Melvin Flashcards
(28 cards)
Who has the highest risk of having schizophrenia in a family
identical twins ~50%
What genetics are in schizophrenia
MHC locus on chromosome 6
express C4A causes increased risk
What dopamine abnormalities are seen in schizophrenia
increased DA neuron activity in limbic system (+ symptoms)
decreased DA neuron activity in prefrontal area (- symptoms)
What is decreased other than certain dopamine neurons in schizophrenia
glutamate (causes cognitive deficits)
What would you see on imaging of someone with schizophrenia
englargement of lateral ventricles
What is required for diagnosis of schizophrenia
2 symptoms within 1 month over 6 months
delusions hallucinations disorganized speech disorganized behavior negative symptoms
What type of hallucination is most common in schizophrenia
auditory commands
negative symptoms of schizophrenia
- flat affect
- lost sense of self
- avolition-difficulty initiating and doing goals
- poverty of thought and speech
What causes the most issues in schizophrenia
cognitive symptoms
onset for schizophrenia
bimodal 20s and then 40s for women
Good prognosis for schizophrenia
- abrupt onset
- positive symptoms
- female
- presence of mood symptoms
- family history of disorder
- good premorbid function
Poor prognosis for schizophrenia
- insidious onset
- negative symptoms
- poor cognitive performance
- CT abnormalitites
- Lack of mood symptoms
- childhood onset
Schizoaffective disorder diagnosis
major mood disorder plus schizophrenia
And
delusions and hallucinations for 2+ weeks in absence of mood episode
When is a breif psychotic disorder diagnosed
1 symptom with
duration 1 day- 1 month
When is schizophreniform disorder diagnosed
2 symptoms with
duration 1 month- 6 months
What is a delusional disorder
1 delusion but retaining functioning behavior
What is capgras syndrome
belief that individuals or pets have been replaced by imposters
sometimes cannot recognize faces
What is delusional parasitosis disorder
Aka Ekboms or morgellons
patient believes they are infested with parasites
What type of therapy do you use for schizophrenia
individual supportive therapy
group therapy
Contraindications for ECT
No absolute contraindications
What is ECT
controlled seizure from a pulsed current
What form of ECT is the best option
unilateral is the best with minimal side effects
What side effects can occur from ECT
antero and retrograde amnesia that resolves within 6 months
What do we see clinically in ECT
Inc dopamine and serotonin
dec metabolic activity in frontal/cingulate cortex
increase in brain derived neurotrophic factor (BDNF)
