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Flashcards in Behav. Sci. L2. Deck (48)
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1
Q

schizophrenia definition

A

“split mind” irrational divergence between behavior and thought content - chronic, debilitating illness associated with deterioration in mental function and behavior

2
Q

when does schizophrenia begin?

A

young adulthood (1/100)

3
Q

what is the hallmark symptom of schizophrenia

A

psychosis - hallucinations, delusions, abnormalities in thought process/organization

4
Q

illusion

A

misperception of REAL external stimuli (distortion)

5
Q

hallucination

A

sensory perceptions not generated by external stimuli

6
Q

ideas of reference

A

false conviction that one is subject of attention by other people (crowds, TV, radio, internet) - feeling as though people are referring to you in their conversations - common

7
Q

delusion

A

false beliefs not correctable by logic or reason - no based on simple ignorance and not shared by culture

8
Q

loss of ego boundaries

A

not knowing where one’s mind and body end and those of others begin

9
Q

alogia

A

lack of informative content in speech, lacking/poverty of speech

10
Q

echolalia

A

repeating statements of others/associating words by their sounds, not by their meaning (I’m very sure i’ve got the cure and i’m not pure”

11
Q

though blocking

A

abrupt hult in the train of thinking, often bc of hallucination

12
Q

neologisms

A

inventing new words

13
Q

circumstantiality

A

in responding to questions, one presents unnecessary and voluminous details ultimately arriving at an answer to the question posed

14
Q

tangentiality

A

beginning a response in a logical fashion but then getting further and further away from the point an fail to answer the questions initially posed

15
Q

loose associations

A

loss of logical meaning btw words or thoughts

16
Q

characteristics of schizophrenia

A

at least one episode of psychosis with persistent disturbances of thought, behavior, appearance, speech and affect (emotion) as well as impairment in occupational and social functioning

17
Q

how does schizophrenia contrast with delirium or substance abuse

A

schizos do not have clouding of consciousness

18
Q

what are the DSM-5 diagnostic criteria?

A
  1. characteristic symptoms (2+); 2. social/occupational dysfunction; 3. duration of AT LEAST 6 MONTHS; 4. cannot be due to another illness 5. cannot be due to substance use
19
Q

what are the characteristic symptoms of schizophrenia

A

delusions, hallucinations, grossly disorganized or catatonic behavior, negative symptoms (flat affect, alogia, avolition), disorganized speech

20
Q

what are the positive symptoms of schizophrenia

A

symptoms that are additional to expected behavior: delusions, hallucination, agitation, talkativeness, thought disorder - respond well to most tradition and atypical antipsychotic agents

21
Q

what are the negative symptoms of schizophrenia

A

symptoms that are missing from expected behavior: lack of motivation, social withdrawal, flattened affect/emotion, cognitive disturbances, poor grooming, poor/impoverished speech

22
Q

prodromal schizophrenia

A

prior to first psychotic break: avoidance of social activities, quiet and passive or irritable, sudden interest in religion or philosophy, physical complaints, anxiety and depression common

23
Q

psychotic/active schizo

A

loss of touch with reality - positive symptoms

24
Q

residual schizo

A

period between psychotic episodes, in touch with reality but doesn’t behave normally - negative symptoms (peculiar thinking, eccentric behavior and withdrawal from social interactions)

25
Q

men vs women with schizo

A

occurs equally in men and women but earlier in men (15-25; women 25-35) and women respond better to antipsychotic meds but have a greater risk of tardive dyskinesia

26
Q

neurological abnormalities in schizo

A

abnormalities in front lobes (decreased use of glucose); lateral and third ventricle enlargement; abnormal cerebral symmetry; changes in brain density (decreased volume of hippocampus, amygdala, and parahippocampal gyrus); EEG abnormal; abnormal eye movements

27
Q

which part of the brain is hyperactive while hallucinations occur?

A

auditory cortex

28
Q

when shown a scary face, which areas of the brain are hot/cold in schizo?

A

hot: limbic system esp amygdala. cold: cortex

29
Q

dopamine hypothesis schizo

A

excessive dopaminergic activity in mesolimbic tract and hypoactivity of mesocortical tract (negative symptoms)

30
Q

how do stimulant drugs cause psychotic symptoms?

A

amplifying mesolimbic tract

31
Q

homovanillic acid

A

metabolite of DA in bodily fluids of schizo - suggests more DA activity and use of CNS

32
Q

which drug has anti-5HT2A receptor activity?

A

clozpine - serotonin symptoms

33
Q

glutamate

A

major excitatory neurotransmitter in CNS

34
Q

glutamate hypothesis

A

antagonists of NMDA subtype of GLU receptors aggravate and create psychosis, while agonists of NMDA receptors may relieve symptoms - NMDA (receptor) hypoactivity

35
Q

normal pathway of glutamate activity

A

glutamate excites, GABA interneuron inhibitory, 2nd glutamate excites, dopamine release

36
Q

psychosis (positive symptoms) pathway of glutamate activity

A

glutamate tries to excite, but no receptor, so no GABA inhibitory signal, so too much excitement of glutamate causing too much dopamine release

37
Q

negative symptoms pathway of glutamate activity

A

normal is GLU-GABA-GLU-GABA-DA; abnormal is the same, but problem with NMDA receptors that Glu binds to, causing too much inhibition since the second glutamate is not inhibited

38
Q

What is the differential diagnosis when it comes to schizo

A

psychotic disorder caused by a general medical condition (B12/folate deficiency, temporal lobe epilepsy), manic phase of bipolar, substance-induced psychotic disorder, other psychotic disorders

39
Q

what other psychotic disorders are similar to schizophrenia

A

brief psychotic disorder, schizophreniform disorder, scizoaffective disorder, delusional disorder, shared psychotic disorder

40
Q

brief psychotic disorder

A

1-29 days of schizophrenia symptoms

41
Q

schizophreniform disorder

A

1-6mo of symptoms

42
Q

schizoaffective disorder

A

schizophrenia + mania and/or depression

43
Q

delusional disorder

A

delusions, but no other schizophrenia symptoms

44
Q

shared psychotic disorder

A

one person is delusional and a second person develops same delusion

45
Q

How do effective antipsychotics work?

A

block D2 receptors in the mesolimbic DA pathway (blocks neurons from excessively firing even in the face of high DA concentrations)

46
Q

What does 5HT2a blockade by atypical SGAs allow?

A

allows dopamine to more freely flow in the nigrostriatal pathway (less side effects)

47
Q

Why is compliance low for antipsychotic drugs?

A

unpleasant side effects of fatigue, grogginess, sedation and poor patient insight

48
Q

What is an option for noncompliant patients

A

long acting injectable forms of drugs (haloperidol decanoate, fluphenzine decanoate, resperidone, paliperidone, aripiprazole)