PSCI 169C > Week 2 > Flashcards

Week 2 Flashcards

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1
Q

Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia

Study Objective

A

To examine social and neuromotor behaviors in children who later developed schizophrenia compared to those who did not.

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2
Q

Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia

Study Design

A

Longitudinal study using childhood videotapes of Danish children aged 11–13 in 1972, with adult diagnostic follow-up in 1991.

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3
Q

Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia

Key Findings

A
  1. Preschizophrenia children showed reduced sociability and, in boys, neuromotor deficits.
  2. Differences were specific to schizophrenia, not other psychiatric disorders.
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4
Q

Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia

Neuromotor Deficits

A

Poor motor coordination and increased involuntary movements observed in childhood predicted schizophrenia in adulthood.

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5
Q

Childhood Videotaped Social and Neuromotor Precursors of Schizophrenia

Conclusions

A

Findings support a neurodevelopmental hypothesis of schizophrenia, with social and motor deficits as early precursors.

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6
Q

Childhood Precursors of Schizophrenia

Neuromotor Abnormalities

A

Children who later developed schizophrenia displayed higher rates of neurological “soft signs” like involuntary movements, poor coordination, and dyskinesia.

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7
Q

Childhood Precursors of Schizophrenia

Social Behavior Deficits

A

Children who developed schizophrenia showed reduced sociability, fewer smiles, and less vocal interaction compared to peers.

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8
Q

Childhood Precursors of Schizophrenia

High-Risk Sample

A

Children with a parent diagnosed with schizophrenia had increased likelihood of developing schizophrenia-related disorders.

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9
Q

Childhood Precursors of Schizophrenia

Gender Differences

A

Boys showed more pronounced neuromotor deficits, while social impairments were observed across genders.

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10
Q

Childhood Precursors of Schizophrenia

Videotape Coding Variables

A

Included measures of smiles, laughter, involuntary hand movements, nystagmus-like eye movements, and abnormal motor signs.

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11
Q

Childhood Precursors of Schizophrenia

Strengths of the Study

A
  1. Prospective design with standardized videotaping protocols.
  2. Long-term follow-up (20 years).
  3. Use of DSM-III-R criteria for adult psychiatric diagnoses.
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12
Q

Childhood Precursors of Schizophrenia

Study Limitations

A
  1. Small sample size for schizophrenia group (N=16).
  2. Moderate interrater reliability for neuromotor measures.
  3. Missing videotape data for some subjects.
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13
Q

Childhood Precursors of Schizophrenia

Longitudinal Results

A

Differences in childhood behaviors were consistent with adult diagnostic outcomes, supporting a neurodevelopmental hypothesis of schizophrenia.

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14
Q

Epidemiology of Schizophrenia: Global Insights

Global Prevalence

A

Schizophrenia affects 1.4–4.6 per 1000 individuals globally, with small variations across populations.

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15
Q

Epidemiology of Schizophrenia: Global Insights

Incidence Rates

A

Schizophrenia incidence is 0.16–0.42 per 1000 annually, with minimal global variation.

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16
Q

Epidemiology of Schizophrenia: Global Insights

Better Outcomes in Developing Countries

A

Patients in developing nations have higher remission rates and lower social impairment, often without sustained medication.

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17
Q

Epidemiology of Schizophrenia: Global Insights

Key Risk Factors

A

Genetic predisposition, early neurodevelopmental issues, and environmental interactions are primary contributors.

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18
Q

Epidemiology of Schizophrenia: Global Insights

Sex Differences

A

Earlier onset in men; women show better premorbid functioning, outcomes, and fewer brain abnormalities.

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19
Q

Epidemiology of Schizophrenia: Global Insights

Schizophrenia Prevalence

A

Occurs in 1.4–4.6 per 1000 people globally, with a consistent prevalence across most populations but notable exceptions, such as isolated or endogamous communities.

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20
Q

Epidemiology of Schizophrenia: Global Insights

Incidence Rates

A

Annual incidence ranges from 0.16 to 0.42 per 1000 individuals, with “broad” criteria (ICD-9) showing higher rates than restrictive diagnostic criteria (DSM or ICD-10).

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21
Q

Epidemiology of Schizophrenia: Global Insights

Better Outcomes in Developing Countries

A

Schizophrenia patients in developing nations (India, Nigeria, Colombia) experience higher remission rates, better social integration, and less chronic disability compared to those in developed countries.

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22
Q

Epidemiology of Schizophrenia: Global Insights

Potential Factors for Better Outcomes in Developing Countries

A

Differences may involve acute illness onset, supportive social networks, and reduced stigma, though environmental and genetic interactions are not fully understood.

