Schizophrenia

Question 1

Capgras syndrome

Answer 1

believes someone has been replaced by a double

Question 2

Cotard’s syndrome

Answer 2

the person believes he or she is dead

Question 3

2 views on delusions

Answer 3

Motivation and Deficit

Question 4

Most common hallucination

Answer 4

Auditory (70% of people)

Question 5

Auditory hallucinations associated with…

Answer 5

Broca’s area

Question 6

People are hearing their own thoughts explains problem with…

Answer 6

poor emotional prosody comprehension

Question 7

Negative symptoms

Answer 7

Avolition, Alogia, Anhednoia, Affective Flattening

Question 8

Avolition

Answer 8

inability to initiate and persist in activities

Question 9

Anhedonia

Answer 9

lack of pleasure

Question 10

Alogia

Answer 10

Relative absence of speech, repetitive and simple

Question 11

Disorganised symptoms positive or negative?

Answer 11

Positive

Question 12

Disorganised symptoms…

Answer 12

Disorganised speech, inappropriate affect, disorganised behaviour

Question 13

Which can you be diagnosed on exclusively? Positive or Negative symptoms?

Answer 13

Positive

Question 14

Brief Psychotic Disorder

Answer 14

1 day

Question 15

Schizophreniform

Answer 15

1-6 months (cause not specified) - exists so as not to ignore symptoms

Question 16

Kreapelin labelled disorder…

Answer 16

“dimensa precox” – considered it an early form of dimensia

Question 17

Blueler came up with concept of…

Answer 17

splitting of the mind “schiz” (split) “phrenia” (mind)

Question 18

Prevalence

Answer 18

1.5%

Question 19

Life expectancy

Answer 19

slightly lower due to suicide and accidents

Question 20

For men, likelihood goes …

For women, likelihood goes…

Answer 20

Down over time

Up over time.

Question 21

Not just increased Dopamine, but also decreased…

Answer 21

Serotonin.

Question 22

Brain abnormalities associated with…

Answer 22

enlarged ventricles and cortical atrophy

Question 23

Do genes or environment cause?

Answer 23

Genes aren’t causative, just predispose.

Question 24

Any treatment to stop enlarging of ventricles or cortical atrophy?

Answer 24

nope.

Question 25

Enlarged ventricles more and men or women?

Answer 25

men.

Question 26

Dopamine hypothesis

Answer 26

increased dopamine increases positive symptoms (not conclusive)

Question 27

People with schizophrenia have more or less dopamine receptors...

Answer 27

MORE!

Question 28

Hypofrontality theory...

Answer 28

LOW levels of dopamine in parts of brain. Low leves of glutamate also.

Question 29

When glutamate levels drop, dopamine...

Answer 29

goes up!

Question 30

Hypofrontality may affect which part of brain...

Answer 30

dorsolateral prefrontal cortex Also less connectivity between this region and others.

Question 31

HyPERfrontality also possible, suggesting...

Answer 31

dysfunctional DLPC

Question 32

Does culture impact disorder?

Answer 32

Yes. Stigma impacts disorder.

Question 33

how do traditional neuroleptics work?

Answer 33

Blocking receptors and and reducing sensitivity of post-synaptic neuron.

Question 34

What do newer neuroleptics do?

Answer 34

increase serotonin, more selective in which dopamine receptors it blocks (not D1 (motor), does block D2)

Question 35

How effective are antispychotics?

Answer 35

85% response.

Question 36

Full recovery?

Answer 36

1 in 7

Question 37

psychotic behaviour usually involves...

Answer 37

delusions or hallucinations

Question 38

Anger and antisocial personality disorder are better predictors than...

Answer 38

psychosis.

Question 39

How many experience hallucinations, delusions or both?

Answer 39

50-70%

Question 40

Which is now used? Dimensional or subtypes?

Answer 40

Dimensional.

Question 41

Historic schizophrenia subtypes

Answer 41

paranoid, disorganised, catatonic

Question 42

When do symptoms appear?

Answer 42

as early as childhood but often late adolescence to early adulthood

Question 43

early features

Answer 43

mild physical abormalities, poor motor coordination, mild cognitive and social problems. Not specific to schizophrenia, could be other problems.

Question 44

prodromal stage

Answer 44

85% of those with schizophrenia go through this stage. 1-2 year period before serious symptoms occcur. Ideas of reference, magical thinking, llusions. isolation, impaired functioning, lack of initiative, interests and energy are common.

Question 45

risk factors

Answer 45

length of time before seeking help, baseline functioning, presence of negative symptoms and disorganised symptoms

Question 46

Problems with studies assessing stress as risk factor

Answer 46

retrospective.

Question 47

Onset of symptoms usually happens as a result of..

Answer 47

environmental stress

Question 48

Cause of higher diagnoses in in minorities?

Answer 48

misdiagnosis and stress

Question 49

One gene or multiple?

Answer 49

Multiple.

Question 50

Is there a familial risk in developing schizophrenia specifically?

Answer 50

no. you inherit a general predisposition for schizophrenia that manifests in the same way or differently to your parents'. Monozygotic twins and children of 2 schiz parents have 1/2 chance of DEVELOPING schizophrenia.

Question 51

Siblings with 1 schiz parent?

Answer 51

around 17% chance of developing

Question 52

If adopted child had schiz mother...

Answer 52

5% chance of developing (compared to 1% in general population).

Question 53

If adopted child had mother with schiz or related psychotic disorder...

Answer 53

child had 22% risk of developing one of those disorders.

Question 54

Can you be a carrier despite not developing the disorder?

Answer 54

Yes, you can. 17% chance of developing if a parent has it means environment makes a difference.

Question 55

Which gene/s are to blame?

Answer 55

COMT is of interest regarding dopamine, but 128 associations thus genome-wide significance.

Question 56

Are researchers looking for schizophrenia gene(s)?

Answer 56

No. they're looking for endophenotypes that explain symptoms.

Question 57

What is a current endophenotype for schizophrenia?

Answer 57

eye-movement/tracking. Ability to track smoothly is deficient. Also in relatives but it tapers off.

Question 58

What evidence contradicts dopamine hypothesis?

Answer 58

some people are NOT helped by neuroleptics. Although neruoleptics are fast acting, symptoms can take days or weeks to abate. These drugs are only partly helpful in reducing negative symptoms.