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Flashcards in Task 8 Schizophrenia Deck (50)
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1

Psychotic

experiences and beliefs that are not in touch with reality

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Psychosis

If you are unable to tell the difference what is real and what not (most prominent is schizophrenia)

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Delusions

ideas that an individual beliefs are true but are highly unlikely and often simply impossible (preoccupied)
o Different types of delusions can cooccur
o Persecutory delusion: False belief that oneself or one’s loved ones are being persecuted, watched, or conspired against by others
o Delusions of reference: Belief that everyday events, objects, or other people have an unusual personal significance
o Grandiose delusion: False belief that one has great power, knowledge, or talent or that one is a famous and powerful person
o Delusions of being controlled: Belief that one’s thoughts, feelings, or behaviours are being imposed or controlled by an external force
o Thought broadcasting: Belief that one’s thoughts are being broadcast from one’s mind for others to hear
o Thought insertion: Belief that another person or object is inserting thoughts into one’s mind
o Thought withdrawal: Belief that thoughts are being removed from one’s mind by another person or by an object
o Delusions of guilt or sin: False that one has committed a terrible act or is responsible for a terrible event
o Somatic delusion: False belief that one’s appearance or part of one’s body is diseased or altered

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Hallucinations

o Healthy people do sometimes experience hallucinations, but they do not impair their daily function
o In schizophrenia they are more frequent, persistent, complex, bizarre and often entwined with delusions

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Auditory hallucinations

most common, e.g. speaking about the individual in third person or giving commands and instructions
 Often negative quality
o Can occur in depression and bipolar too
o Cultural background can influence the content, same as with delusions

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Visual hallucinations

seeing not existing things

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Tactile hallucinations

involve the perception that something is happening to the outside of the persons body, e.g. bugs crawling up her back

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Somatic hallucinations

perception that something is happening inside the persons body, e.g. worms eating the intestines

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Disorganized thought and speech

o Formal thought disorder: disorganized thinking of people with schizophrenia
o Loose associations: the tendency to switch to seemingly unrelated topics
o Neologism: making up words that only make sense for them
o Clangs: making up associations because of same sounds of words rather than content
o More common in men because language centrum is only in one site of brain in women its more bilateral

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Disorganized behaviour

o May display unpredictable and apparently untriggered agitation , e.g. suddenly shouting
 Might be a response to delusions or hallucinations
o Often show problems with task as getting dressed because of impairments in memory and attention ´

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Catatonia

unresponsiveness to the environment
 Negativism: lack of response to instructions
 Mutism: rigid, inappropriate, or bizarre posture, to a complete lack of verbal or motor responses
 Catatonic excitement: purposeless and excessive motor activity for no apparent reason

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Negative symptoms

o Labelled this way because it involves the loss of certain qualities
o Tend to be persistent and more difficult to treat compared to positive symptoms

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Restricted affect (negative symptom)

 Refers to a severe reduction in or absence of emotional expression in persons with schizophrenia
 People report anhedonia, the loss of the ability to experience pleasure (might be falsified by self-report)
 Might still experience emotions just can’t show them

14

Avolition (negative symptom)

inability to initiate or persist at common, goal directed activities
• Slowed down in movements and seems unmotivated
• May be expressed as asociality, the lack of desire to interact with other people
o Can only be diagnosed of indviduals have access to welcoming family and friends but show no interest in socializing with them (often they are dropped by family and friends)

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Cognitive deficits (negative symptom)

• Deficits in attention, memory, working memory and processing speed
• Might be the underlying cause for the other symptoms (e.g. distinguish real from unreal)
• Cognitive deficits can be used as indication for later development of schizophrenia

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Prognosis of schizophrenia

o Between 50 and 80% will be rehospitalized after the first hospitalization
o 10 years shorter life expectancy
o Suffer more form infectious and circulatory disease
o 10 to 15% commit suicide
o 15 year study found 41% had at least one or more periods of complete recovery lasting at least one year

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Gender and age factors

o Women tend to have better prognosis than men
 Also show milder negative symptoms
 Also later onset late 20s early 30s (so often already more settled and educated)
 Estrogen may affect dopamine which might protect women
o Males show greater abnormalities in brain
o General decrease with age due to lower dopamine levels

18

Sociocultural factors

o Less severe in developing countries
 Might be due to social environment, closer and broader family networks

19

Other psychotic disorders

fall along a continuum of severity. Schizophrenia is worst, followed by schizoaffective disorder, schizophreniform disorder and other psychotic disorders

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Schizoaffective disorder

mix of schizophrenia and mood disorder
 Simultaneously experience psychotic symptoms and prominent mood symptoms meeting the criteria for major depressive or manic episodes
 Mood symptoms must be present for the majority of the period of illness and 2 weeks with hallucinations or delusion without mood symptoms

21

Schizophreniform disorder

: requires that individual meet criteria A,D an E but show symptoms that only last for 1-6 months
 Functional impairment can be present but is not necessary
 2/3 will receive schizophrenia or schizoaffective diagnose

22

Brief psychotic disorder

 Show sudden onset of delusions, hallucinations, disorganizes speech and/or disorganized behaviour
 Only last between 1 day and 1 month
 Sometimes triggered by major stressor e.g. accident
 Most people show excellent outcome

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Delusional disorder

 Have delusions lasting at least 1 month
 No psychotic symptoms and other than reactions to delusions don’t act odd or have difficulties in functioning

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Schizotypal PD

 Life long pattern of significant oddities in self-concept, their ways of relating to others and their thinking and behaviour
 Lack of sense of self and trouble setting goals
 Restricted emotionality
 Do not understand other humans behaviour
 Maintain grasp on reality
 Think that random events are related to them
 Cognitive deficits are present but less severe than in schizophrenia

25

Genetic contributors

different genes are thought to be responsible for different symptoms
 50% percent of shared genes have 10% chance of developing

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Structural and functional abnormalities

o Neurodevelopmental disorder, in which a variety of factors lead to abnormal development of the brain in the uterus and early life
o Gross reduction of gray matter in cortex
o Hippocampus differs from the norm (functional and structural)
o Reductions and abnormalities in white matter (present before onset)
 Reduces the interaction between brain regions
o Enlargement of ventricles (also present before onset)
o Abnormal connections

27

Birth complications

 Perinatal hypoxia: deprivation of oxygen in the few weeks before or after birth
• Might interact with genetic factors and triggers Schizophrenia
 Prenatal Viral Exposure: high rates of desease when mother had a virus while pregnant

28

Revised theory (davis)

different types of dopamine receptors and different levels of dopamine in various areas of the brain can account for symptoms
 Mesolimbic pathway: excess dopamine activity, Impairs reward and salience
• Might lead to processing salience where non should be, contributing to hallucinations and delusions and deficits in motivation
 Unusual low dopamine activity in PFC, attention, motivation and organization of behaviour
• Might lead to negative symptoms

29

Serotonin

serotonin neurons regulate dopamine neurons in the mesolimbic system

30

Social drift

Because schizophrenia symptoms interfere with a person’s ability to complete an education and hold a job, people with schizophrenia tend to drift downward in social class compared to the class of their family of origin