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Module 202 Neuroscience & behaviour > Schizophrenia symposium > Flashcards

Schizophrenia symposium Flashcards

1
Q

What are some positive symptoms of schizophrenia?

A

Delusions
Hallucinations
Disorganised speech
Catatonia

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2
Q

What are some negative symptoms of schizophrenia?

A

Affective flattening
Alogia
Avolition
Anhedonia

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3
Q

What is the risk of family members being affected by psychosis?

A 
Parent - 5%
Sibling - 10%
Child - 13%
Child of 2 affected parents - 46%
Monozygotic twin - 45%
Dizygotic twin - 15%
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4
Q

What genome wide association studies have been implicated in schizophrenia?

A 
Major histocompatibility complex locus on chromosome 6
Gene encoding microRNA
TCF4
Region of chromosome 10
CSMD1
NGRN
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5
Q

What obstetric complications increase the risk of developing schizophrenia?

A 
Premature birth
Low birth weight
Perinatal hypoxia
Intrauterine infection in 1st / 2nd trimester
Antepartum bleeding
Immune activation
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6
Q

Describe the macro neurodevelopment abnormalities reported in schizophrenia

A 
Ventricular enlargement
Widening cortical sulci
Cortical grey matter loss
Loss of asymmetry
Decreased limbic structure & thalamic volume
Progressive deficits in some, if not all
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7
Q

Describe the micro neurodevelopment abnormalities reported in schizophrenia

A 
Cortical glial loss
Increased neuron density
Aberrant neuron migration
Synaptic loss
Decreased dendritic complexity
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8
Q

What deficits do neuropsychological abnormalities cause?

A 
Attention
Arousal (too much)
Working memory
Executive function
Eye movement
Social cognition
Theory of mind 
Loss of functional symmetry
Receptive language function
Subtle motor function, speech, IQ
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9
Q

What effect does blocking dopamine have on prolactin?

A

It increases prolactin release which leads to breast development in men, lactation & sexual dysfunction

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10
Q

What is reduced frontal glutamate associated with?

A

Negative symptoms

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11
Q

What is increased stratal dopamine associated with?

A

Positive symptoms

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12
Q

What drugs have a psychosis influence via dopamine, serotonin & glutamate function?

A 
L-DOPA
Amphetamine
LSD
Cannabis
Cocaine
Ketamine
MDMA
PCP
Other novel psychoactives
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13
Q

What is the differential diagnosis of psychosis?

A

Affective psychosis

  • Bipolar disorder
  • Depressive psychosis

Organic psychosis

  • Epilepsy (temporal lobe)
  • Infections - encephalitis, subacute sclerosing panencephalitis, HIV
  • Cerebral trauma
  • Cerebrovascular disease
  • Demyelination - multiple sclerosis
  • Neurodevelopmental disorders
  • Endocrine - thyroid disorders, Cushing’s syndrome
  • Metabolic - hepatic failure, uraemia
  • Immunological - SLE, autoantibodies
  • Drugs
  • Toxins - lead
  • Dementia

Personality disorder

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14
Q

What drug has the greatest efficacy in resistant cases?

A

Clozapine

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15
Q

What is the adverse effect of activating H1 receptor?

A

Histamine leads to sedation & weight gain

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16
Q

What is the adverse effect of activating M1 receptor?

A

Antagonism - constipation, urinary retention, blurred vision, confusion
Agonism (clozapine) - saliva overproduction

17
Q

What are the side effects of typical antipsychotics?

A 
Sedation
Extrapyramidal symptoms: parkinsonian symptoms, dystonia, akathisia, tar dive dyskinesia
Cardiac - hypotension, arrhythmia
Temperature dysregulation
Neuroleptic malignant syndrome
Anticholinergic side effects
Weight gain
Raised prolactin - galactorrhea, decreased sexual function, osteoporosis
18
Q

What are some atypical antipsychotics?

A 
Amisulpride
Aripiprazole
Clozapine
Risperidone
Olanzapine
Quetiapine
Lurasidone
19
Q

What are some long acting injections?

A 
Depixol
Clopixol
Piportil
Paloperidone (risperidone)
Aripiprazole
20
Q

Describe clozapine

A

Oral medication
Licensed with regular neutrophil monitoring
Slow titration to optimal dose with monitoring of pulse, BP & neutrophil count
Little parkinsonian effects or tardive dyskinesia
Sedation, weight gain

21
Q

Describe metabolic syndrome

A

Exacerbated by atypical antipsychotics
Obesity, dysglycaemia, dyslipidaemia, hypertension
Appears more prevalent in schizophrenics pre-treatment than general population
Higher risk of coronary heart disease, cerebrovascular pathology & earlier death

22
Q

Why can’t we just give medication?

A 
Treatment resistant symptoms
Partially resistant symptoms
Side effects
Service user choice
Comorbidity: anxiety, depression, PTSD
23
Q

CBT plan

A 
12-20 sessions
Timeline of events leading to psychosis
Relapse signature
Early warning signs
Crisis plan
Problem solving
Psychoeducation
Self-management
24
Q

What types of reasoning bias need to be changed?

A

Jumping to conclusions
External attribution bias
Selective attention
Theory of mind

25
Q

What is the session content for family intervention?

A

Sharing information about mental health problems & treatment
Problem solving
Crisis management
Managing medication compliance
Working on good communication between family members
Encouraging family members to refocus on own lives

26
Q

What family therapy techniques are there?

A

Sculpting
Reframing
Circular questions
Reflecting teams

27
Q

Describe the things worked on in art therapy

A 
Negative symptoms
Concentration
Isolation
Self-confidence
Creative medium to explore feelings
Safe space

Module 202 Neuroscience & behaviour (39 decks)

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