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23
Q

Epidemiology of Schizophrenia: Global Insights

WHO Ten-Country Study Findings

A
  1. Remission rates were higher in developing countries (62.7%) compared to developed countries (36.8%).
  2. Fewer patients in developing countries required long-term hospitalization or antipsychotic medication.
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24
Q

Epidemiology of Schizophrenia: Global Insights

Sex Differences in Schizophrenia

A

Men: Earlier onset (by 4–5 years), worse premorbid functioning, and more brain abnormalities.

Women: Better outcomes and higher remission rates, especially post-menopause.

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25
**Epidemiology of Schizophrenia: Global Insights** Challenges in Diagnosing Schizophrenia in Epidemiology
1. Reliance on self-reports and lack of biological markers complicates diagnosis. 2. Verbatim diagnostic interviews (e.g., DIS, CIDI) have limited sensitivity for psychosis.
26
**Epidemiology of Schizophrenia: Global Insights** Impact of Late-Onset Schizophrenia
Schizophrenia onset after 40 years changes sex ratios (more common in women) and symptoms, with predominance of delusions and fewer negative symptoms.
27
**Epidemiology of Schizophrenia: Global Insights** Historical Development of Schizophrenia Epidemiology
1. Early studies by Kraepelin focused on heredity and cultural factors. 2. Modern epidemiology uses longitudinal and cross-cultural methods to understand schizophrenia's global distribution.
28
**Epidemiology of Schizophrenia: Global Insights** Population-Specific Observations
1. Low prevalence in Hutterite communities due to genetic selection and cultural norms. 2. High prevalence in isolated populations like northern Sweden and Croatia due to genetic bottlenecks.
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**Epidemiology of Schizophrenia: Global Insights** Course and Prognosis of Schizophrenia
1. Chronic but highly variable course; up to 60% achieve remission after long-term follow-up. 2. Longitudinal studies confirm higher recovery rates in developing nations.
30
**Categorical versus dimensional models of early psychosis** Categorical Model of Psychosis
Psychosis is viewed as a distinct, separate entity from normal mental functioning, classified into discrete disorders like schizophrenia or bipolar disorder.
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**Categorical versus dimensional models of early psychosis** Dimensional Model of Psychosis
Psychotic symptoms are seen on a continuum, varying in severity across the general population rather than being confined to specific diagnoses.
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**Categorical versus dimensional models of early psychosis** Key Differences Between Models
- Categorical Model: Clear boundaries between "ill" and "healthy." - Dimensional Model: Overlapping symptoms and gradients of severity across populations.
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**Categorical versus dimensional models of early psychosis** Advantages of the Dimensional Model
1. Reflects the full spectrum of psychotic experiences. 2. Captures subthreshold symptoms and early markers. 3. Allows for personalized treatment approaches.
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**Categorical versus dimensional models of early psychosis** Limitations of the Dimensional Model
1. Challenges traditional diagnostic boundaries. 2. Difficult to apply in legal and clinical contexts requiring categorical decisions.
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**Categorical versus dimensional models of early psychosis** Clinical Utility of Categorical Models
- Clear criteria aid in diagnosis and treatment decisions. - Useful for research standardization and epidemiological studies.
36
**Categorical versus dimensional models of early psychosis** Continuum of Psychotic Experiences
Psychotic symptoms, such as hallucinations or delusions, occur in milder forms in the general population, with only severe cases meeting clinical thresholds.
37
**Categorical versus dimensional models of early psychosis** Subthreshold Symptoms
Symptoms that do not meet full diagnostic criteria but indicate vulnerability to developing psychotic disorders.
38
**Categorical versus dimensional models of early psychosis** Implications for Early Intervention
Dimensional models support identifying and treating individuals with mild or subclinical symptoms to prevent full-blown psychosis.
39
**Categorical versus dimensional models of early psychosis** Neurobiological Correlates
Evidence supports shared genetic and neurobiological underpinnings across psychotic disorders, aligning with the dimensional model.
40
**Categorical versus dimensional models of early psychosis** Hybrid Approaches
Combines categorical and dimensional perspectives to capture the complexity of psychosis and improve diagnostic accuracy.
41
**Categorical versus dimensional models of early psychosis** Criticisms of Categorical Models
1. Oversimplifies complex symptom presentations. 2. May overlook individuals with significant impairment but no diagnosis.
42
**Categorical versus dimensional models of early psychosis** Transdiagnostic Research
Studies focusing on shared mechanisms across disorders, supporting the dimensional approach.
43
**Categorical versus dimensional models of early psychosis** Global Burden of Psychosis
Psychotic disorders are significant contributors to disability worldwide, highlighting the need for comprehensive diagnostic models.
44
