Schizophrenia spectrum and other psychotic disorders 10-2

Schizophrenia: Diagnosis and Comorbidity- What requires the presence of two of the following five symptoms of schizophrenia?

•Delusions

•Hallucinations

•Disorganized speech

•Grossly disorganized or catatonic behavior

•Negative symptoms

What other disorders is schizophrenia comorbid with?

•Depression (50%)

•Suicide, self-harm (5% die by suicide)

•Anxiety (38%)

•Substance-related disorders (47%)

•Smoking (90%)

What is brief psychotic disorder?

disorder is the sudden onset of psychotic symptoms that does not last for more than a month

What is Schizophreniform disorder?

is identical to schizophrenia but the illness lasts less than six months

What is Schizoaffective disorder?

disorder is when, in addition to psychosis, the patient also has a major depressive, manic, or mixed episode disorder

What is delusional disorder?

is the presence of non-bizarre delusions

What is shared psychotic disorder?

occurs when two people sharing a delusional belief

According to the Etiology of biological factors, what are the abnormalities in neurotransmitters include in the dopamine hypothesis?

•Increase in dopamine associated with worsening of psychotic symptoms

•Substances that decrease dopamine associated with reduced symptoms

According to the Etiology of biological factors, what are the abnormalities in neurotransmitters include in the dopamine hypothesis part 2?

Serotonin deficits associated with negative symptoms

GABA, glutamate, and acetylcholine deficits associated with negative symptoms and cognitive impairment

According to etiology: biological factors, what do genetics and family studies suggest?

-Schizophrenia “runs in families”

-Twin studies suggest heritability estimate of 79%

-Studies indicate that hundreds of genes (polygenic influence) in addition to epigenetic and environmental factors are likely to play a role

According to the etiology: Biological factors what is the contribution in structural and functional neuroanatomy?

•Enlargement of brain ventricles

•Individual brain cells show disorganization

•Viral theories and prenatal stressors may change brain areas and lead to vulnerability to schizophrenia

■Synaptic pruning occurs abnormally in people who have schizophrenia

According to family influences, there is no evidence to support “schizophrenogenic mother” theory

true

According to family influences what are expressed emotion (EE)?

family’s emotional involvement and critical attitude

What can high expressed emotion (EE) increase?

-the likelihood of relapse and rehospitalization

-Difficult to change family patterns once they have been established

What is gene-environment correlation?

the same person who provides patient’s genetic makeup also provides the environment in which that person lives

What do individuals who are at increased genetic risk for schizophrenia are likely to be exposed to?

environments that increase risk

What are the biological treatments of schizophrenia?

typical antipsychotics

What does the biological treatment of typical antipsychotics do for schizophrenia?

•Reduce positive symptoms but have serious side effects

–Muscle stiffness, tremors, and tardive dyskinesia

What age group is preferred for the treatment biological treatment of atypical antipsychotics?

Preferred for the treatment of schizophrenia in adults and youth

Atypical antipsychotics differ from typical antipsychotics, in what way?

compared to typical antipsychotics they are as effective on positive symptoms but have fewer side effects and have some effect on negative symptoms and cognitive impairments

Biological treatments have cultural differences in pharmacological treatments

true

In biological treatments there are challenges with medication compliance

true

What are other biological treatments?

Electroconvulsive therapy and transcranial magnetic stimulation