Sadock Ch 7 Schizophrenia + Psych disorders + Study Guide, Complete Solution

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