Schizophrenia

Question 1

What kind of disorder is schizophrenia classified as?

Answer 1

A psychotic disorder

Question 2

What were the historical names for schizophrenia?

Answer 2

Back in the olden days, schizophrenia was known simply as madness or lunacy?

Question 3

Who was the first to thoroughly define the symptoms of schizophrenia?

Answer 3

Emil Kraeplin was the first, he did this by combining several elements of insanity into one. He called it schizophrenia dementia praecox (premature dementia) because this disorder appears late in adolescence

Question 4

Who introduced the term schizophrenia and what ddi they believe?

Answer 4

Eugen Bleuler introduced the term. He believed that the core problem was not the premature aging of the brain. He believed that the various elements of the individuals mind become disconnected from each other. That thoughts no longer have any logical connection to each other.

Question 5

What are the 3 basic groups that schizophrenic symptoms can be divided into?

Answer 5

1. Positive symptoms: symptoms that go beyond normally occurring experiences
2. Negative symptoms: characterized by a deficit or absence in normal behaviour
3. Cogntiive Symptoms: symptoms characterized by erratic changes in speech, motor behaviour, and emotions

Question 6

What are the symptoms of Positive Symptoms?

Answer 6

• Delusions: irrational beliefs or paranoia that misrepresents reality, can be classified as bizarre if if they are clearly implausible but can be also classified as non bizarre is somewhat plausible
• Hallucinations: the experience of sensory events without any inout for surrounding environment, can involve any senses but auditory hallucinations are most common

Question 7

What are the symptoms of negative symptoms?

Answer 7

• Apathy: inability to get started, to perform basic day-to-day functions (can lead to problems with hygiene, keeping a job, etc)
• Autism: refers to tendency to keep to oneself and lose interest in everything else
• Ambivalence: emotional and social withdrawal
• Anhedonia: without pleasure, indifferent to activities that are considered pleasurable
• Active flattening: absence of visible emotions, facial expressions, and emotional inflections in speech

Question 8

What are the symptoms of cognitive symptoms?

Answer 8

• Disorganized speech: confusing way of talking , jump around randomly from topic to topic, or go off on illogical tangents
• Inappropriate affect: displaying of emotions inappropriate for current situation
• Disorganized behaviour: motor symptoms ranging from wild agitation to catatonic immobility, the ability to seem frozen in place but display waxy flexibility

Question 9

What are the key points for the diagnostic criteria?

Answer 9

• Individual must have atleast one of delusions, hallucinations, or disorganized speech
• Diminished level of function
• Long lasting symptoms
• Not due to drugs or medical condition

Question 10

When does schizophrenia develop?

Answer 10

It is usually diagnosed in late adolescence or early adulthood, usually preceded by a prodromal stage which is a 1-2 year period where subdued symptoms begin to appear

Question 11

What are the statistic for remission?

Answer 11

Complete remission is very rare as 78% of schizophrenic patients go through a patten of relapse and recovery.
- Remission is more likely given if:
- Good social adjustment before onset of schizophrenia
- Low proportion of negative symptoms
- Good support system

Question 12

What are some factors that lead to schizophrenia?

Answer 12

• Through genetics if members in family have it
• Problems shortly after child birth
• Fetal exposure to influenza and viral diseases
• Pregnancy and delivery complications
• Prenatal nutrition and stress

Question 13

What is seen in the brain of a schizophrenic patient?

Answer 13

• Enlarged lateral ventricles due to lack of development or atrophy and is filled with CSF
• Reduced dendritic spines density in prefrontal cortex
• Reductions in hippocampal size due to degradation, disorganized neurons in hippocampus of brain

Question 14

What are antipsychotic drugs?

Answer 14

They are drugs that reduce psychotic symptoms without producing too much too much general sedation like chlorpromazine

Question 15

How do antipsychotics work?

Answer 15

They reduce schizophrenia symptoms. They work by blocking dopamine receptors, especially the D2 variants. They are D2 antagonists

Question 16

What is the Positron Emission Tomography (PET)

Answer 16

PET is an imaging technique that detects changes in blood flow by measuring changes in uptake of compounds such as oxygen or glucose. Radioactive molecules are injected into the bloodstream, used to analyze the metabolic activity of neurons

Question 17

What is the striatum?

Answer 17

• It is part of the basal ganglia.
  2 parts of the striatum,:
• Dorsal striatum: involved in habit learning, motor and action planning
  -Ventral striatum (nucleus accumbens): involved in reward learning, motivation

Question 18

What is the importance of D2 receptors in schizophrenia?

Answer 18

Positive symptoms of schizophrenia seem to be caused by excessive stimulation of dopamine D2 receptors in the striatum

Question 19

What do stimulant drugs do?

Answer 19

Stimulant drugs such as cocaines and amphetamines can cause psychosis when taken in high doses.

Question 20

What importance in schizophrenia do D1 receptors have?

Answer 20

Schizophrenia may also involve under-stimulation in of dopamine D1 receptors in the PFC. This condition is called hypofrontality and can explain why people with schizophrenia struggle with planning, problem sovling, and high level reasoning

Question 21

What would the ideal drug for schizophrenia do?

Answer 21

Block D2 receptors but activate D1 receptors

Question 22

What are some side effects of antipsychotics?

Answer 22

Sedation, excess salivation, motor function, feeling of being fine.
Quitting these drugs can prove disastrous as the full spectrum can return after only a few days