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UWM Patho II Exam 4
Thought Disorder
| Question | Answer |
|---|---|
| What is Schizophrenia? | “shattered mind”, and comes from the Greek (schizo, “to split” or “to divide”) and (phrēn, “mind”). Is a group of psychotic disorders characterized by disturbances in perception, behavior and communication that last > 6 mo |
| What is the epidemiology of schizophrenia? | Prevalence: 1% of pop. cross-culturally;less chronic and severe in developing countries than in developed, M>F, black>white, Downward drift to low SES 1/3-1/2 of homeless US have it. Onset occurs in late teen or early adult,males show symptoms earlier |
| Where do schizophrenics live? How often is suicide attempted? | Over 50% of schizophrenics do not live with their families, nor are they institutionalized Suicide is attempted by 20%~50% of patients with schizophrenia, 9%~13% succeed. |
| What are the genetic factors in schizophrenia? | Rates for monozygotic twins reared apart = rates for MZ twins raised together (47%) Dizygotic concordance: 13% If 2 schizophrenic parents: 40% incidence, If one parent or one sibling: 12% Risk in biologic relatives 10 times general population (i.e., 10 |
| What are the environment factors associated with schizophrenia? | Stress events cause or trigger (childhood experiences of abuse or trauma) Poverty and discrimination (Rh factor incompatibility) Prenatal exposure to influenza during the second trimester Prenatal malnutrition. |
| What brain structures and developments contribute to schizophrenia? | Abnormalities in the prefrontal cerebral cortex, the hippocampus, the thalamus and related limbic structures Brain imaging in chronic schizophrenia shows cortical atrophy, with enlargement of the cerebral ventricles. |
| How are neurochemical pathways involved in causing schizophrenia? | Genetic factors outweigh non-genetic factors in the etiology of schizophrenia |
| What is The dopamine hypothesis for schizophrenia based on? | dopamine D2 receptor antagonists Findings of increased dopamine receptor (D2) sensitivity in postmortem studies. PET scans show low rates of glucose metabolism in the frontal lobes and dopamine areas of the brain compared with controls. |
| What is the Role of serotonin (5-HT) in schizophrenia? | sero. NT are implicated on the pathogenesis LSD (lysergic acid diethylamide) affects serotonin and can produce a psychotic like state. Newer antipsychotics have high affinity for 5-HT2 receptors. Sero. rises when dopa. falls in some areas of the brain |
| What is the Role of glutamate in schizophrenia? | Fact that various compounds that block NMDA receptor effects all produce subjective affects in humans (hallucinations, thought disorder) that resemble mental state changes in schizophrenia, -> diminished glutamate transmission might be a factor |
| What is the Diagnostic and Statistical Manual of Mental Disorders (DSM)? | DSM is a handbook for mental health professionals that lists different categories of mental disorder and the criteria for diagnosing them, according to the publishing organization the American Psychiatric Association |
| What are the Five Major Axes of Diagnosis? | Axis I: Clinical disorders, Axis II: Personality disorders, Axis III: Physical conditions, Axis IV: Psychosocial and environmental problems, Axis V: Global assessment of functioning |
| What disorders are covered under the Axis I: Clinical disorders? | schizophrenic, affective, anxiety, and somatoform disorders. Also includes anorexia nervosa, bulimia nervosa, sexual disorders, sleep disorders, and autism |
| What disorders are covered under Axis II? | Personality disorders and mental retardation |
| What disorders are covered under Axis III? | Physical conditions and disorders, i.e., any physical diagnosis |
| What disorders are covered under Axis VI: Psychosocial and environmental problems? | primary support group, social occupation, education, housing, economics, health care services, and legal Issues |
| What are Positive symptoms (Type I) of schizophrenia? | What schizophrenic persons have that normals do not e.g., delusions, hallucinations, bizarre behavior Associated with dopamine receptors |
| What are Negative symptoms (Type II) of schizophrenia? | What normals have that schizophrenics do not e.g., flat affect, motor retardation, apathy, mutism (no speech), anhedonia (can't experience or even imagine any pleasant emotion) Associated with muscarinic receptors |
| Anhedonia | can't experience or even imagine any pleasant emotion such as eating, exercise. |
| Clang associations | illogical connections by rhythm or puns rather than by meaning |
| Word salad | speech becomes incoherent (produces language that is not meaningful and might or might not be grammatical. "Salad" indicates that the words are tossed together randomly) |
| Echolalia | repeating in answer many of same words as in question |