**Schizophrenia Spectrum Disorders** Schizophrenia Spectrum Disorders
A group of related conditions sharing psychotic features, including schizophrenia, schizoaffective disorder, delusional disorder, and schizotypal personality disorder.
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**Schizophrenia Spectrum Disorders** Core Symptoms of Schizophrenia
1. Delusions: Fixed, false beliefs. 2. Hallucinations: Sensory experiences without stimuli, usually auditory. 3. Disorganized Thinking: Often evidenced through incoherent speech. 4. Abnormal Motor Behavior: Ranges from agitation to catatonia. 5. Negative Symptoms: Reduced emotional expression, motivation, or social engagement.
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**Schizophrenia Spectrum Disorders** Negative Symptoms
1. Avolition: Lack of motivation. 2. Alogia: Reduced speech. 3. Anhedonia: Inability to feel pleasure. 4. Asociality: Lack of interest in social relationships.
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**Schizophrenia Spectrum Disorders** Schizophreniform Disorder
Symptoms similar to schizophrenia but lasting 1-6 months, with no requirement for impaired social or occupational functioning.
48
**Schizophrenia Spectrum Disorders** Schizoaffective Disorder
Features of schizophrenia co-occurring with major mood episodes (depressive or manic) for a significant portion of the illness duration.
49
**Schizophrenia Spectrum Disorders** Delusional Disorder
Persistent delusions lasting 1+ months without other schizophrenia spectrum symptoms.
50
**Schizophrenia Spectrum Disorders** Risk Factors for Schizophrenia Spectrum Disorders
1. Genetic Factors: Family history increases risk. 2. Prenatal Complications: Malnutrition, infections, or hypoxia. 3. Early Developmental Issues: Delays in motor skills or language. 4. Environmental Stressors: Urban upbringing, trauma, or cannabis use.
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**Schizophrenia Spectrum Disorders** Prevalence and Incidence
Schizophrenia affects about 1% of the global population, with onset typically in late adolescence or early adulthood.
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**Schizophrenia Spectrum Disorders** Neurodevelopmental Hypothesis
Schizophrenia results from disruptions in brain development, influenced by genetic and environmental factors, evident before the illness onset.
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**Schizophrenia Spectrum Disorders** Differential Diagnosis
Distinguishing schizophrenia spectrum disorders from conditions like mood disorders with psychotic features, substance-induced psychosis, and personality disorders.
54
**Schizophrenia Spectrum Disorders** Treatment Approaches
- Medication: Antipsychotics for symptom control. - Psychotherapy: Cognitive-behavioral therapy (CBT). - Rehabilitation: Social skills training and vocational support.
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**Schizophrenia Spectrum Disorders** Prognosis
Variable outcomes with a spectrum of recovery, from full remission to chronic disability; better prognosis associated with early intervention and supportive environments.
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**Schizophrenia Spectrum Disorders** Early Intervention Benefits
Treatment during prodromal or early stages improves long-term outcomes, reducing relapse rates and functional impairment.
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**Schizophrenia Spectrum Disorders** Comorbidities
Common comorbidities include substance use disorders, depression, anxiety, and cardiovascular diseases.
58
**Lessons from the Wings of Drosophila** Timing of Organ Teratogens in Development
The effects of organ teratogens during fetal development depend heavily on timing. For example, the drug thalidomide acts as a teratogen during one specific week of the first trimester, leading to specific and recognizable effects. Similar mechanisms are observed in *Drosophila melanogaster*, where heat shock during specific developmental windows affects the growth of body parts such as wings and legs.
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**Lessons from the Wings of Drosophila** Developmental Windows in *Drosophila*
Each part of the *Drosophila* body has a unique narrow developmental window. For instance, heat shock during 37-41 hours of the pupal stage can result in wing deformities, while heat shock during 40-44 hours can impair head development.
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**Lessons from the Wings of Drosophila** Gene Expression and Teratogens
During critical periods of rapid gene expression in *Drosophila*, teratogens like heat shock can pause development. When the stressor subsides, genes resume expression, but developmental errors remain uncorrected, resulting in deformities.
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**Lessons from the Wings of Drosophila** Heat Shock as a Model Teratogen
In *Drosophila melanogaster*, heat shock is used as a model teratogen. It highlights how environmental stress during key developmental windows impacts gene expression and morphology, providing insights into the timing and mechanisms of teratogenesis.
62
**Lessons from the Wings of Drosophila** Insights from Drosophila Models
Studies on Drosophila help understand how early developmental disruptions can lead to disorders like schizophrenia.
63
**Lessons from the Wings of Drosophila** Schizophrenia and Developmental Disruption
Schizophrenia may result from environmental disruptions during critical developmental windows.
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**Lessons from the Wings of Drosophila** Teratogens and Schizophrenia
