Term
| Who coined the term "schizophrenia"? |
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Definition
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Term
| Literal translation of schizophrenia |
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Definition
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Term
| Other types of psychotic disorders |
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Definition
• Schizoaffective DO
• Delusional DO
• Brief Psychotic DO
• Schizotypal Personal DO
• Schizophreniform DO |
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Term
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Definition
Sub-categorized schizophrenia:
• Paranoid
• Catatonic
• Hebephrenic (Disorganized) |
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Term
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Definition
| People may become unaware of the environment and maintain a fixed or rigid posture |
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Term
| Hebephrenic Schizophrenia |
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Definition
• An extreme expression of the disorganization syndrome
• One aspect of the three-factor model |
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Term
| The Three-Factor Model of Schizophrenia |
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Definition
• Disorganization
• Reality distortion (delusions and hallucinations)
• Psychomotor poverty (poverty of speech, lack of spontaneous movement and various aspects of blunting of emotion) |
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Term
| Prevalence of schizophrenia in US |
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Definition
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Term
| Age onset of schizophrenia |
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Definition
• Males early adolescence
• Females early to mid 20s |
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Term
| 30-40-30 of Schizophrenia |
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Definition
• 30% will recover very well from their first psychotic episode
• 40% will experience chronic, moderate dysfunction
• 30% will experience chronic, severe dysfunction |
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Term
| Best predictor of recovery for schizophrenia |
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Definition
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Term
| Most common symptoms of schizophrenia |
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Definition
• Blunted or inappropriate affect
• Avolition or lack of drive
• Agitation or anxiety |
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Term
| Schizophrenics' threat to society |
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Definition
| Most are more afraid of us then we are of them, so limited threat |
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Term
| Definition of positive symptom of Schizophrenia |
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Definition
| Excesses of thought, emotion, and behavior |
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Term
| Positive symptoms of Schizophrenia |
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Definition
• Delusions
• Disorganized thinking and speech
• Heightened perceptions/hallucinations
• Inappropriate affect
• Agitation or hyperactivity |
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Term
| Definition of negative symptom of Schizophrenia |
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Definition
| Deficits in thought, emotion, and behavior |
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Term
| Negative symptoms of Schizophrenia |
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Definition
• Poverty of speech or speech content
• Flat or blunted affect
• Avolition
• Social withdrawal |
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Term
| Psychomotor symptoms of Schizophrenia |
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Definition
| Odd or unusual mannerisms, gestures, facial expressions, movements, or changes in posture |
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Term
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Definition
| Positive symptoms predominate |
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Term
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Definition
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Term
| Diagnostic Criteria for Schizophrenia |
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Definition
1. At least 2 symptoms, each present for at least 1 month. At least one symptom must be delusions, hallucinations, or disorganized speech.
2. Functional impairment
3. Continuous signs of the disturbance for at least 6 months, at least 1 month of which includes symptoms active form.
4. Can't be due to Bipolar DO, Schizoaffective DO, or drugs |
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Term
| Schizophreniform Disorder |
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Definition
| If an individual meets all the diagnostic criteria for schizophrenia with the exception of the minimum 6 months time period, then this diagnosis is given |
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Term
| 3 phases of Schizophrenia |
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Definition
1. Prodromal phase
2. Active phase
3. Residual phase |
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Term
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Definition
• First phase of Schizophrenia (sometimes surpassed)
• Characterized by subtle symptoms involving unusual thoughts or abnormal perceptions (but not outright delusions or hallucinations)
• Ex. Waning interest in social activities, difficulty meeting responsibilities of daily living, and impaired cognitive functioning |
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Term
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Definition
• Third phase of Schizophrenia
• After acute episodes, their behavior returns to the level of the prodromal phase
• Flagrant psychotic behaviors are absent, but the person is still impaired by significant cognitive, social, and emotional deficits |
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Term
| Iatrogenic effects of Schizophrenia |
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Definition
• Unintended, negative side effects caused by treatment
• Such as tardive dyskinesia |
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Term
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Definition
• Refers to a permanent side effect of chronic use of neuroleptics
• Characterized by involuntary movements of the face, mouth, and tongue (such as lip smacking, tongue thrusting, and facial grimacing) |
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Term
| Biological theory of Schizophrenia |
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Definition
| Modified dopamine hypothesis |
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Term
| Modified Dopamine Hypothesis of Schizophrenia |
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Definition
• For unknown reasons, dopamine decreases binding in the meso-cortical region (prefrontal cortex), which then leads to underactivity and therefore negative symptoms
• At the same time, it does not regulate dopamine binding in the meso-limbic system, which leads to dopamine overactivity and therefore positive symptoms |
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Term
| Psychological theory of Schizophrenia |
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Definition
| Stress plays a key role in interacting with a biological vulernablity. |
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Term
| 2 types of life stressors in Schizophrenia |
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Definition
