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Behavioral Health II > Sutherland- Schizophrenia > Flashcards

Sutherland- Schizophrenia Flashcards

1
Q

What is schizophrenia and when is it’s onset?

A

Severe neurodevelopmental illness.

Onset in early adulthood after years of prodromal symptoms.

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2
Q

What are the key symptoms of schizophrenia?

A

Cognitive impairment
Affective sx
Perceptual and thought disturbance
Social function impairment

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3
Q

What is the prevalence of schizophrenia?

A 
Less than 1% of pop
M (17--27) >F (17-37)
Loss of >20 years 
Urban > rural
Low SES > high (social drift)
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4
Q

Describe cognitive impairment in schizophrenia.

A

Precedes onset of classical psychosis.
Outlasts hallucinations and delusions
Poor working memory/attention.
Impaired frontal-executive function and disorganized thought.
-disrupts relationships w/ friends, coursework in school

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5
Q

What are Negative Sx associated with schizophrenia?

A 
Apathy
Flat affect
Withdrawal
Social avoidance
Poor motivation
Self neglect
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6
Q

What are positive sx?

A

*Paranoid delusions/nihilistic
Hallucinations (auditory > visual > other)
Odd behavior

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7
Q

How is social funcitoning impaired with schizophrenia?

A

Educational, vocational, independent living, small social networks

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8
Q

What are the subtypes of schizophrenia?

A

Disorganized
Paranoid
Catatonic (movements slowed/excessive)
Undifferentiated

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9
Q

Where does mental illness come from?

A 
Noted for 3000 years.
1700s psychosis seen as disease.
1900s asylum research identified as illness.
1950s de-institutionalization.
19902 first SGAs.
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10
Q

What are the risk factors associated with schizophrenia?

A

Positive family hx
Perinatal complications-infection
Late winter/early spring births have higher likelihood
Lower rates in village cultures
Use of stimulant, hallucinogenic drugs and marijuana have a 3x increase

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11
Q

What is the course of schizophrenia?

A

Onset: late teens
20s: 5-10 years of acute illness
Late illness: positive sx decline
High mortality: medical illness, accidents > suicide

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12
Q

What is suicide risk w/ schizophrenia?

A

HUGE risk of suicide 4-5%
Death by heart disease at lesat 50% higher than population rates
Lifespan reduce by more than 20 years.

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13
Q

What is the pathophysiology of schizophrenia?

A

Increased brain DA
Loss of brain mass (dorsolateral prefrontal cortex deficit, enlarged ventricles, decreased temporal lobe)
Loss of brain connections (white matter)

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14
Q

What is the genetic component of schizophrenia?

A

Increase in risk with first degree relative (both parents w/ schizophrenia)
Concordance with monozygotic twins

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15
Q

How do perinatal issues and infections relate to schizophrenia?

A 
Maternal infections
birth complications
Rh incompatibility
Malnutrition
Late winter/early spring
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16
Q

How do immune issues and schizophrenia relate to schizophrenia?

A 
*Higher incidence of schizo
Higher latitude
Influenza
Borna disease
Borrelia
Toxoplasmosis
REtrovirus
Poliomyelitis
17
Q

What is expressed emotion theory?

A

Difference in course of illness with families with harsher vs calmer environments.

18
Q

What causes psychosis? What are the sx of psychosis? What drugs induce psychosis?

A

Increase in DA
hallucinations, paranoia, manic sx
Amphetamine, cocaine, L-dopa

19
Q

What reduces psychotic sx? Drugs?

A

Decreased DA
Antipsychotics
Campazine, Reglan

20
Q

What is observed in untreated schizophrenia?

A

Increased DA

21
Q

How does 5HT relate to schizo?

A

5HT stimulates DA

22
Q

How does Glutamate relate to schizo?

A

May cause an increase in DA

-PCP blocks Glu (best drug model of pschizophrenia)

23
Q

How does GABA relate to schizo?

A

Modulates DA and Glu

24
Q

Why do people w/ schizophrenia (80%) have a high rate of nicotine use?

A

Helps to stimulate primary nicotinic receptor decrease that’s a part of the disease. Increases metabolism to reduce blood levels of medication.

25
Q

How does NE relate to schizo?

A

If it decreases may worsen neg sx

26
Q

What are the neurodevelopmental factors related to schizo?

A

Disturbed brain development
Loss of brain development with enlarged ventricles
Superior temporal gyrus loss
Dorsolateral prefrontal and limbic disconnect
Cortex/thalamus/cerebellum disturbance (+ sx)

27
Q

What are the key features for diagnosis?

A 
Chronic illness > 6 mos
Deterioration from previous funciton level
Complex psychotic sx >2:
-hallucinations
-delusions
-speech disorganization
-disorganized behavior
-negative sx
Not better explained by another illness
28
Q

What is the differential diagnosis for schizophrenia?

A
  1. Psychiatric Disordes
    - Other psychotic disorders
    - Mood disorders (20% have hallucinations)
    - Autism: odd behavior, positive sx not as prominent
  2. Substance use disorder
    - Amphetamine and other stimulants
    - synthetic cannabinoids, marijunana, PCP
    - comorbidity up to 65%
  3. General medical disorder
    - brain tumor
    - metabolic, endocrine, infectious, neurological
    - drugs
    - dementia
29
Q

What is a schizoaffective disorder?

A

Schizophrenia + concurrent major mood sx that are persistent through disorder

30
Q

What is a delusional disorder?

A

Paranoia, minimal hallucinations, GOOD FUNCTION

31
Q

What is a schizotypal personality?

A

Social isolation, lack of desire for relationship

Odd ideas, experiences but no delusions/hallucinations

32
Q

How can you differentiate between mania and schizophrenia?

A

Schizo-slow thought processing

Mania- fast thought processing

33
Q

What is the treatment for schizophrenia?

A
  1. Medication: D2 DA blockers, NMDA receptors should work but we don’t have a drug yet
  2. Rehabilitation and Recovery: employment

Behavioral Health II (20 decks)

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