Environmental factors, such as infections or toxins, during prenatal development could increase schizophrenia risk.
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**Lessons from the Wings of Drosophila** Heat Shock Analogy in Schizophrenia
The effects of heat shock in *Drosophila* are used as a model to study environmental impacts on brain development in schizophrenia.
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**Lessons from the Wings of Drosophila** Gene Expression and Schizophrenia
Interruption of gene expression during fetal development may lead to errors associated with schizophrenia.
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**Lessons from the Wings of Drosophila** Critical Periods and Mental Health
Schizophrenia may arise if disruptions occur during critical periods of brain development.
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**Lessons from the Wings of Drosophila** Environmental Stress and Schizophrenia
Prenatal stressors, such as maternal infection, can influence neural development and increase schizophrenia risk.
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**Lessons from the Wings of Drosophila** Insights from *Drosophila* Models
Studies on *Drosophila* help understand how early developmental disruptions can lead to disorders like schizophrenia.
70
**Lessons from the Wings of Drosophila** Developmental Errors in the Brain
Schizophrenia may be linked to uncorrected developmental errors during prenatal brain growth.
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**Lessons from the Wings of Drosophila** Teratogenic Mechanisms and Psychiatry
Teratogens illustrate how environmental factors disrupt normal development, offering insights into psychiatric conditions like schizophrenia.
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**Lessons from the Wings of Drosophila** Timing of Neural Development
The brain’s sensitivity to disruptions during specific developmental phases parallels findings in schizophrenia research.
73
**Epidemiology and Natural History of Schizophrenia** Epidemiology in Schizophrenia
The study of the frequency, determinants, incidence, prevalence, and course of schizophrenia in populations.
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**Epidemiology and Natural History of Schizophrenia** Lifetime Prevalence Rate of Schizophrenia
Approximately 0.7%.
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**Epidemiology and Natural History of Schizophrenia** Strongly Confirmed Risk Factors for Schizophrenia
Family history of schizophrenia and lower social class.
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**Epidemiology and Natural History of Schizophrenia** Insidious Onset
A gradual development of symptoms in schizophrenia, making the exact onset of the illness difficult to identify.
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**Epidemiology and Natural History of Schizophrenia** Research Designs for Schizophrenia Identification
General population surveys, two-stage community surveys, and treatment setting samples.
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**Epidemiology and Natural History of Schizophrenia** Risk in Children of Two Schizophrenic Parents
Approximately 46.3% higher risk of schizophrenia compared to the general population.
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**Epidemiology and Natural History of Schizophrenia** Heritability Estimate for Schizophrenia
60% to 70%.
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**Epidemiology and Natural History of Schizophrenia** Social Drift Hypothesis
The hypothesis that individuals with schizophrenia fail to achieve their potential due to the illness, explaining the inverse relationship between social class and schizophrenia.
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**Epidemiology and Natural History of Schizophrenia** Male-to-Female Ratio in First-Episode Schizophrenia
More males than females diagnosed, especially in populations under 35 years old.
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**Epidemiology and Natural History of Schizophrenia** Season of Birth and Schizophrenia Risk
A slightly higher risk of schizophrenia is associated with being born in winter.
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**Epidemiology and Natural History of Schizophrenia** Prenatal Complications and Schizophrenia Risk
Complications such as preeclampsia, low maternal weight, small head circumference, and fetal distress increase the risk of schizophrenia.
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**Epidemiology and Natural History of Schizophrenia** Cannabis Consumption and Schizophrenia Risk
Heavy cannabis use is linked to a higher risk of developing schizophrenia, though causation remains uncertain.
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**Epidemiology and Natural History of Schizophrenia** Predictor of Relapse in Schizophrenia
Noncompliance with medication after treatment begins is the most consistent predictor of relapse.
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**Epidemiology and Natural History of Schizophrenia** Suffolk County Mental Health Project 24-Month Findings
40.2% of patients with schizophrenia were continuously ill, and only 13.3% achieved complete remission.
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**Epidemiology and Natural History of Schizophrenia** Key Factors Affecting Schizophrenia Outcomes
Severity of psychosis and insidious onset significantly influence the course of schizophrenia.
PSCI 169C
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