Schizophrenia [SYMPOSIA] Flashcards
What Environmental / Biological stress factors are associated with schizophrenia
Obstetric complications ↑risk (from meta analysis):
- Premature birth - Low birth weight - Perinatal hypoxia
Intrauterine infection 1st/2nd trimester (winter births)
Antepartum bleeding
Immune activation
Neurodevelopmental abnormalities reported in schizophrenia at the MACRO level
Ventricular enlargement widening cortical sulci cortical grey matter loss loss of asymmetry ↓limbic structure and thalamic volume Progressive deficits in some, not all
Neurodevelopmental abnormalities reported in schizophrenia at the MICRO level
Cortical glial loss ↑neurone density aberrant neurone migration synaptic loss ↓dendritic complexity
Negative Symptoms in Schizophrenia
Affective flattening
Alogia
Avolition
Anhedonia
Positive Symptoms in Schizophrenia
Delusions
Hallucinations
Disorganised speech
Catatonia
Give examples of organic diseases that cause psychosis
Temporal lobe epilepsy
dementia
Infection
trauma
Drug treatments
Typical/old- e.g Haloperidol. Only block DA
Atypical/new. Blocks other receptors such as 5HT, alpha 1, M1
Clozapine has the greatest efficacy in resistant cases.
Treatment benefit usually clinically evident by 2 weeks
Side effects are predicted by receptor affinity of the drug.
HALOPERIDOL
Typical antipsychotic
CLOZAPINE
atypical antipsychotic oral associated with more side effects neutropenia- can develop infection/sepsis Sedation, weight gain, dribbling common
RISPERIDONE
atypical antipsychotic
Electroconvulsive treatment
Not a primary treatment of psychosis
Very effective in psychosis associated with depression or with catatonia
Cognitive Behaviour Therapy (CBT) for Psychosis (CBTp)
12-20 sessions
Treatment resistant symptoms
Alternative to medication for distressing symptoms
Aim is to relieve distress and increase function rather than “treat” delusions or “get rid” of hallucinations.
