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

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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-...

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  • January 20, 2023
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  • 2022/2023
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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
chronic
unfavorable prognosis

Late-Onset Schizophrenia

after age 45
more frequently women
predominance of paranoid sx
do well on antipsychotics

Deficit Schizophrenia

=enduring idiopathic negative sx
more severe illness course
higher prev of abnorm invol. movements b4 meds start
poorer social fxn
insidious onset
less long term recovery
less likely to marry
DECREASED RISK of MAJOR DEPRESSION + SUICIDE!

Schizo pts perform poor on psychological testing such as

=vigilance, memory, concept formation
pathological involvement of frontotemporal cortex

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