PSYCH 4035 Chapter 15 (Schizophrenia)

Schizophrenia age onset....

Schizophrenia is a disease that typically begins in early adulthood; between the ages of 15 and 25. Men tend to get develop schizophrenia slightly earlier than women; whereas most males become ill between 16 and 25 years old, most females develop symptoms several years later, and the incidence in women is noticably higher in women after age 30. The average age of onset is 18 in men and 25 in women. Schizophrenia onset is quite rare for people under 10 years of age, or over 40 years of age. The diagram demonstrates the general "age of onset" trends for schizophrenia in men and women, from a representative study on the topic.

What cognitive deficits are typically found in schizophrenia patients?

Schizophrenics typically have deficits in working memory, reference memory, attention, and executive functioning.

What findings support the glutamate hypothesis of schizophrenia?

Support for this hypothesis comes from human drug overdose cases and experimental studies with the dissociative anesthetics (which are NMDA receptor antagonists) phencyclidine and ketamine. These drugs cause users to exhibit behaviors similar to negative symptoms and cognitive impairment, as well as positive symptoms, in schizophrenia.

What is tardive dyskinesia?

Tardive dyskinesia is a motor disorder that affects muscles primarily around the mouth and other parts of the face. Characteristic features of tardive dyskinesia include facial tics and rhythmic, involuntary movements of the jaw such as chewing or teeth grinding, involuntary use of the tongue such as in lip licking, or excessive lip smacking and pursing.

What are the two broad categories of antipsychotic drugs?

1. Atypical 2. Typical

What are the serious adverse effects of atypical antipsychotic drugs?

1. Atypical antipsychotic drugs are capable of treating schizophrenia at doses that do not produce EPS. However, most atypical antipsychotic drugs will produce EPS at a sufficiently high dose. 2. They also carry a risk of neuroleptic malignant syndrome. 3. Although having lower risk than typical antipsychotic drugs, atypical antipsychotic drugs may produce hyperprolactinemia. 4. Metabolic dysfunction. Many atypical antipsychotic drugs produce significant increases in body weight. Increases in body weight accompany a substantial risk of Type II diabetes. 5. Many produce a cardiovascular effect called the QT interval prolongation. This condition can degenerate into a more serious condition called torsades de pointes, which may lead to cardiac arrest. 6. Lastly, some pose a slight risk of producing agranulocytosis, a disorder characterized by reduced white blood cell counts in the immune system. Clozapine is most noted for this adverse effect.

What are the contributing factors to the development of schizophrenia?

1. Genetic factors increase the risk of developing schizophrenia, such as the DISC1 gene. 2. The environment also seems to contribute to the development of schizophrenia.

Atypical psychotic drugs may also require as long as ________ weeks to produce full efficacy.

6-8

Typical antipsychotic drugs may require as long as ________ weeks to produce full efficacy.

6-8 weeks

When does a first diagnosis of schizophrenia occur?

A first diagnosis for schizophrenia is usually found in one's late teens or early 20's.

What is cognitive dysmetria?

A theory known as cognitive dysmetria attempts to link facets of sensory processing with cognitive functioning and the manifestation of positive and negative symptoms. Cognitive dysmetria consists of abnormalities in processing, coordinating, and responding to information. As a result, one may perceive hallucinations, form delusions, exhibit odd or disorganized speech, incorrectly respond to emotional stimuli, have impaired attention, and exhibit other characteristics found in schizophrenia.

What is the glutamate hypothesis of schizophrenia?

According to the glutamate hypothesis for schizophrenia, diminished levels of glutamate released throughout the cerebral cortex and limbic system may lead to positive and negative symptoms of schizophrenia. Glutamate neurons begin in the cortex and synapse with GABA neurons in the VTA. GABA neurons then synapse with dopamine neurons that terminate in the NAC. When GABA is inhibited by decreased glutamate neuron stimulation, then more dopamine is released in the NAC due to decreased GABA inhibition. Furthermore, other glutamate neurons project into the VTA, directly stimulating dopamine neurons that terminate in the cortex. Decreased glutamate stimulation causes decreased dopamine levels in the cortex, causing the negative symptoms of schizophrenia. Diminished glutamatergic (NMDA) neurotransmission from cortex to VTA leads to overactivation of mesolimbic pathway producing positive symptoms oDiminished glutamatergic (NMDA) neurotransmission from cortex to VTA leads to cognitive impairment, affective symptoms, and negative symptoms

What is an antiemetic?