• Social class
• Family factors |
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Term
| Biological treatments in Schizophrenia |
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Definition
• Insulin coma therapy
• ECT
• Psychosurgery (prefrontal lobotomy)
• Drug therapy (neuroleptics) (however bad side effects) |
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Term
| Psychotic drugs and schizophrenia |
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Definition
| • About 30% of patients do not respond favorably to the traditional antipsychotics |
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Term
| Atypical antipsychotic drugs for schizophrenia |
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Definition
• Patients may respond to these newer antipsychotic drugs
• They seem to be as effective as traditional antipsychotics in reducing positive symptoms, and are superior in reducing relapse rates |
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Term
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Definition
• A serious side effect of clozapine
• It can impair the functioning of the immune system in about 1% of patients by drastically lowering white blood cell counts, making patients vulnerable to infection and even death |
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Term
| Psychodynamic therapies of Schizophrenia |
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Definition
• Harry Stack Sullivan pioneered the use of psychotherapy with schizophrenic hospitalized patients
• Led to little support of effectiveness |
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Term
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Definition
| Reattribution, problem solving, relaxation, conflict resolution, coping skills training, and rehearsal can be helpful with drugs in dealing with hallucinations and delusions |
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Term
| Personal therapy of Schizophrenia |
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Definition
• Developed by Hogarty
• Designed to teach people with schizophrenia how to succeed in a wide variety of interpersonal situations
• Teaching life skills that are necessary to master for quality of life
• Effective in promoting functioning, fewer relapses, better social functioning, and higher quality of life in severely disturbed patients |
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Term
| Family therapy in Schizophrenia |
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Definition
| Patient requires ongoing assistance, supervision, and support from family |
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Term
| Best Treatment for Schizophrenia |
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Definition
• Medication
• Plus well-coordinated multidisciplinary treatment approaches including social skills training, family education and therapy, occupational training and placement, and social support |
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Term
| Schizophrenia and suicide |
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Definition
| 15% of people commit suicide |
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Term
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Definition
• Men are more likely to display negative symptoms
• Men are more likely to have a more severe or deteriorating course than are women |
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Term
| Co-morbidity with Schizophrenia |
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Definition
| About 50% of individuals with schizophrenia may have a co-morbid substance use disorder (self medicating?) |
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Term
| Age onset of Schizophrenia |
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Definition
| 75% of schizophrenic patients have illness onset between the ages of 16 to 25 |
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Term
| Schizophrenia and socioeconomic status |
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Definition
| It is 2 – 8x more prevalent among the lower SES class |
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Term
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Definition
• An belief that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument
• Most common delusions are paranoid, delusions of reference, delusions of being controlled, and delusions of grandeur |
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Term
| Delusions of persecution or paranoia |
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Definition
| "The CIA is out to get me" |
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Term
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Definition
"People on the bus are talking about me"
"People on TV are making fun of me" |
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Term
| Delusions of being controlled |
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Definition
| Believing one's thoughts, feelings, impulses, or actions are controlled by external forces such as agents or the devil |
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Term
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Definition
| Believing oneself to be Jesus or believing one is on a special mission, or having grand but illogical plans for saving the world |
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Term
| Disorganized thinking and speech |
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Definition
• Neologisms
• Loose associations
• Perseverations |
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Term
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Definition
• A newly coined word or expression
• Basically, it is a made-up word that people with schizophrenia use as if it is a real word |
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Term
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Definition
• A thought disorder
• Characterized by discourse consisting of a sequence of unrelated or only remotely related ideas
• The frame of reference often changes from one sentence to the next. |
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Term
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Definition
| The pathological, persistent repetition of a word, gesture, or act |
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Term
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Definition
• Sensory perceptions experienced in the absence of external stimulation
• Difficult to distinguish from reality |
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Term
| The most common type of hallucination |
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Definition
• Auditory (i.e. hearing voices)
• Affects about 3/4 people with schizophrenia |
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Term
| Etiology of schizophrenia |
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Definition
• Siblings 9%
• Children 13%
• DZ twins 17%
• Both birth parents schiz. 46%
• MZ twins 48% |
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Term
| Schizophrenia and family history |
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Definition
• Schizophrenic patients with positive family histories of schizophrenia had more negative symptoms than those with no family history of schizophrenia
• Negative sx’s – genetics? |
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Term
| Schizophrenia and Schizotypal PD |
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Definition
• Genetically linked
• Both have eye tracking dysfuntion
• Many Schizotypal PD never develop full blown schizophrenia |
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Term
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Definition
• Considered to be a stable, genetic trait.
