Sadock Ch 7 Schizophrenia + Psych disorders + Study
Guide, Complete Solution
Bleuler's 4 A's
Association
Affect
Ambivalence
Autism
Onset Schizophrenia
men= 10-25
women= 25-35 (bimodel; 2nd peak at middle age)
Schizophrenia in men:
in women:
men- more likely have negative sx
women- have better social functioning; better outcome
Schizophrenia pts more likely born in
winter + early spring
Nicotene
decreases blood concentration of antipsychotics
may decrease positive sx
improves some cognitive impairments + parkinsonism
dopamine hypothesis of schizophrenia
idea that schizophrenia results from excess activity at dopamine synapses in certain brain areas --
(excess dopamine=linked to excess of positive sx)
mesocortical +mesolimbic tracts = most often
Serotonin Hypothesis of Schizophrenia
serotonin excess
causes pos + neg sx
Norepinephrine
,selective neuronal degregation within the norepi reward neural system could account for anhedonia
GABA
Pts w. schizophrenia have a loss of GABAergic neurons in the hippocampus
GABA has regulatory effect on dopamine activity;
the loss of inhib GABAergic neurons could lead to HYPERACTIVITY of dopaminergic neurons.
BRAIN CHANGES
- Lateral and 3rd ventricular enlargement
- Reduction in cortical volume
- Reduction of gray matter volume
- Reduced symmetry (temporal, frontal, occipital)
- Decrease size of Limbic system (amygdala, hippocmp)
- Hippocam smaller + fxnally abnormal
- Functional deficits of prefrontal cortex
- Volume shrinkage/ neuronal loss of Thalamus
basal ganglia + cerebellum control......
lead to what sx?
control of movement
lead to Tardive Dyskinesia: awkward gait, facial grimacing, stereotypies
What movement d/o's are most commonly assoc w schizophrenia?
Involving the BASAL GANGLIA
Huntingtons + Parkinsons Disease
5 subtypes of schizophrenia
paranoid, disorganized, catatonic, undifferentiated, residual
Paranoid Schizophrenia
dominated by delusions of persecution, along with delusions of grandeur
characterized by 1 or more delusions or freq auditory hallucinations
Disorganized Schizophrenia
marked regression to primitive/disinhibited/unorganized behavior.
severely disturbed thought processes, frequent incoherence, disorganized behavior, and inappropriate
affect.
Disheveled; 'burst out in laughter'
Catatonic Schizophrenia
, marked by striking motor disturbances, ranging from muscular rigidity to random motor activity; rapid
alterations between excitement + stupor
stupor, negativism, rigidity, excitement, posturing, mutism, waxy flex
Catatonic Schizophrenia Classic feature = ?
marked disturbance in motor function
(may involve stupor, negativism, rigidity, excitement, posturing, mutism, waxy flex)
Undifferentiated Schizophrenia
mixture of sx
does not meet diagnostic criteria for any 1 type
Risidual Schizophrenia
Continuing evidence of the schizophrenic disturbance in absence of a complete set of active sx.
(emotional blunting, social w/d, eccentric behav, illogical thinking, mild looseness of assoc.)
Early-Onset Schizophrenia
childhood manifestation of sx
insidious onset
chronic
unfavorable prognosis
Late-Onset Schizophrenia
after age 45
more frequently women
predominance of paranoid sx
do well on antipsychotics
Deficit Schizophrenia
=enduring idiopathic negative sx
more severe illness course
higher prev of abnorm invol. movements b4 meds start
poorer social fxn
insidious onset
less long term recovery
less likely to marry
DECREASED RISK of MAJOR DEPRESSION + SUICIDE!
Schizo pts perform poor on psychological testing such as
=vigilance, memory, concept formation
pathological involvement of frontotemporal cortex
Guide, Complete Solution
Bleuler's 4 A's
Association
Affect
Ambivalence
Autism
Onset Schizophrenia
men= 10-25
women= 25-35 (bimodel; 2nd peak at middle age)
Schizophrenia in men:
in women:
men- more likely have negative sx
women- have better social functioning; better outcome
Schizophrenia pts more likely born in
winter + early spring
Nicotene
decreases blood concentration of antipsychotics
may decrease positive sx
improves some cognitive impairments + parkinsonism
dopamine hypothesis of schizophrenia
idea that schizophrenia results from excess activity at dopamine synapses in certain brain areas --
(excess dopamine=linked to excess of positive sx)
mesocortical +mesolimbic tracts = most often
Serotonin Hypothesis of Schizophrenia
serotonin excess
causes pos + neg sx
Norepinephrine
,selective neuronal degregation within the norepi reward neural system could account for anhedonia
GABA
Pts w. schizophrenia have a loss of GABAergic neurons in the hippocampus
GABA has regulatory effect on dopamine activity;
the loss of inhib GABAergic neurons could lead to HYPERACTIVITY of dopaminergic neurons.
BRAIN CHANGES
- Lateral and 3rd ventricular enlargement
- Reduction in cortical volume
- Reduction of gray matter volume
- Reduced symmetry (temporal, frontal, occipital)
- Decrease size of Limbic system (amygdala, hippocmp)
- Hippocam smaller + fxnally abnormal
- Functional deficits of prefrontal cortex
- Volume shrinkage/ neuronal loss of Thalamus
basal ganglia + cerebellum control......
lead to what sx?
control of movement
lead to Tardive Dyskinesia: awkward gait, facial grimacing, stereotypies
What movement d/o's are most commonly assoc w schizophrenia?
Involving the BASAL GANGLIA
Huntingtons + Parkinsons Disease
5 subtypes of schizophrenia
paranoid, disorganized, catatonic, undifferentiated, residual
Paranoid Schizophrenia
dominated by delusions of persecution, along with delusions of grandeur
characterized by 1 or more delusions or freq auditory hallucinations
Disorganized Schizophrenia
marked regression to primitive/disinhibited/unorganized behavior.
severely disturbed thought processes, frequent incoherence, disorganized behavior, and inappropriate
affect.
Disheveled; 'burst out in laughter'
Catatonic Schizophrenia
, marked by striking motor disturbances, ranging from muscular rigidity to random motor activity; rapid
alterations between excitement + stupor
stupor, negativism, rigidity, excitement, posturing, mutism, waxy flex
Catatonic Schizophrenia Classic feature = ?
marked disturbance in motor function
(may involve stupor, negativism, rigidity, excitement, posturing, mutism, waxy flex)
Undifferentiated Schizophrenia
mixture of sx
does not meet diagnostic criteria for any 1 type
Risidual Schizophrenia
Continuing evidence of the schizophrenic disturbance in absence of a complete set of active sx.
(emotional blunting, social w/d, eccentric behav, illogical thinking, mild looseness of assoc.)
Early-Onset Schizophrenia
childhood manifestation of sx
insidious onset
chronic
unfavorable prognosis
Late-Onset Schizophrenia
after age 45
more frequently women
predominance of paranoid sx
do well on antipsychotics
Deficit Schizophrenia
=enduring idiopathic negative sx
more severe illness course
higher prev of abnorm invol. movements b4 meds start
poorer social fxn
insidious onset
less long term recovery
less likely to marry
DECREASED RISK of MAJOR DEPRESSION + SUICIDE!
Schizo pts perform poor on psychological testing such as
=vigilance, memory, concept formation
pathological involvement of frontotemporal cortex
