Cognition- Schizophrenia

Question 1

Definition

Schizophrenia

Answer 1

profound neurobiological disorder characterized by psychotic symptoms, diminished capacity to relate to others, odd or bizzare behaviors

Question 2

Involuntary commitment

Answer 2

person is unable to care for self or deemed a danger to self or others

Criteria: danger to self and/or others

Question 3

Emergency vs. Civil/Judicial commitments

Answer 3

Emergency- risk of harm to self or others
Civil- protects the community from person posing a threat

short term & long term

Question 4

DE’s commitment Process

Answer 4

Complaint
Arrest/Custody
ED physician exam determines danger
Taken to psych facility
Psychiatrist certifies as mentally ill (hold for 2 days)
Court determines involuntary commitment

Question 5

Structural anatomic alterations

Answer 5

-decreased matter of gray matter
-enlarged ventricles/sulci

Question 6

Neuro

Neurotransmitter abnormalities

Answer 6

-dopamine system
-nicotine acetylcholine receptors
-dysregulation of NMDA subclass of glutamine receptors

Question 7

Etiology

Answer 7

mylenation and reorganization of neuronal structures that typically occur in adolescence

Question 8

Risk factors

• Genetic
• Epigenic
• Psychological
• Developmental

Answer 8

• Genetic: first degree relatives have 50% risk
• Epigenic: birth complications, poor prenatal care, weed use
• Psychological: early life adversities
• Developmental: stress during developmental periods

Question 9

Symotomatology

Positive vs. Negative

Answer 9

Positive: Hallucinations, delusions, alterations in speech, bizarre behavior, manifestations of things that are not normally present

Negative: Affect, alogia, anergia, anhedonia, avolition

Question 10

Phases of Schizophrenia

• phase I- premorbid
• phase II- prodromal
• phase III- acute
• phase IV- residual

Answer 10

phase I- nonspecific emotional, cognitive and motor delays
phase II- symptomatic period with shift from premorbid functioning. sleep disturbances, poor concentration, social withdrawal, weak/mild symptoms of psychosis
phase III- onset of florid psychotic positive symptoms, causes significant distress, if untreated if may be difficult to treat
phase IV- stabilization and maintenance

Question 11

Dopamine pathways

1. mesolimbic
2. mesocortical
3. tuberoindunfibular
4. nigrostriatal

Answer 11

1. responsible for positive symptoms
2. responsible for negative symptoms
3. responsible for increased prolactin levels
4. responsible for movement disorders from medications

too much or too little dopamine

Question 12

Role of typical antipsychotics in the dopamine pathways

Answer 12

• block all 4 pathways
• good for positive symptoms not good for treating negative symptoms
• movement disorders increase due to lack of dopamine into nigrostriatal

Question 13

DSM-5 criteria for schizophrenia

must be present >6 months

Answer 13

must have caused significant impairment of functioning in one or more areas
* home
* work
* self-care

Question 14

generic names

typical antipsychotics

Answer 14

• chlorpromazine
• haloperidol
• loxapine

Question 15

adverse effects

typical antipsychotics

Answer 15

• anticholinergic effects
• sexual effects
• endocrine effects
• EPS
• NMS