransmitters such as glutamate can be toxic if overreleased
t- cell polarisation to inflammatory phenotype
increases in IL-6 represents heightened inflammation/immune activation
how do antipsychotic drugs benefit people ?
regulate dopamine in the brain (dopaminergic transmission) and control neurotransmissions
only treats positive symptoms
what are issues of anti-psychotics ?
weight gain
- can lead to diabetes due impaired glucose tolerance
doesn’t alleviate neg+ cog symptoms
33% people don’t respond
hypertensions, inflammation abnormalities , CV disease , metabolic syndrome
what are the benefits of early intervention in FEP ?
clinically effective and cost effective
facilitates better:
symptomatic + functional outcomes
physiological condition
influences chances of optimum recovery
what did Dunleavy et al 2022 find on biomarkers and what did the research involve ?
meta- analysis on links between biomarkers and negative symptoms
found a moderate positive relationship between IL-6 and negative symptoms
significant elevated pro inflammatory cytokines in FEP populations and findings on relationships bewteen inflammation + neg symptoms
what did shaw et al 2018 see about t-cells during inflammation
during inflammation:
- Th1 expression of t-cells
- pro inflammatory cytokine release (causes inflammation)
- reactive O2 species from into lipids + proteins
- impedes cell function leading to cell damage
what did Shaw et al 2018 find about T cells during exercise ?
during exercise:
- t-cells shift from Th1 into Th2
- creates anti-inflammatory cytokines
- reduces inflammation
What HR is best to create anti-inflammatory responses ? and why
?
60% HR max and above
facilitates up regulation of cytokines + growth factors to elect neuroprotective effects
helps offset weight gain from antipsychotic drugs , prevents glucose intolerance
how does exercise benefit the brain ?
increases grey matter - improving brain function
improved cog functioning, working memory, social cognition , attention
influences neurogenesis + synaptic potentiation
down regulates cerebral cytokines to reduce neruoinflammation
delays onset of degenerative diseases
who did a FEPEX 12 week intervention with participants working at 50-70% Hr max and what was the outcome ?
fisher et al 2020
pps worked at 50-70% HR max doing different sports like tennis, running and circuits
80% adherence
significant reduction in positive symptoms and general psych symptoms
no significant change in negative symptoms, no inflammation changes
what did Firth et al 2016 find on exercise interventions for FEP?
31 patients did 10 week exercise intervention aiming for 90 mins of mod-vig exercise with individualised training programmes
pps average of 107 mins a week
positive and negative symptom scores reduced significantly compared to control
neg symp reduced greatest by 33%
Cv fitness + processing speed positive associated with exercise
what did Dunleavy et al 2022 research in a 6 week intervention?
looked at effects of moderate-vig exercise on inflammation biomarkers + negative symptoms in FEP
what did the study search + find ?
2 session a week of individualised exercise
1 group exercise session of football
worked at 65-75% HR max in 60 min sessions
group session would create highest Hr average
significant reduction in basal circulating IL-6 concentration after working at target HR
significant reduction in negative symptoms
no signif change in positive/general/ cog symptoms
what are benefit of dunleavy et al 2022 study ?
exercise can be used in treatment of symptom profiles not targeted by anti-psychotics
exercise can cause significant inflammation biomarker change
what are limitations of Dunleavy et all 2022 study ?
only conducted on men
- can’t generalise to women
