Schizophrenia

• Schizophrenia Symptoms

  Positive Symptoms (Active Psychosis):

  • Hallucinations
  • Delusions
  • Confusion and Disorganization

  Negative Symptoms (Not psychotic):

  • Lacks motivation, hygiene, emotion
• Hallucinations

  Sensory experiences in absence of an external source

  • Hearing, seeing, feeling, etc.
• Delusions

  Fixed/False belief

  • Persecutory
  • Grandiose,
  • Erotomanic
  • Somatic
  • Reference Nihilistic
  • Control
  • Shared
• Schizophrenia

  2 or more (1 month):

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized behavior
  • Negative symptoms

  Schizophrenia Subtypes:

  • Paranoid, Catatonic, etc.

  Info:

  • Insidious onset
  • Psychotic symptoms lower with age
  • Risks:
  • Late winter/early spring birth
  • Brain injury
• Catatonia Associated w/another Mental Disorder

  3 or more:

  • Stupor
  • Mutism
  • Agitation
  • Grimacing
• Brief Psychotic Disorder

  
  

  One or more (1 day – 1 month):

  • Delusions
  • Hallucinations
  • Disorganized speech
  • Disorganized behavior
• Schizophreniform Disorder

  2 or more (1 month – 6 months):

  • Delusions
  • Hallucinations
  • Disorganized Speech
  • Disorganized Behavior
  • Negative symptoms

  Can develop into Schizophrenia

  • Etiology:
  • Genetic
• Schizoaffective Disorder

  Uninterrupted period of major depressive episode, manic episode, or mixed episode concurrent with symptoms of Criterion A for Schizophrenia

  • Delusions/Hallucinations in the absence of mood symptoms (psychosis – depression – psychosis)
  • Etiology:
  • Genetic
• Delusional Disorder

  One or more delusions (1 month):

  • Criterion A for Schizophrenia not met
  • Functioning not markedly impaired
• Etiology of Delusions

  Deficit View (Medical):

  Brain dysfunction causes categorical deficits in cognitive information processing

  Motivational View (Developmental):

  Delusions represent cause-effect inferences
• Genetics of Schizophrenia


  Family:

  • First Cousin: 2%
  • Aunt/Uncle: 2-4%
  • Parent/Sibling/Grandparent: 6-13%
  • Fraternal Twin: 17%
  • Both Parents: 50%
  • Identical Twin: 50%

  General Population:

  • 1%

  Linked to DA metabolism genes
• Schizophrenia and Brain Abnormalities

  
  

  Higher prevalence for any brain insult
• Neurochemistry of Schizophrenia

  
  

  DA antagonists and agonists can trigger psychosis
• Treatment of Schizophrenia

  Antipsychotics:

  • Broad conclusions unwarranted!
  • DA (D2) Antagonists
  • DA (D1) Agonists

  Side Effects:

  • Nigrostriatal D2 Receptor Blockage – Treat w/ anticholinergic
  • Nigrostriatal D2 Receptor Stimulation – Irreversible
  • Akinesia
  • Tardive Dyskinesia