Scizophrenia

Question 1

schizophrenia

Answer 1

chronic, debilitating illness associated with deterioration in mental function and behavior. involves a gene by environment interaction. not caused by known social or environmental factor, exacerbated by social stress.

Question 2

hallmark symptom of schizophrenia

Answer 2

psychosis. impairment in reality testing that may present as alteration in sensory perceptions, abnormalities in thought content, abnormalities in thought process/organization.

Question 3

illusion

Answer 3

misperception of real external stimuli

Question 4

hallucinations

Answer 4

sensory perceptions not generated by external stimuli

Question 5

ideas of reference

Answer 5

false convictions that one is subject of attention by other people. feeling as though people are referring to you in their conversations

Question 6

delusions

Answer 6

false beliefs not correctable by logic or reason, not based on simple ignorance, and not shared by culture; delusions of persecution most common

Question 7

loss of ego boundaries

Answer 7

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

Question 8

alogia

Answer 8

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

Question 9

echolalia

Answer 9

repeating statements of others/associating words by their sounds, not by their meaning

Question 10

thought blocking

Answer 10

abrupt halt in the train of thinking, often because of hallucinations

Question 11

neologisms

Answer 11

inventing new words

Question 12

circumstantiality

Answer 12

in responding to questions, one presents unneccessary and voluminous details before arriving at answer

Question 13

tangentiality

Answer 13

beginning a response in a logical fashion but then getting further and further away from the point and failing to answer the original question

Question 14

loose associations

Answer 14

loss of logical meaning between words or thoughts, when asked a question, illogically jumps from one subject to another

Question 15

characteristics of schizophrenia

Answer 15

at least one episode of psychosis with persistent disturbances of thought, behavior, appearance, speech, and affect as well as impairment in occupation and social functioning. No clouding of consciousness! attention and memory are intact when not psychotic. alert and oriented.

Question 16

DSM-5 diagnostic criteria for schizophrenia

Answer 16

2 or more of the following, each present for a significant portion of time during a 1-month period: delusions, hallucinations, grossly disorganized or catatonic behavior, negative symptoms, disorganized speech. One or more major areas of functioning are markedly below level achieved prior to onset. Continuous signs of the disturbance persist for at least 6 months!! Symptoms cannot be due to another illness. Symptoms cannot be due to substance use or a medical disorder or a drug.

Question 17

positive symptoms

Answer 17

additional to expected behavior. delusions, hallucinations, agitation, talkativeness, thought disorder

Question 18

negative symptoms

Answer 18

missing from expected behavior. lack of motivation, social withdrawal, flattened affect/emotion, cognitive disturbances, poor grooming, poor speech.

Question 19

why were subtypes of schizophrenia eliminated?

Answer 19

poor validity, limited diagnostic stability, low reliability

Question 20

prodromal phase

Answer 20

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

Question 21

psychotic/active phase

Answer 21

loss of touch with reality. associated with the positive symptoms

Question 22

residual phase

Answer 22

period between psychotic episodes. in touch with reality, but doesnt behave normally. negative symptoms, peculiar thinking, eccentric behavior, and withdrawal from social interactions

Question 23

genetics of schizophrenia

Answer 23

more common in twins. advanced paternal age can hurt. equally in men and women. women respond better to antipsychotics. women have greater risk of tardive dyskinesia though.

Question 24

environmental factors for schizophrenia

Answer 24

viral infection and exposure to drugs. increased incidence when born in cold weather months. third trimester maternal use of diuretics. anti-NMDA receptor antibodies?? (unsure about this)

Question 25

neurological abnormalities

Answer 25

decreased use of glucose in prefrontal cortex. laterand and third ventricle enlargement. abnormal cerebral symmetry (loss of asymmetry). decreased volume of hippocampus, amygdala, and parahippocampal gyrus. decreased alpha waves, increased theta and delta waves and epileptiform activity on EEG. abnormalities in eye movements.

Question 26

brain activity in schizophrenia

Answer 26

dorsolateral prefrontal cortex is hypoactive. ventromedial cortex is hyperactive. auditory cortex is hyperactive while hallucinations occur.

Question 27

dopamine hypothesis

Answer 27

excessive dopaminergic activity in mesolimbic tract. negative symptoms can involve hypoactivity of mesocortical dopamine tract. elevated levels of homovanillic acid (metabolite of DA) suggests more DA activity and use in the CNS

Question 28

serotonin hpyeractivity

Answer 28

hallucinogens such as LSD, which increase serotonin, cause hallucinations and delusions. newer atypical antipsychotics have anti 5HT2A receptor activity

Question 29

norepinephrine hyperactivity

Answer 29

paranoid subtype may have increased metabolites

Question 30

glutamate hypothesis

Answer 30

major excitatory neurotransmitter in CNS. antagonists of NMDA subtype of GLU receptors aggravate and create psychosis while agonists of NMDA receptors may experimentally relieve symptoms.

Question 31

NMDA receptor hypoactivity hypothesis

Answer 31

NMDAR proteins become ineffective or underactive if mutated. if they sit on GABA interneurons, can cause loss of inhibition to lead to increase in firing and extra DA in the limbic system

Question 32

normal functioning glutamate stuff

Answer 32

GLU-GABA-GLU-DA. Glu stimulates GABA, which turns off second Glu receptor, which causes minor increase in DA, but controlled.

Question 33

positive symptoms in glutamate stuff

Answer 33

Glu cant reach GABA, due to bad receptor. no inhibition. second glu goes wild and causes tons of DA release

Question 34

negative symptoms

Answer 34

GLU-GABA-GLU-GABA-DA. GABA receptor is messed up and doesnt get stimulated, lose inhibition, and pump out too much Glu. second GABA gets inhibited too much and you lose DA.

Question 35

medication for schizophrenia

Answer 35

all effective antipsychotics block D2 receptors in the mesolimbic DA path. often a life long treatment. higher potency drugs cause more side effects. 5HT2a blockade allows DA to more freely flow in the nigrostriatal path. low compliance rates

Question 36

psychotherapy for schizophrenia

Answer 36

provide long term support for patient and family. foster compliance with drug regimen. cognitive behavioral therapy improves executive dysfunction. family therapy. peer and mentor support or social skills groups.