4.1 Schizophrenia

Question 1

Psychosis

Answer 1

• Mental condition with disorganization of personality, deterioration in social functioning and loss of contact with or distortion of reality
• Hallucinations - False sensory perceptions not associated with real external stimuli
• Delusions - Fixed, false beliefs

PSYCHOSIS CAN OCCUR WITH OR WITHOUT PRESENCE OF ORGANIC IMPAIRMENT

SCHIZOPHRENIA IS THE MOST COMMON FORM OF PSYCHOSIS

Question 2

Schizophrenia

Answer 2

• Severe deterioration of social and occupational functioning
• Men are at greater risk and may develop the disorder earlier
• Suicide is the major contributor to the mortality statistic
• Symptoms usually appear late in adolescents or early adulthood

Question 3

Phases of Schizophrenia

Answer 3

Phase 1 - Premorbid Phase
- Occurs before there is clear evidence of illness. May include traits such as being very shy and withdrawn, having poor peer relationships, doing poor in school, and being antisocial

Phase 2 - Prodromal Phase
- Symptoms are clearly manifest. Between premorbid and psychotic symptoms. Usually lasts 2-5 years. Usually experiences deterioration in function, social withdrawal, and cognitive impairment. 5% complain of depression. Adolescents have sudden onset of obsessive-compulsive behavior. Recognition during this phase provides opportunity for early intervention.

Phase 3 - Acute Schizophrenic Episode
- Chronic illness with acute episodes. Symptoms include delusions, hallucinations, and impairment in work, social-relations and self-care.

Phase 4 - Residual Phase
- Remission after active phase of illness. Symptoms of active schizophrenia are no longer present. Symptoms are similar to prodromal phase. Flat affect and impairment in role functioning are prominent.

Question 4

Biological Factors of Schizophrenia

Answer 4

• Genetics
• Heritability

Question 5

Biochemical Factors of Schizophrenia

Answer 5

• Dopamine (Overactive neurotransmitter of dopamine)
• Excess dopamine dependent neuronal activity in the brain

Other causes
- Abnormalities in neurotransmitters (norepinephrine, serotonin, acetylcholine, gamma-aminobutyric acid, and neuroregulatory prostaglandins, endorphins).
- Excess serotonin may cause positive/negative affects of schizophrenia (evidenced by effectiveness of clozapine)

Antipsychotic medications block dopamine activity to decrease hallucinations/delusions
- When 1 neurotransmitter is blocked, others increase which cause many side-effects.

Question 6

Physiological Factors of Schizophrenia

Answer 6

• Autoimmune antibodies developed from infection of neurotoxic virus
• Structural brain abnormalities (ventricular enlargement is most common) and reduction in grey matter
• Reduced symmetry in several lobes of the brain

ADDITIONAL
- Viral infection
- Anatomical abnormalities
- Electrophysiology
- Epilepsy
- Huntington’s disease
- Birth trauma

Question 7

Environmental Factors

Answer 7

• Possible link with low socioeconomic class (poverty)

Explanation
- Congested housing accommodations
- Inadequate nutrition
- Absence of prenatal care
- Few resources for dealing with stressful situations
- Feeling hopeless for changing ones lifestyle of poverty.

Question 8

Downward Drift Hypothesis

Answer 8

• Symptoms of schizophrenia make it hard for these people to maintain employment. Poor social conditions is a consequence rather than cause of schizophrenia

Question 9

Theory of Schizophrenia

Answer 9

• Schizophrenia is a biological disease influenced by environmental factors

Question 10

Positive Symptoms of Schizophrenia

Answer 10

• What the patient is doing
• Agitated
• Delusions
• Paranoid
• Ideas of reference
• Hallucinations
• Illusions
• Associated disturbances
• Insomnia
• Disorganized speech
• Behavioral disturbances

Question 11

Negative Symptoms of Schizophrenia

Answer 11

• What the patient is not doing
• Speaking (Alogia - Poverty of speech/Lack of conversation)
• Enjoying anything (Anhedonia - inability to feel pleasure)
• Expressing Emotion (blunted affect)
• Grooming
• Absence of normal cognition
• Avolition - Total lack of motivation