Week 10 Flashcards
People with mental illness are violent and dangerous People with mental illness are poor or less intelligent
Mental illness is caused by a personal weakness
Mental illness is a single, rare disorder
Mental Illness myths
In mental illnesses ________ are common.
Comorbidities are common
True / False: Many mental illnesses are very complicated as 1.__________________________________ and 2.________________________________________
Because of this mental illnesses should be shown as a 3.__________________
- Many people who fit a diagnosis for one
mental disorder may partially fit the
diagnosis for another as well - People may not completely match any
specific diagnosis. - Spectrum (Severity of Symptoms)
Originally called Dementia Praecox
(“premature dementia”; Emile Kraepein,
1883).
(“splitting of mind”), a split
between the emotional and intellectual
aspects of experience (Eugen Bleuler, 1910)
- Disorganized speech
- Disorganized behavior
- Hallucinations
- Delusions
- Psychosis
- Emotional/Affective Symptoms
- Cognitive impairment
etc
Schizophrenia
Schizophrenia that involves: frequent visual and auditory hallucinations /delusions, disorganized speech, trouble
concentrating, and significant behavioral impairment.
Paranoid
Schizophrenia that involves: Excessive movement (__________ excitement), or decreased movement ( ________ stupor), Inability to speak (mutism), mimicking words (echolalia), and mimicking actions (echopraxia).
Catatonic
(Excessive movement (catatonic excitement), or decreased movement ( catatonic stupor).)
Schizophrenia that involves: Disorganized behaviors and nonsensical speech in the absence of delusions and
hallucinations.
– Most common form
Disorganized
Schizophrenia that involves: Previously diagnosed - no longer experiencing prominent symptoms
– still exhibited symptoms including a flattened affect, psychomotor difficulties, and disturbed
speech
Residual
Schizophrenia that involves: symptoms fit into more than one subtype of schizophrenia
Undifferentiated
Schizophrenia’s prevalence is higher in ______ than
______ (_____ratio)
Men than Women (7:5 Ratio)
True / False: Schizophrenia is more prominent in ________
prosperous
countries than 3rd World
Schizophrenia: Etiological Theories
n Genetic Theories
n Twin studies
n Adoption studies
n Gene mutation
n Neurodevelopment Hypotheses
n Neurology of Schizophrenia
n Seasonal effects
n Dopamine & Glutamate Hypothesis
Genetics in Schizophrenia shows that:
■ Adopted children studies
suggest a genetic role.
– Prenatal environment of
the biological mother
cannot be discounted.
■ Environmental influence,
such as family environment,
shown to have a role
In Schizophrenia Genetics, one major rare gene disruption is known to greatly increase the risk of schizophrenia, mostly by disrupting the development of glutamate synapses or by
interfering with the immune system. This is known as
DISC1 (disrupted in schizophrenia 1) controls differentiation and
migration of neurons in brain development.
Suppported by
§ High prevalence of “broken copy” in large Scottish family over 5
generations - development of schizophrenia, bipolar & other mood
disorders (St. Clair et al, 1990)
§ Meta-analysis confirmed overall association and found strongest
estimate in Chinese population (Wang et al., 2018)
§ Animal studies:
§ Mutant mice with no DICS1 in brain stem cells show behaviors that
mimic schizophrenia
In Schizophrenia Genetics, one major rare gene disruption occurs because a gene protein important for
neurodevelopment is defective, this is known as
Neuregulin 1 (NRG1 )
Despite some genes showing correlations to schizophrenia, a new more popular hypothesis (other than DISC1 and NRG1) shows that schizophrenia is
not just one gene, but new mutations in
any one of hundreds of genes
The neurodevelopmental hypothesis for Schizophrenia suggests
Abnormalities in the neonatal development of the nervous system leads to mild abnormalities of brain anatomy and major abnormalities in behavior
- Abnormalities could result from genetics or other influences (e.g.,
intrauterine environment)
- Environmental influences later in life aggravate the symptoms
The neurodevelopmental hypothesis for Schizophrenia: research shows that
Research evidence:
- Babies born from mother who contracted flu in 1st trimester 7x more likely to develop schizophrenia
- Increased schizophrenia rates among people born 2-3 months after
major influenza epidemics
Risk factors increasing the likelihood include:
n Poor nutrition of the mother during pregnancy
n Premature birth
n Low birth weight
n Complications during delivery
n Extreme stress of mother during pregnancy
n Immunological rejection e.g., Rhesus factor(Rh) incompatible
n Other infections during pregnancy (Toxoplasma gondii)
n Postnatal stressors
etccccc
Schizophrenia?: The two-hit hypothesis
Schizophrenia is the result of a combination of a genetic
predisposition and impacts from the environment in
prenatal/neonatal development, later in life, or both
Brain Area Abornormalities as a result of Schizophrenia
- Enlarged lateral ventricle and prominent sulci
- Decreased tissue cerebral gray matter
- Smaller PFC and hippocampus
- Less gray matter and white matter
- Reduced cortical connectivity and activity
- Glial reductions (glial theory) : oligodendrocytes and myelin integrity (DISC1); altered microglia in temporal and frontal lobes; astrocyte
glutamate transporters in PFC
Schizophrenia:The Dopamine Hypothesis
Positive symptoms are
caused by over-activity of
synapses between dopamine
neurons of the ventral
tegmental area (VTA) and
nucleus accumbens and
amygdala (Mesolimbic)
(TOO MUCH DOPAMINE)
The Glutamate Hypothesis
Schizophrenia due to excessive glutamate / under-stimulation of
glutamate receptors.
Glutamate neurons fail
to excite DA neurons
(negative symptoms)
Glutamate neurons fail to excite GABA
neurons (GABA = Inhibitory)
Mesolimbic path
overactivated
Before antipsychotic drugs became
available in the mid-1950s, most
people with schizophrenia were
indefinitely confined to ______________
mental
hospitals.
