Flashcards in Mental illness --> Schizophrenia Deck (18):
Schizophrenia is an illness of what?
impairment of thought and volition
what are some statistics of schizophrenia?
top ten most frequent cause of disability
30% of all hospitalizations
affects 1% of the population and 30% of all homeless ppl
10% of all cases will commit suicide
What are some general symptoms of schizophrenia?
impairment of cognition, emotion, thought, affect, perception, language and sense of self
symptoms are acoustic, sometimes visual, olfactory, tactile or gustatory hallucinations
what are the prodromal signs of a psychotic episode?
social isolation and withdrawal
impairment in the normal fulfillment of expected role
odd behavior and ideas
neglect of personal hygiene
flatt affect (communicating but no connection)
what are the types of symptoms seen with schizophrenia?
positive --> addition of pathological symptoms
negative --> loss of normal function
disorganized --> disorder of thoughts, memory dysfunction and confusion
what are disorganized some disorganized symptoms?
1. Disorganized speech --> frequent derailment or incoherence, word salad
2. Grossly disorganized or caatonic behavior --> characterized by stupor/inactivity, mania and either rigidity or extreme flexibility
what are some cognitive symptoms associated with schizophrenia?
disorganized/slow thinking, poor understanding, concentrating, expressing thoughts and memory
what are some social/occupation dysfunction?
work, interpersonal relations and self care
In general terms what is a psychotic episode in a schizophrenic patient?
mental state in which the patients thoughts do not represent reality correctly
what are the positive symptoms associated with a psychotic episode in a schizophrenic patient?
One or more of these must be present
1. Delusions---> one is being persecuted, one's feelings, thoughts, and actions are controlled by an outside force
2. Hallucinations--> usually auditory, hearing voices commenting one's actions
3. Disordered thoughts, incoherence --> loss of normal association between ideas, poverty of speech accompanied by loss of emotional expression
patients may also exhibit unusual postures, mannerisms or rigidity
What symptoms are associated with a non-psychotic period?
negative symptoms, eccentric behavior, social isolation, flat affect, reduced social drive, poverty of speech, poor attention span, and lack of motivation
Before making a diagnosis of schizophrenia, what other diseases MUST be ruled out?
3. brain tumor
4. manic/depressive illness
what is the prognosis for patients with schizophrenia?
generally poor, patients with negative symptoms have poorer prognosis
what is the pathogenesis associated with schizophrenia?
genetic aspect --> polygenetic (Similar to HTN or diabetes)
what are the anatomical abnormalities seen in patients with negative symptoms of schizophrenia?
1. decreased blood flow to globus pallidus (connection of basal ganglia to frontal lobe)
2. No increase in blood flow to frontal lobe during memory tests
3. Thin cortex in medial temporal lobe and smaller anterior hippocampus (Defect in memory)
4. Lateral and third ventricles are enlarged, wider sulci, reduced volume of temporal and frontal lobe
what are the typical antipsychotic drugs used in patients with schizophrenia?
High affinity to D2 receptors--> the higher the affinity to D2 receptor the better the clinical potency
more dopamine means psychotic symptoms
Side effects: blockage of D1 and D2 receptors in the basal ganglia
short term effects: hand-tremor, rigidity of muscles
aka drug induced parkinsons
Long term effects: tardive dyskinesia--> involuntary movements esp mouth and tongue
what are the atypical antipsychotic drugs given to schizophrenic patients?
high affinity to D3 and D4 receptors
Almost no side effects in the extrapyramidal system (aka by passing the motor systems)
clozapine and olanzapire