Schizophrenia- Neurological Disorders

what is the most severe neuropsychiatric illness

schizophrenia

how many people have schizophrenia world wide

20+ million

how many people in the US have schizophrenia

2.2 million

does schizophrenia have a sex difference?

no

how many hospital beds are occupied by schizophrenia patients

1/3

when do symptoms start with schizophrenia patients

18-25 years

what are positive symptoms

hallucinations, delusions, and paranoia

what are negative symptoms

loss of motivation, apathy, asocial behavior, loss of affect and speech

what are cognitive symptoms

impaired working memory, reduced attention span, disorganized thoughts, speech, and movement, impaired executive function

what is an example of disorganized movement

catatonia and child like behavior

what does catatonia look like

immobile and unresponsive

do you need all symptoms to be diagnosed?

no

what are negative symptoms misdiagnosed as

depression

what usually causes someone to be diagnosed with schizophrenia

a psychotic break

what is a the prodromal phase

withdrawn

what are symptoms in teenagers (early symptoms)

withdrawing from friends/family, not doing well in school, trouble sleeping, feeling irritable/depressed, lacking motivation

what are NOT symptoms in teenagers

NOT hallucinations, delusions, disorganization

before medication how were schizophrenia patients treated?

sedations and physical restraint

what type of symptoms do anti-psychotic drugs treat

positive symtoms

how was chlorpromazine created

double blind study created to test efficacy, too much can cause movement problems, created to be a sedative anti-histamine, eliminated post surgical shock

when did doctors used to know if the patient had enough chlorpromazine

when it caused PD symptoms

what is the heritability coefficient for schizophrenia

0.79

what are moderate risk factors

winter birth (higher risk for viral infection), maternal malnutrition, perinatal injury, solar flares at birth, growing up in urban area, minority groups

is there physical changes in the brain with people with schizophrenia

larger ventricles due to brain atrophy and disorganization of pyramidal cells in hippocampus

what areas of the brain have functional differences

amygdala, hippocampus, dorsolateral prefrontal cortex, and ventrolateral prefrontal cortex

is there one specific gene for schizophrenia

no, there are many different gene

what does chlorpromazine do

D2 receptor antagonist

what is increased release of dopamine linked to

psychotic behavior

when is dopamine the highest is schizophrenia patients

during the psychotic episode

what type of symptoms does dopamine release address?

positive symptoms only

when people are given chlorpromazine during surgery what happens

they are consciousness but disinterested

what happens to NMDA receptors in schizophrenia

hypofunction (insufficient)

what blocks NMDA receptors

PCP and ketamine

what does PCP and ketamine cause

both positive and negative symptoms

what does glutamate do to dopamine

controls dopamine activity

what does GABA have to do in schizophrenia

an enzyme involved with the synthesis of GABA is decreased in dorsolateral prefrontal cortex

what does an EEG measure

electrical activity

what do gamma waves do in the brain

bind info and working memory, allow words and mouth movement to sync

normal gamma waves

schizophrenia

why do auditory hallucinations occur

internal voice seems like an external sound, info binding issue

what happens to dendrites with schizophrenia patients

smaller pyramidal cell bodies and dendrites with fewer spines

what happens to dendrites in adolescent schizophrenia patients

over pruning, causing symptoms to start

what happens to oligodendrocytes

less of them, could be due to fewer axons?

what happens to white matter volume in people with schizophrenia

reduced white matter volume, brain regions are less connected

are these physical symptoms a cause or effect of schizophrenia

we don’t know, we can only study postmortem brains

what do typical antipsychotic drugs look like

D2 receptor antagonist, 70% effective at treating psychosis, side effects, poor compliance

what do side effects of typical antipsychotic drugs look like

weight gain, slowed movement, loss of sex drive

what do atypical antipsychotic drugs look like

D2 plus some other neurotransmitter

do atypical antipsychotic drugs actually have fewer side effects

no, they just marketed them that way, however improved movement

are typical or atypical antipsychotic drugs more common

atypical

do antipsychotic drugs work on overall schizophrenia symptoms

favored antipsychotic drugs by 0.5% (12 year old to 14 year old difference)

do antipsychotic drugs work on positive symptoms

worse than overall symptom management

what does compliance look like in antipsychotic medication

high possibility of relapse, 80% non-compliance

does increasing glutamate help manage symptoms

excitotoxicity with too much but works

does increasing glycine help treat schizophrenia symptoms

no, astrocytes are too good at regulation

why would glycine help improve schizophrenia symptoms

agonist for NMDA receptor (maximum response)

does nicotine help schizophrenia symptoms

90% of schizophrenia patients self medicate with nicotine

what does ECT do

induces a seizure, like restarting a computer

does ECT work as a schizophrenia treatment

yes, especially for catatonic patients

what are side effects of ECT

progressive memory loss the more times you do it (24 hour to 48 to 96)

why is ECT used in depression treatment

instant results that wear off over time, but in time for depression medication to start working

what does trancranial magnetic stimulation do for schizophrenia patients

restores gamma osciliations and increases dopamine activity

does trancranial magnetic stimulation actually work for schizophrenia treatment

meta analysis showed 0% improvement, another one showed improved negative symptoms but results can be biased

do dietary changes help schizophrenia patients

nope

why is it hard to tell if treatment works in schizophrenia patients

subjective assessments and patient self reports

does dopamine activity increase or decrease

increase

does glutamate activate increase or decrease

decrease

what GABA activity increase or decrease

decrease