Schizophrenia Flashcards

Question

What is the original DA hypothesis for Schizophrenia?

Answer 1

Schizophrenia goes to DA excess dopamine hypothesis is huge. THe original hypothesis was that schizophrenia is too much dopamine because when you take a bunch of drug you can imitate a bunchoof symptoms of schizophrenia. Drugs that reduce dopamin in the system take away schizophrenia like behaviour. Drugs Drugs increase DA Result in schizophrenia-like behaviour e.g., Amphetamine, L-Dopa for Parkinson’s disease Drugs decreases DA Reduce schizophrenia-like behaviour e.g., Neuroleptics Do not treat negative symptoms

Answer 2

Negative symptoms - decreases DA in cortical regions * underactivity at D1 receptors (but it doesn;t explain negative systems so they revised it. Less dopamine in the cortical regions. Underactivity at the D 1 receptors) Positive symptoms increases DA in subcortical regions * pre-synaptic * too much produced and released into synapse → overactivity at D2 receptors * post-synaptic * some findings of too many D2 receptors (positive symptoms seem to be related to increased dopamine activity in subcoritical areas like the limbic system.)

Answer 3

Mesolimbic Pathway (positive symptoms) we have basically this is where a ton of the dopamine is produced and its sending it to the nucleus accumbems and othertings like the limibc system. Nucleus Accumbens (NA) Ventral Tegmental Area (VTA) Mesocortical Pathway (negative symtptoms) frontal cortex when theres more dopamine up here it says you’re solid you don’t need to produce it. the reduced activity means the frontal cortex allows the VTA to keep producing it still.

Answer 4

decreased glutamate (PCP & ketamine → schizophrenia-like behavior) Underactivity at NMDA receptors DA receptors also inhibit glutamate activity, so… Too ↑ DA activity → too ↓ glutamate activity Glutamate plays a role in learning, memory, neural processing * Explain problems with attention, working memory, executive function?

Answer 5

"silent lesion" this is the best theory and it will be on the test. Abnormalities lie dormant until normal developmental processes expose problems you are born and things are ownky but they are dormant until normal developmental processes happen and you aren’t able to process things. So...neuropathology before SCZ onset (so the pathology/the problems in the system are thre way before you see the symptoms. )

Answer 6

Neuromotor, cognitive & behavioral abnormalities Smaller head circumference at birth Slower to reach developmental milestones Higher rates of left-handedness - Congenital minor physical & craniofacial anomalies Velocardial Facial Syndrome

Answer 7

* Viral infection * Early nutritional deficiencies & maternal * Pregnancy & birth complications Gestational & perinatal Maternal starvation (1st trimester) Dutch Hunger Winter of 1944/1945 2x risk (this is when Nazis were ruling areas and they prevented food supplies from getting to these people. women in their first trimeste were more likely to have kids that develop schizophrenia) Obstetric complications Premature birth, hypoxia (relating to less oxygen availability. Cell death happens at this point and we are losing pieces.) Maternal viral infections 1957 Helsinki influenza (2nd trimes Mother fever > 38ºC → 3.7x risk (if a mom was in her second trimester and had a really bad fever she had more risk of her baby having schizophrenia.. Proteins are denaturing/things are dying and not functinoing. )

Answer 8

Cannabis People with schizophrenia are 2x as likely as the general population to smoke cannabis they use it more to deal with their schizophrenia. BUT also if people use a shit ton of weed at the age of 14, that was the age that conferred the most risk later/ The stud was done decades ago. Weed now is not the same. Weed now is way more intense. We are starting to see more adolescents coming in with first onset psychoses.

Answer 9

COMT gene Breaks down proteins (incl. DA, NE, etc.) * 2 alleles * Met → high DA * Val → lower DA we have this gene and 2 alleles for it. The met allele gives you high dopamine and the val gives you low dopamine. If you have the met met gene and you don’t use weed vs you do use weed in adolescence. Whats the difference. If you have one val and one met, what would you tell your friend to do. Don’t use it. If they have the val val gene don’t do it. Way worse.

Answer 10

genetic factors and prenatal perinatal Events goes to Brain Vulnerability goes to stress and developmental maturation processes goes to psychosis

Answer 11

but... "doomed from the womb? No environmental factor necessary or sufficient you can have a whole bunch of genes and still not develop it. You need environmental stressors.

Answer 12

Brain development from conception to early adulthood (e.g., neuron formation, migration, synaptic pruning) Anatomical & functional disruption in neuronal connectivity & communication Cognitive dysmetria (dysregulation of information processing in the brain) Impairments in higher-order cognitive processes (e.g., attention, memory, language, emotion) Symptoms of schizophrenia (e.g., hallucinations, delusions, negative symptoms, disorganized speech) these are our cognitive symptoms that we’re starting to see. this leads to higher order problems in cognitions. psycho etiology is in this slide.

Answer 13

(psychological stress tends to lead more to relapse than onset.) Psychological Stress increase Relapse rate * Migration * Urbanization * Lowest SES (it comes from your SES or you end up in that SES. ) Sociogenic hypothesis Social-selection theory “downward drift”

Answer 14

Risk for developing schizophrenia: 1st generation migrants: 2.7 (risk for schizophrenia is about double. as a second gen migrant.) 2nd generation migrants: 4.5 (first gen migrants tend to come into social circles that have more than them and they haie kids are more in betwee nand have less ingroup memebers.) From developing vs. developed countries: 3.3 (migrants from developing countries are more at risk. ) From areas with predominantly black population: 4.8 (racism. If you are coming from a place with a predominantly black population and going into a place where this is not the case you are likely to experience a ton of racism. Chronic stress. ) Potential explanations? Diagnostic bias? No Selective migration? No Discrimination and social defeat? (chronic stressful experience of outsider status)

Answer 15

Family Outdated “Schizophrenogenic mother” Current (relapse rartes are higher with expressed emotion) Expressed emotion – relapse (3.7x) - Criticism - Hostility - Emotional over-involvement

Answer 16

33% continue to have symptoms and problems even after treatment 12% need long-term institutional care 38% function well 15-25 years later (i.e., can manage symptoms) 10-15% fully recover (symptoms remit > 2 yrs, good social functioning) (this doesn’t mean its gone. ) No “cure”

Answer 17

Prefrontal lobotomy Controversy about cognitive deficits Institutionalization Insulin coma ECT

Answer 18

Antipsychotic Medication Mechanism: Block DA receptors (2 kinds both count for the grid. So this could be the whole grid.) * 1st generation “Conventional” antipsychotics * 2nd generation “Atypical” antipsychotics

Answer 19

1+ psychotic episodes * Episode has relatively rapid return to normal functioning * Good prospects for recovery (if you get back to your normal functioning quickly you have a better prognosis) Years of recurrent psychotic relapses * Periods of remission * Varying degrees of residual impairment Failure to respond

Answer 20

CBT (you need the meds. YOu aren’t gonna great it wit hthese things. This is a severe mental illness meaning you NEED the medication but psychological stuff on top of it improves. ) * Reframe positive symptoms (trying to help create a tiny little space of consideration that the things they are seeing, hearing, smelling, beheliving migh t be true. ) * Identify triggers for symptoms * Improve social skills (people often become depressed because they know whats coming.) * Reduce relapse *Not helpful for negative symptoms Cognitive remediation * Improve cognitive functioning Other individual * CBT + life skills

Answer 21

Family Therapy Communication skills Decreased expressed emotion getting families to be less hostile and less critical. Case Management Social and Living Skills Training Vocational rehabilitation

Schizophrenia Flashcards

(45 cards)