Brain and Behavior: Schizophrenia

The … of schizophrenia is a major reason for its complexity

heterogeneity

There is an increased prevalence in … and equal incidence across the socioeconomic classes

lower socioeconomic

High incidence during: … (2)

winter, early spring

…: inability to distinguish reality from fantasy, impaired reality0testing with creation of new reality

psychosis

Psychosis is characterized by: … (4)

delusions, hallucinations, disorganized thinking, abnormal motor behavior, negative symptoms

…: fixed beliefs that are not amenable to change in light of conflicting evidence, not in keeping with patients socio-cultural background

delusions

…: perception-like experiences that occur without an external stimulus, vivid and clear, with the full force and impact of normal perceptions and not under voluntary control

hallucinations

Types of hallucinations: … (5)

auditory, visual, olfactory, gustatory, tactile

Schizophrenia patients have trouble with … leading to difficulties in performing activates of daily living

goal-directed behavior

Negative symptoms of schizophrenia: … (5)

diminished emotional expression, avolition, alogia, anhedonia, asociality

…: thoughts not connected in any coherent or logical manner

disorganized speech

…: switched quickly from one idea to another

flight of ideas

…: long-winded, delayed reaching goal

circumstantiality

2 or more of the following symptoms doe more that 1 month to be diagnoses: … (5)

delusions, hallucinations, disorganized speech, catatonic behavior, negative symptoms

medical conditions may induce psychosis: … (11)

substance abuse, space-occupying lesions, head trauma, infections, endocrine disease, huntingtins, parkinson’s, migraine/temporal arteritis, porphyria, delirium/dementia, withdrawl

…: bipolar I disorder and major depressive disorder, the duration of psychotic symptoms is relatively brief in relation to the affective symptoms

affective disorders

…: in schizophrenia the total duration of affective symptoms is brief relative to the total duration of the illness

schizoaffective disorder

…: patients may have beliefs that border on delusions but generally recognize that are somewhat irrational

obsessive-compulsive disorder

…: patients with borderline or other personality disorders, as well as dissociative disorders

brief reactive psychosis

…: may involve visual, auditory, tactile and olfactory hallucinations during flashbacks

PTSD

Very high rates of … in schizophrenic patients

suicide

…: 1/3 normal lives, 1/3 symptoms continue but are functional, 1/3 markedly impaired and hospitalized

rule of thirds

…: block dopamine and dampen symptoms

antipsychotics

Groups of antipsychotics: … (2)

typical (1st gen), atypical (2nd gen)

Typical antipsychotics: … (2)

chlorpromazine, haloperidol

Atypical antipsychotics: … (3)

olanzapine, risperidone, clozapine

Psychosocial interventions: … (5)

sheltered employment, social skill training, family work, carers groups, CBT

Symptoms of schizophrenia that lead to medication no-adherence: … (7)

denial of illness, memory fluctuations, lack of intiative, lack of motivation, paranoia, disruption due to drugs/alc

With each relapse: … (6)

progressive grey/white matter loss, slower response, more frequent hospitalizations, resistant to treatment, increased risk of self-harm, loss of self-esteem