• More common among families positive for schizophrenia spectrum disorders than for control families |
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Term
| Fish's research on Schizophrenia |
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Definition
• Predicted schizophrenia with 100% accuracy
• Pandysmaturation Syndrome
If these three developmental markers are present, then they will develop schizophrenia
• Atypical muscular & visual development
• Atypical bone growth paralleling above
• Atypical motor coordination development |
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Term
| Mednick's Denmark high risk study |
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Definition
• Prenatal risk
• Incidence of viral infections (i.e. flu) during 2nd trimester in mother changed the course of brain development in fetus
• 7x more likely to develop schizophrenia if mother had a viral infection in 2nd trimester
• Higher incidence of schizophrenia if born in winter (flu season) |
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Term
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Definition
• Schizophrenia
• Continuous Performance Task (CPT): Attentional deficits
• Low IQ
• Poor neurobehavioral functioning: (e.g., poor concentration, poor verbal ability, lack of motor control and coordination) |
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Term
| Hollister and Mednick's study |
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Definition
• Found link between mother's immune system and schizophrenia
• Possible that mom's opposite blood type read daughter's blood type as an invader and put out antibodies
• PREVENTABLE! |
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Term
| Extrapyramidal side effects |
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Definition
• Resemble the symptoms of Parkinson’s disease (hand tremors, a shuffling gait, and drooling)
• Most common side effect of neuroleptics |
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Term
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Definition
• A state of muscular rigidity
• Side effect of neuroleptics |
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Term
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Definition
• An abnormal motion of voluntary and involuntary muscles
• Produces chewing movements as well as other movements of the lips, fingers, and legs
• Side effect of neuroleptics |
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Term
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Definition
| Together they cause arching of the back and a twisted posture of the neck and body |
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Term
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Definition
• Side effect of neuroleptics
• An inability to remain still; people pace and fidget constantly |
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Term
| Neuroleptic malignant syndrome |
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Definition
• A side effect which occurs in about 1% of patients with schizophrenia
• This sometimes fatal condition involves severe muscular rigidity, accompanied by fever
• The heart races, blood pressure increases, and a comatose state may occur. |
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Term
| Statistics of traditional antipsychotic drugs |
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Definition
Because of the side effects, about 50% of patients who take them quit after 1 year
• Up to 75% quit after 2 years |
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Term
| Catch-22 of traditional antipsychotic drugs |
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Definition
• If medication is too low, the chance of relapse increases
• If medication is continued or is too high, serious and untreatable side effects may develop |
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Term
| Types of atypical antipsychotic drugs |
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Definition
• Clozapine (Clozaril)
• Olanzapine (Zyprexa)
• Quetiapine (Seroquel)
• Risperidone (Risperdal) |
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Term
| Advantages of Olanzapine (Zyprexa) and risperidone (Risperdal) |
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Definition
• Produces fewer motor side effects of the traditional antipsychotics
• Perhaps because of this, patients are somewhat less likely to discontinue treatment |
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Term
| Gottesman and Shields' landmark twin studies on schizophrenia |
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Definition
• If index twin has severe course of sz, the other twin has a 77% prevalence of developing it
• If index twin has a moderate course of sx, the other twin has only a 27% prevalence of developing it |
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Term
| Bracha’s disconcordant twins study |
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Definition
• Hand abnormalities in twins
• Something must happen prenatally in-utero that may cause one twin to develop schizophrenia but not the other |
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Term
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Definition
• Double blind procedure
• Tested patients with a 1st generation antipsychotic and then a 2nd gen antipsychotic
• Regardless of the drug, side effects made it hard to stick with
• No evidence that 2nd gen drugs were better for negative symptoms
• No difference in side effects |
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Term
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Definition
• Done in the UK
• Trial one: 1st gen antipsychotic vs. 2nd gen (other than clozapine)
• Result of trial one is that there was no sig difference. But the 1st gen was better after a year.
• Second trial involved clozapine
• Result of second trial was that clozapine had greater effectiveness |
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Term
| Significance of the CATIE and CUtLASS Studies |
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Definition
| 2nd generation drugs are way more money, but they have no real difference |
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Term
| Schizophrenia: brain cell death or underdeveloped? |
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Definition
• See a lot of structural changes in brain. Primarily loss of brain matter.
• Dendritic spine loss (neurons are still in tact and functioning, but because of unknown reasons, the dendritic spines stop working and therefore problems with neurons functioning) |
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Term
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Definition
| The link between DNA and what actually comes into being |
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Term
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Definition
| A mood disorder with schizophrenia concurrently present |
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Term
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Definition
| Have a psychotic episode for less than 1 month |
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Term
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Definition
• One symptom psychotic disorder
• Eratomania |
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