unit 7b

Question 1

schizophrenia

Answer 1

disorder characterized by POSITIVE symptoms:
- hallucinations, delusions, disorg. speech & thought
NEGATIVE symptoms:
- absence of normal cognition or affect, flat affect, poverty of speech, lack of motivation & cognitive symptoms (problems w/ working memory + attention)

Prevalence of symptoms is similar across cultures (1-2%)
- incidence = same for men & women

Question 2

hallucination (+)

Answer 2

perception in absence of stimulus
- stricter sense: defined as perceptions in a conscious & awake state in the absence of external stimuli ~ which have qualities of real perception, in that they are vivid, substantial, & located in external objective space (think sensory disorder)

Command hallucinations can occur + involve voices giving orders

Question 3

Delusion (+)

Answer 3

an idiosyncratic, irrational belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument
- typically a symptom of mental disorder (think thought disorder)

Question 4

Disorganized speech/thought (+)

Answer 4

Over-Inclusion
- jumping f/ idea to idea w/o benefit of logical association

Paralogic thought
-on the surface, thinking may appear logical, but is actually seriously flawed
- - ‘Para’= ‘almost’ or ‘next to’ so this terms means “almost logical”

Question 5

Flat affect (-)

Answer 5

affect is a medical term for mood

A patient has very little reaction to events around them
- display little-to-no emotion physically, & may not feel emotions very much either

Question 6

Inappropriate affect (-)

Answer 6

Mood (affect). patient displays does not match the circumstances

ex: laughing at serious things

Question 7

Catatonic behavior (catatonia) (-)

Answer 7

unresponsiveness to environment, usually marked by immobility for extended periods & echolalia

~Echolalia- parrot-like repetition of speech
~Wavy flexibility- a psychomotor symptom which leads to decreased response to stimuli & tendency to remain in an immobile posture

Question 8

Subtypes of schizophrenia

Answer 8

-Paranoid
-Disorganized
-Residual
-Catatonic
-Undifferentiated

Question 9

Paranoid type

Answer 9

well formed hallucinations & delusions (eg of persecution, grandeur)

Mostly positive symptoms /fewer symptoms

Most common & best prognosis

Question 10

Disorganized type

Answer 10

disorganized speech, silly behavior, & flat affect / disturbed emotional expression

Delusions & hallucinations are less pronounced than in the paranoid type + have little meaning or logic

Patients tend to be incoherent/unintelligible have issues w/ daily self-care
- AKA hebephrenic (‘childish behavior’)

Question 11

Residual type

Answer 11

primarily displays negative (-) symptoms like flat affect, reduced speech, lack of motivation

Question 12

Catatonic type

Answer 12

unresponsive to surroundings w/ echolalia, waxy flexibility; rare

Question 13

Undifferentiated type

Answer 13

Combination of hallucinations, specific delusions, & general disorganization
- no single symptoms type is most prominent

As w/ undifferentiated versions of other nuerorpsych disorders, these patients **dont fit well **into other categories

Question 14

Possible causes of schizophrenia

Answer 14

-congenital risks
-brain structure changes
→ hypofrontality hypothesis
-neurochemical changes
→ dopamine & glutamate

Question 15

Congenital risks (schizo.)

Answer 15

difficult birth (eg oxygen deprivation), prenatal viral infection

Question 16

brain structure changes (schizo.)

Answer 16

Enlarged ventricles, decr. hippocampus & amygdala, loss of temporal + frontal cortex

Question 17

Hypofrontality changes (schizo.)

Answer 17

theory that **problems in frontal lobe are assoc. w/ schizo. **

Ex; In identical twins, the 1 w/ schizo has decr. ↓ blood flow to frontal lobes

Schizophrenics have problems w/ exec. func. tasks like Wisconsin card sorting task.
- evidence suggests genetic & environ. changes to frontal lobes may cause schizo.

Question 18

neurochemical changes (schizo.)

Answer 18

Dopamine
- affects mood, energy, sexual desire & motor coordination
- may play role in schizo., esp. w/ hallucinations
-antipsychotic meds decr. ↓ dopamine

Glutamate
- key excitatory neurotransmitter
-key evidence suggests that glutamate decr. ↓ may be correlated w/ schizo.
-meds that incr. ^ glutamate DO NOT help symptoms (instead incr. ^ risk of seizures)

Question 19

Treatments for Schizophrenia

Answer 19

-Anti-psychotic medications
→ tardive dyskinesia
-Electroconvulsive Shock Therapy (ECT)
→ used mainly in CATATONIC schizo.
-Occupational therapy
→ self-care, work options

Question 20

antipsychotic medications

Answer 20

typical antipsychotic (older, more side effects) decr. ↓ dopamine BRAIN WIDE
- primary effect on POSITIVE (+) symptoms

Atypical antipsychotics (fewer side effects) affect dopamine pathways in more complex form & may also interact w/ serotonin pathways
- primary effect on POS. (+) symptoms, also some negative (-) ones

Question 21

Tardive dyskinesia

Answer 21

Possible permanent disorder of involuntary, repetitive, purposeless mvmts as side effect of long-term or high dose use of dopamine ANTAGONISTS, like antipsychotics

Compare to L-Dopa for Parkinson’s, (which cause psychosis [abnormal cognition like delusions + hallucinations] in patients w/ PD by incr. ^ dopamine too much )
- Here antipsychotics decr. ↓ dopamine so much that patients may develop mvmt disorders - tar dive dyskinesia specifically

Question 22

Schizophrenic Spectrum Disorders

Answer 22

-Schizophreniform disorder
-Schizoaffective disorder
-Schizotypal personality disorder
→ magical thinking
-Schizoid personality disorder

Question 23

-Schizophreniform disorder

Answer 23

disorder characterized by symptoms of schizo.
- FOR LESS THAN 6 MONTHS
- less social dysfunction than schizophrenia
-more likely recovery

May simply be early diagnosis of schizo.

Question 24

Schizoaffective disorder

Answer 24

disorder characterized by mood changes & psychosis

(think SCHIZO. + BIPOLAR disorder)

Question 25

Schizotypal personality disorder

Answer 25

personality disorder characterized by symptoms of:
- social anxiety, paranoia, inapp. & reduced affect, lack of close relationships, MAGICAL THINKING, & vague metaphorical speech

These symptoms resemble positive (+) symptoms of schizo., which is why its included in spectrum

Question 26

Magical Thinking

Answer 26

thought pattern commonly seen in schizotypal personality disorder
- patient experiences fear of performing certain acts & or having certain thought b/c of an assumed correlation b/t doing so & threatening calamities

may lead ppl to believe that their thoughts by themselves can bring abt effect in world or that thinking something corresponds w/ doing it

Question 27

Schizoid personality disorder

Answer 27

disorder characterized by:
- lack of interest in social relationships
- tendency towards solitary lifestyle
-secretiveness
- emotional coldness

These symptoms resembles negative (-) symptoms of schizo.

Such patients often act like HERMITS, happily withdrawing f/ society