| Echopraxia | imitations of movements or gestures |
| Neologisms | new expressions |
| Perseveration | responding to all questions the same way or Persistent repetition of words |
| Affective flattening (Blunted affect) | unchanging facial expressions, poor or no eye contact, reduced body language and decreased spontaneous movements |
| Poverty of speech (Alogia) | sparse and slow speech, often manifested as short, empty replies to questions |
| Avolition | general lack of desire, drive, or motivation to pursue meaningful goals |
| Pressured speech | abundant and accelerated speech |
| Verbigeration | senseless repetition of same words or phrase |
| What are the Psychotic Symptoms of schizophrenia? | Delusion: false beliefs not shared by culture Illusions: misperception of real external stimuli Hallucinations (sensory impression in the absence of external stimuli) Note: not visual hallucinations |
| What are the cognitive impairments (disordered thinking)of schizophrenia? | Disorganized thinking Slow thinking Difficulty understanding Poor concentration Poor memory Difficulty expressing thoughts Difficulty integrating thoughts, feelings and behavior |
| What are Negative symptoms of schizophrenia? | Lack of emotion -inability to enjoy regular activities Low energy,Lack of interest in life, low motivation,blank expression, flat voice or physical movements. Alogia,Inappropriate social skills Inability to make friends,Social isolation |
| Characteristic Schizophrenia symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period. | Delusions,Hallucinations,Disorganized speech,Grossly disorganized or catatonic behavior, "Negative" symptoms of Schizophrenia |
| What are Social/occupational dysfunction criteria of schizophrenia? | Social/occupational dysfunction: must cause significant social and occupational dysfunction Duration: continuous signs of the disturbance persist for at least six months |
| Schizophreniform | if same symptoms as those in Schizophrenia, but last < 6 months |
| Schizoaffective disorder | Concurrent symptoms of schizophrenia and depression or mania (mood disorder) |
| Brief psychotic disorder (e.g., postpartum psychosis) | Presence of delusions, hallucinations, or disorganized speech and behavior Symptoms last 1~30 days. Return to full former functioning. Not a cultural response pattern. Not due to substance abuse or organic cause |
| Delusional disorder | a psychotic mental illness that involves holding one or more non-bizarre delusions (have a certain plausibility, often quite logical) for at least one month in the absence of other symptoms of schizophrenia. |
| Drug-induced psychosis | Certain chemical substances such as amphetamines, cocaine and phencyclidine (PCP or Angel Dust) can induce psychosis. Prescription medication such as certain antibiotics, cardiovascular drugs, and anticholinergics (atropine) can also induce psychosis. |
| Catatonic subtype of schizophrenia | very rare, and is characterized by episodes of prolonged speechlessness and lack of movement (e.g., hold rigid poses for hours and will ignore any external stimuli) |
| Disorganized subtype of schizophrenia | extremely disorganized thinking, speech and behavior. |
| Paranoid subtype of schizophrenia | delusions, grandeur and hallucinations, but exhibits few negative symptoms and little cognitive impairment, 2nd most common type |
| Undifferentiated subtype of schizophrenia | Do not fit the above categories. Most common type. |
| Residual subtype of schizophrenia | Previous episode, but no prominent psychotic symptoms at evaluation. negative symptoms in the absence of positive symptoms |
| What are predictors for good prognosis of schizophrenia? | Paranoid or catatonic Late onset (female) Quick onset Positive symptoms No family history of schizophrenia Family history of mood disorder Absence of structural brain abnormalities |
| What antipsychotics are used to treat schizophrenia? | antipsychotics Phenothiazide Chlorpromazine Haloperidol Thioridazine |
| What is the main side effect of Chlorpromazine? (an antipsychotic used to treat schizophrenia) | (causes orthostatic hypotension) |
| What is the primary use of Haloperidol? (an antipsychotic used to treat schizophrenia) | (treats acute symptoms) |
| What is the main side effect of Thioridazine? (an antipsychotic used to treat schizophrenia) | (retinal deposits → vision problems) |
| What Atypical antipsychotics are used to treat schizophrenia? | Blockade of D1 receptors and serotonin receptors Reduce both positive and negative symptoms with fewer EPS side effect Clozapine (causes agranulocytosis, requires WBC monitoring weekly) Olanzapine (usually low rate of side effects) |
| Evolution of EPS side effects | 4 hours acute dystonia 4 days akinesia 4 weeks akathisia 4 months tardive dyskinesia (often irreversible) |
Created by:
czenecke
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