Term
| why is psychosis the most severe form of psychiatric disorder? |
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Definition
| it represents a real impairment in ability to recognize what is real and what is not. there can be a distortion of any of the senses: black swan character did not see herself in a mirror (cortical dysfunction). |
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Term
| what characterizes schizophrenia? |
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Definition
| a psychosis which is generally considered to be the most severe mental illness characterizes by a major disturbance in thinking, behavior and mood. schizophrenics experience delusions (false beliefs that a person will adhere to despite all the contradicting evidence that is presented), changes in speech quality and organization, a disconnection between emotion and thought (thought disorder), and usually some intellectual deficit. the etiology is unknown. |
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Term
| is the brain objectively different in schizophrenia? |
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Definition
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Term
| what did schizophrenia used to be called? |
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Definition
| schizophrenia used to be called dementia praecox (as called by emil kreaepelin in the 19th century b/c it starts in adolescence). eugene bleuler coined the current name in the 20th century. |
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Term
| what is the difference between schizophrenia and multiple personality disorder? |
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Definition
| schizophrenia = split mind (not personality) where thought and mood split, thought and perception split, communication and speech split and the ability to conduct a thought is fragmented. |
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Term
| what is the epidemiology of schizophrenia? |
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Definition
| incidence is equal for M/F, lifetime prevalence is 1% and it is more common people born in the winter months (vs spring and summer - maternal illness during pregnancy?) lower class and urban areas. |
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Term
| what is the neuropathology of schizophrenia? |
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Definition
| lower brain volume, reduced axon density, decreased axon density in thalamus/basal ganglia (often clumsy developmentally, problems w/saccadic eye movements), decreased dendrites (particularly in associative areas), enlarged lateral+3rd ventricles, and decreased volume of the cerebellum (ataxia) |
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Term
| does schizophrenia seem to have a genetic basis? |
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Definition
| yes, the incidence in monozygotic twins is high as well as adopted children from schizophrenic pts. |
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Term
| what is the dopamine hypothesis? what neurotransmitters are involved? |
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Definition
| there increased dopamine in the limbic system of schizophrenics, but less in the prefrontal cortex. the first antipsychotic meds block dopamine and those which create schizophrenia like symptoms release a lot of dopamine. schizophrenics have increased NE (more sensory input), less GABA, disturbances in glutamine receptors and less serotonin. |
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Term
| who is at a higher risk for schizophrenia? |
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Definition
| pts raised in families w/a high level of expressed emotion |
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Term
| why are delusions created? |
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Definition
| to explain things w/o explanations as a form of disordered thinking |
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Term
| what characterizes paranoid schizophrenia? |
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Definition
| a common form of schizophrenia characterized by delusions (100% believe in), usually following a theme of persecution or grandeur. |
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Term
| what is a command hallucination? |
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Definition
| a schizophrenic pt may "hear" a command to do something and feel compelled to obey |
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Term
| what is disorganized schizophrenia (hebephrenia)? |
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Definition
| pts w/this are very dis-inhibited (smearing feces on walls) and regressed in behavior. their ability to conduct logical thought in speech becomes impaired (some can't even take notes) due to loosening of thought associations (no logical train of thought). they create neologisms and often act silly, giggly, or cackle constantly. |
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Term
| what is catatonic schizophrenia? |
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Definition
| this has all the hallmarks of schizophrenia but also has a psychomotor problem - will remain in mannequin-like postures for extended periods of time. these pts have "waxy flexibility", may have impaired speech (switch between mute and hyper-excitability), and little expression of pain. |
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Term
| what is residual schizophrenia? |
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Definition
| no chronic delusions/hallucinations, but still have withdrawal and difficulty w/communication. these pts really rely on what is w/in themselves to get stimulation. difficulty w/4 As: association (of thought), affect (flat), autism (stimulation comes from w/in), and ambivalence (see both sides of an issue and react as if both sides are the issue) |
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Term
| what is tx for schizophrenia? |
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Definition
| hospitalization (safety from harm to the pt and others, support and therapy), antipsychotic meds (serotonin, H2, dopamine receptor antagonists), and interview (have to be gentle, b/c these pts have weak ego function - need someone to believe them to establish trust) |
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Term
| what is shared psychotic disorder? |
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Definition
| 2 people (usually from the same family) share the same delusion |
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Term
| what is schizophreniform psychosis? |
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Definition
| in schizophrenia, there is a 6 months+ build up of symptoms until they have initiate break - but in schizophreniform psychosis, the build up period is more like a month long. these pts have delusions and hallucinations but are not subject to remission and chronicity like schizophrenia (greater cure rate). |
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Term
| what is schizoaffective disorder? |
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Definition
| where a pt starts off looking schizophrenic – with delusions and hallucinations and then about 2 wks later develops a sudden major affective component (profoundly depressed/manic). |
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Term
| what is delusional disorder? tx? |
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Definition
| primary symptoms: delusions supported by non-bizarre hallucinations like infidelity, erotomania (delusion of a secret love), somatic delusions (believe something is wrong w/body), or grandiose delusions (believe you are a deity). this occurs more in middle age to previously well functioning pts. tx: hospitalization and anti-psychotics |
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