Antiemetics are drugs that reduce nausea and vomiting.

What is the function of typical antipsychotic drugs?

As a class, typical antipsychotic drugs reduce the positive symptoms of schizophrenia and have weak efficacy for negative symptoms and cognitive impairment.

What symptom of the prodromal phase of schizophrenia is the most predictive?

Attention impairments tend to be the most predictive of the prodromal phase.

Can atypical antipsychotics cause EPS?

Atypical antipsychotic drugs are capable of treating schizophrenia at doses that do not produce EPS. However, most atypical antipsychotic drugs will produce EPS at a sufficiently high dose.

How are atypical antipsychotics effective in treating the negative symptoms of schizophrenia?

Atypical, but not typical, antipsychotics elevate dopamine levels in prefrontal cortex. Clozapine (atypical) elevates dopamine levels in the prefrontal cortex. Haloperidol (typical) only gives small elevations of dopamine levels in the prefrontal cortex. The reason clozapine increases levels because it blocks D2 and 5-HT2A receptors at the same time, increasing the efficacy in treating negative symptoms.

Before the development of chlorpromazine in the 1950's, what are some non-pharmacological treatments that were used to treat mental illness?

Before discovery of chlorpromazine in 1950, some brutal non-pharmacological treatments for mental illness. For example, bloodletting, hot irons, flogging, revolving chairs, starvation, and sneezing powder were commonly used to "treat" mental illness.

typical antipsychotics

Chlorpromazine Haloperidol

Describe the development of chlorpromazine.

Chlorpromazine was first synthesized in France by Paul Charpentier in 1950. At first, it was used as anesthetic in surgery by Henri Laborit. However, Laborit noted the effects of chlorpromazine on patients not undergoing surgery and recommended use in psychiatry. Initial trials Val-de-Grace indicated that agitated psychotic patients were calmed by chlorpromazine. As a result, the use of chlorpromazine (Thorazine) spread rapidly. In the U.S., the number of hospitalized psychiatric patients plummeted from 600,000 in 1955 to about 150,000 today.

What is chlorpromazine?

Chlorpromazine was the first antipsychotic used to treat schizophrenia.

What is the serotonin-dopamine hypothesis?

The first hypothesis, referred to as the serotonin-dopamine hypothesis, states that atypical antipsychotic drugs effects derive from preferential antagonism of serotonin receptors compared to dopamine receptors. The majority of atypical antipsychotic drugs have a higher affinity for serotonin receptors than dopamine receptors.

What is the dopamine hypothesis of schizophrenia?

The first well-established hypothesis for schizophrenia is the dopamine hypothesis, which states that positive symptoms arise from excessive dopamine release in the limbic system. Dopamine neurons of the mesolimbic pathway begin in the VTA and terminate in the NAC. This hypothesis focuses on excess dopamine stimulation of dopamine D2 receptors in the NAC.

What findings support the dopamine hypothesis of schizophrenia?

The hypothesis derives from 1. the discovery that antipsychotic drugs act as antagonists for D2 receptors and 2. that amphetamine through increasing dopamine release, causes psychotic-like symptoms. Antipsychotic drug doses effective for schizophrenia correlate highly to their strength of binding to D2 receptors.

What is the neurodevelopmental hypothesis for schizophrenia?

The neurodevelopmental hypothesis for schizophrenia states that abnormal nervous system development leads to irregular neuronal signaling in the brain, resulting in the characteristics of schizophrenia.

What is the pharmacological actions of typical antipsychotic drugs?

The pharmacological actions of antipsychotic drugs derive from antagonism of dopamine D2 receptors.

What is the function of atypical antipsychotic drugs?

The remarkable efficacy of clozapine led to the development of many other atypical antipsychotic drugs such as olanzapine and risperidone that reduce positive and negative symptoms and carry a low risk of EPS at therapeutic doses. Reduced risk of EPS and tardive dyskinesia attributed to 5-HT2A versus D2 affinity (>1 for typicals; <1 for atypicals) and/or fast D2-off actions

What is the fast D2-off hypothesis?

