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
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