Week 8 - Psychosis Flashcards
Positive psychotic symptoms
Hallucinations
Delusions
Disorganized speech
Negative psychotic symptoms
Anhedonia - reduced ability to experience pleasure
Anergia - lack of energy
Apathy - suppression of emotion
Avolition - not wanting to persist with activities
Cognitive psychotic symptoms
Cognitive impairment
Poor memory
Processing speed
When is Schizophrenia often developed?
19-23years old
Describe psychosis and the signs of psychosis.
An episode where one is detached from reality. A symptom of sleep deprivation, substance use, mental illness and other conditions.
Signs include:
- Hallucinations
- Delusions
- Agitation
- Disorganized thought and behaviour
Describe Schizophrenia and the signs of it.
A mental illness that impacts thought processes, emotions and behaviour. To be diagnosed, one must experience at least 2 of the following symptoms for 6 months, including one of the first 3:
- Delusions
- Hallucinations
- Disorganized speech
- Catatonic behaviour
- Negative symptoms (lessened emotional expression)
What are the contributing factors to Schizophrenia onset?
Genetic susceptibility (IL-6, MHC, IFR3)
Exposure to peripheral and central stressors in childhood (parent problems) elicit maladaptive responses to stress in immune cells
Environmental factor: those who live in the city have a 3% greater risk of developing Scz
Pregnancy infection increases the risk of Scz
Summarise how stress can result in schizophrenia (peripheral and central inflammation).
Stress results in peripheral inflammation (pro-inflammatory cytokine release - TNFa, IL-6, IL-1) and T-cell polarization to inflammatory phenotype.
Stress can also activate astrocytes (brain cell) and cause them to become reactive. They release cytokines which can cause neuroinflammation, loss of supportive function, glutamate toxicity, dysfunctional neuron activity.
Why is an early intervention crucial for first episode psychosis?
Pathology is still in its infancy and we can change the trajectory of illness to prevent long-term prognosis.
Early intervention facilitates better symptomatic and functional outcomes, better physiological condition, influences the chances of optimum recovery and increases lifespan.
Side effects of anti-psychotic drugs
- Fail to ameliorate negative and cognitive symptoms
- 33% SCZ don’t respond
- Poor motivation
- Emotional numbing
- Sedation
- Substantial weight gain
- Impaired glucose tolerance
- Hypertension (bp)
- Inflammatory abnormalities
- Dyslipidemia (cholesterol)
- Increased risk of premature mortality
What symptoms do antipsychotic drugs improve?
Effectively reduce positive symptoms experienced in SCZ (i.e. hallucinations, delusions, anxiety).
Operate via D2 dopamine receptor blockade reducing the amount of dopamine that can attach to receptors.
How does exercise influence T-cell subsets?
Regular exercise results in a phenotype shift to Th2 which releases anti-inflammatory cytokines and myokines
Benefits of exercise for SCZ
- Reduce inflammation: upregulation in peripheral anti-inflammatory processes and cytokines + growth factors that can pass BBB (brain-blood barrier) to elicit neuroprotective effects
- Offset antipsychotic induced weight gain
- Prevent CVD (insulin, glucose)
- Reduce premature mortality risk
Effect of exercise on cytokines and growth factors?
Increased
- IL-6
- IL-10
- BDNF
- GSH
- Th2
Decreased
- IL-6 (adipose)
- TNF
- Th1
Benefits of exercise in the brain and CNS.
- Increased grey matter volume
- Improved cognitive functioning (working memory, social cognition, attention)
- Influences neurogenesis and synaptic potentiation
- Downregulates cerebral cytokines to reduce neuroinflammation
- Delays onset of degenerative disease
