Chapter Fifteen Flashcards

1
Q

Schizophrenia affects…

A

1% of the population

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2
Q

When do symptoms of schizophrenia emerge?

A

between late teens and mid-thirties

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3
Q

What is the mortality rate of those with schizophrenia?

A

10% due to suicide

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4
Q

Positive symptoms

A

made known by its presence; non-schizos will NOT do this

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5
Q

Negative symptoms

A

made known by its absence; non-schizos WILL do this

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6
Q

Biological determinants of Schizophrenia

A

heredity; studies of adoption ruled out environment; MZ twins run a 50% concordance rate; likely that children inherit a vulnerability that is brought out by something environmental

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7
Q

Dopamine/Pharmacology of Schizophrenia

A

over-accumulation of dopamine in the brain; DA antagonists reduce positive symptoms, while agonists make them worse;

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8
Q

What drug products Schizophrenia symptoms?

A

cocaine

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9
Q

Too much dopamine?

A

too much released, receptors might be overly sensitive to DA, slow reuptake keeps DA in synapse

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10
Q

Laruelle et al. (1996)

A

when given amphetamines, schizos released more DA than controls

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11
Q

Other studies done on Schizo’s show..

A

increased number of DA receptors in brains of schizo patients

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12
Q

What appears to account for positive symptoms?

A

increased DA

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13
Q

Weinberger & Wyatt (1982)

A

ventricles getting larger ; other studies show the cortex is getting smaller, which is normal process of aging, but accelerated in schizos

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14
Q

Epidemiological Research

A

studies of diseases among a population-looks at trends in occurrences

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15
Q

Seasonal Effects of Schizo

A

more born between Feb and May; numbers increased if previous fall was especially cold; could be a virus/bacteria picked up in fall/early winter that “plants the seed” for manifestation later on; higher rates in cities; higher rates in babies born after flu epidemic; higher rates in women who experience extreme stress during pregnancy;

NOT cause and effect; but points to environmental trigger for the disease

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16
Q

Monochorionic (MC)

A

fed by 1 placenta; share amniotic sac; same prenatal environment; 60% concordance rate with Schizo

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17
Q

Dichoriotic (DC)

A

fed by 2 placenta; 2 amniotic sacs; 11% concordance rate with Schizo

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18
Q

If split happens after day 4—>

A

MC

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19
Q

If split happens prior to day 4–>

A

DC

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20
Q

Unipolar

A

major depression

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21
Q

bipolar

A

mania and depression

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22
Q

what percent of those with unipolar attempt suicide?

A

15-30%

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23
Q

Biological Substrates of Affective Disorders

A

run in families; if close family member suffers, others 10x as likely, 69% concordance rate among identical twins, 13% concordance rate among fraternal twins

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24
Q

Bipolar

A

lithium salts work 70-80% of patients; curbs manic symptoms, no lasting side effects

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25
Q

What do schizo patients report feeling before an episode?

A

euphoria/elation before an episode which might be the same system involved in rewarding drug effects

26
Q

Unipolar depression treatments

A

increase NE and SE levels in the brain

27
Q

MAO inhibitors

A

work but have side effects

28
Q

Tricyclic antidepressants

A

early meds that work

29
Q

SSRI

A

specific serotonin reuptake inhibitors- prozac is well known

30
Q

How long to antidepressants typically take to work?

A

2-4 weeks

31
Q

Electroconvulsive Therapy (ECT)

A

physicians noticed improvement in symptoms after patients had seizures

32
Q

What are the steps to ECT?

A

anesthesia, muscle relaxers, current applied to right hemisphere

33
Q

How many treatments do ECT patients get?

A

3x/week for 2-4 weeks

34
Q

What is the side effect of ECT?

A

memory loss

35
Q

Monoamines

A

depression is accociated with insufficient monoamines, especially NE and SE

36
Q

What do monoamine antagonists do?

A

cause depression- reserpine is used to blood pressure but has a side effect of depression

37
Q

What is related to monoamine depletion?

A

suicidal tendencies

38
Q

Brain imaging studies

A

found difference in activity in the amygdala & prefrontal cortex, but no differences in structure

39
Q

What type of sleep do depressed people show?

A

shallow sleep; more stage 1, less stage 3/4

40
Q

REM sleep deprivation and depression

A

effective treatment; takes a few weeks to be effective, just like antidepressants

41
Q

Scherschilicht et al. (1982)

A

looked at common meds for treating depression and all of them affected REM sleep patterns

42
Q

Total sleep deprivation and depression

A

produces immediate relief of depressions

43
Q

Wu and Bunny (1990)

A

showed that responders benefit the most from total sleep deprivation

44
Q

responders

A

those who feel more depressed in the morning but get in a better mood as the day progresses

45
Q

Seasonal affective disorder (SAD)

A

depression caused by changes in seasons…specifically in sunlight exposure

46
Q

what does light exposure regulate?

A

melatonin released by pineal

47
Q

What do SAD patients often crave?

A

carbohydrates; will show weight gain during episodes

48
Q

what is the most effective treatment for SAD?

A

phototherapy

49
Q

Anxiety Disorder physiological symptoms

A

rapid breathing, sweating, dry mouth, increased heart rate

50
Q

Anxiety Disorder psychological symptoms

A

feeling of dread; fear

51
Q

Panic Disorder

A

unpredictable bouts of high anxiety

52
Q

Who does anxiety disorder effect?

A

1-2% of population; early onset equal among males and females

53
Q

causes of anxiety disorders

A

runs in families; higher rates for MZ twins

54
Q

How are anxiety disorders triggered?

A

arousal of autonomic nervous system; caffeine, amphetamines

55
Q

How are anxiety disorders treated?

A

medications and behavioral therapy

56
Q

OCD

A

upsetting thoughts (O) and repetitive behaviors (C)

57
Q

who does OCD effect?

A

1-2%; females slightly more

58
Q

what are different examples of those with OCD?

A

counters, checkers, cleaners

59
Q

Treatment of OCD

A

medications show promise, but its a hard disorder to treat

60
Q

causes of OCD

A

linked to tourettes syndrome, birth trauma, encephalitis, head trauma

61
Q

What are the brain differences in those with OCD?

A

differences in the basal ganglia and prefrontal cortex; increased activity in frontal lobes and caudate nucleus