Schizophrenia Lecture Notes

A set of practice flashcards covering the background, symptoms, pathophysiology, and treatment of Schizophrenia as presented in the PHOL 488 lecture.

Schizophrenia

A chronic psychiatric disorder characterized by a combination of psychotic symptoms, motivational, and cognitive dysfunctions.

Positive symptoms

Behaviors and thoughts that are not normally present, including delusions, hallucinations, and disorganized speech and behavior.

Negative symptoms

Amotivational behaviors such as social withdrawal, affective flattening, anhedonia, and diminished initiative and energy.

Cognitive dysfunctions

A category of schizophrenia symptoms that involves impairments in mental processes like memory and attention.

Anhedonia

A specific negative symptom characterized by the inability to experience pleasure.

Affective flattening

A negative symptom referring to a reduction in the range and intensity of emotional expression.

Male to female ratio

The prevalence ratio of schizophrenia, recorded as $1.41:1$, with more severe disorder observed in males.

Peak onset in males

The age range of $20 - 24$ years when symptoms typically first appear in men.

Urban environment risk factor

A geographic factor associated with disadvantaged areas of inner cities that increases the risk of schizophrenia.

Drug abuse

The persistent use of amphetamine, methamphetamine, and cocaine which can produce states nearly identical to paranoid schizophrenia.

Dopamine Hypothesis

A theory suggesting that hyperactive dopamine in the mesolimbic pathway may lead to auditory hallucinations and paranoid delusions.

Glutamate Hypothesis

A theory involving hypocunctional NMDA receptors on GABA interneurons in the prefrontal cortex, leading to downstream excess dopamine.

Serotonin Hypothesis

A theory proposing hyperactivation of $5-HT_{2A}$ receptors on glutamate neurons, possibly due to excess serotonin or receptor upregulation.

NMDA receptors

Glutamate receptors that are hypofunctional on GABA interneurons in the prefrontal cortex according to the Glutamate Hypothesis.

5-HT2A receptors

Receptors on glutamate neurons that, when hyperactivated, lead to a downstream release of glutamate that activates the VTA.

Pyramidal dendritic spines

Structures whose loss leads to a net reduction in excitatory activity and a subsequent reduction in the inhibition of pyramidal cells.

Typical antipsychotics

First-generation neuroleptics that act as antagonists at $D_2$ receptors to improve positive symptoms.

Atypical antipsychotics

Second-generation medications that are antagonists at both $D_2$ and $5-HT_{2A}$ receptors to improve positive and negative symptoms.

Chlorpromazine

A specific medication listed as a Typical/1st generation antipsychotic.

Haloperidol

A widely used first-generation antipsychotic medication that acts as a $D_2$ receptor antagonist.

Clozapine

An Atypical/2nd generation antipsychotic medication mentioned as a treatment option.

Aripiprazole

An example of a second-generation (atypical) antipsychotic medication.

Extrapyramidal symptoms (EPS)

Motor symptoms caused by typical antipsychotics, including akathisia, parkinsonism, and dystonia.

Akathisia

An extrapyramidal symptom characterized by uncontrollable restlessness.

Acute dystonia

Painful, involuntary muscle contractions or spasms resulting from first-generation antipsychotic use.

Tardive dyskinesia

A potentially permanent side effect involving repetitive, involuntary body movements like lip smacking and grimacing.

Remission

A treatment outcome involving the stabilization of symptoms, occurring in approximately $40\%$ of patients.

Recovery

A long-term treatment outcome achieved by approximately $13.5\%$ (range $8 - 20\%$) of patients.

Resistance

A state where symptoms do not respond to treatment, affecting $10 - 45\%$ of patients.

Social adversity

A risk factor category including childhood physical abuse, sexual trauma, maltreatment, and bullying.