The second hypothesis, referred to as the fast D2-off hypothesis, states that atypical antipsychotic effects derive from a rapid dissociation of the antipsychotic drug from the D2 receptor. Typical antipsychotic drugs dissociate slowly from the D2 receptor. In other words, atypical antipsychotic drugs do not block D2 receptors for as long as typical antipsychotic drugs. This allows dopamine to have a chance to act on those dopamine receptors, preventing EPS and tardive dyskinesia.

What symptoms characterize the prodromal phase of schizophrenia?

The symptoms that characterize the prodromal phase of schizophrenia include deficits in working memory, attention, sensory gating, and sociability.

What is the role of α2 adrenoreceptors in atypical antipsychotic drug effects?

The α2 adrenoreceptor for norepinephrine may play a role. Researchers combined the administration of an α2 adrenoreceptor antagonist with a dopamine D2 receptor antagonist led to atypical antipsychotic drug-like effects on conditioned avoidance responding without producing catalepsy.

What is hyperprolactinemia?

Typical antipsychotic drugs also are noted for hyperprolactinemia, Dopamine inhibits prolactin production through tuberoinfundibular pathway Dopamine D2 receptors regulate the release of prolactin from the anterior hypothalamus. D2 receptor antagonists increase prolactin levels The increase in prolactin in the blood over long periods of time causes hyperprolactinemia The symptoms of hyperprolactinemia include... reduced lactation loss of libido disruptions in menstrual cycles erectile dysfunction hypogonadism.

What is neuroleptic malignant syndrome?

Typical antipsychotic drugs also may produce neuroleptic malignant syndrome, who symptoms resemble those of influenza, including sweating and fever, whereas other symptoms include blood pressure changes, autonomic nervous system irregularities such as changes in heart and breathing rate, and muscle rigidity.

Why do typical antipsychotic drugs not treat the negative symptoms of schizophrenia?

Typical antipsychotic drugs are dopamine D2 receptor antagonist. Negative schizophrenia symptoms are caused by decreased dopamine levels in the cortex. A dopamine D2 receptor antagonist will decrease dopamine levels even more.

What causes tardive dyskinesia?

When D2 receptors are blocked in the nigrostriatal DA pathway for a long period of time by a typical antipsychotic drug the body will compensate for this change in receptor efficacy by upregulating D2 receptors increasing dopamine stimulation of these receptors

Is electroconvulsive shock therapy still used today?

Yes! Of the previous treatments used for schizophrenia, only electroconvulsive shock is still used in cases of treatment-resistant schizophrenia. ECT may be useful in improving cognition. However, some argue that ECT can be used early on in treatment.

What was the first used atypical antipsychotic drug?

Clozapine (Clozaril) was the first atypical antipsychotic drug.

Agranulocytosis

a disorder characterized by reduced white blood cell counts in the immune system

What are the pharmacological actions of third-generation antipsychotic drugs?

Currently, the only available compound that might qualify as a third-generation antipsychotic drug is aripiprazole (Abilify). Abilify functions as a weak partial agonist for dopamine D2 receptors at therapeutic doses. Yet aripiprazole shares antagonist effects at 5-HT2A receptors, making this drug somewhat similar to atypical antipsychotic drugs.

Schizophrenia

a severe, lifelong mental illness consisting of disturbed thinking, abnormal behavior, and inability to understand what is real, and impaired processing of emotions

Approximately what percentage of people have schizophrenia? a. 1% b. 10% c. 5% d. 15%

a. 1%

For identical twins, if one of the twins has schizophrenia, what is the chance that the other twin will have schizophrenia? a. 50% b. 0% c. 100% d. 25%

a. 50%

When a typical antipsychotic drug is prescribed, physicians commonly also prescribe... a. an anticholinergic drug. b. a benzodiazepine drug. c. a psychostimulant drug. d. a non-benzodiazepine hypnotic.

a. an anticholinergic drug

Increasing firing of dopamine neurons originating in the substantia nigra might be expected to a. decrease EPS due to typical antipsychotics b. increase cognitive impairment in schizophrenia c. reduce positive symptoms of schizophrenia d. increase positive symptoms of schizophrenia

a. decrease EPS due to typical antipsychotics

The reason why an identical twin does not while her other twin does have schizophrenia is likely due to... a. differences in how genes are expressed. b. a willingness not to engage in paranoid thoughts. c. one's medication history d. the length of time of engaging in imaginary play as children.

a. difference in how genes are expressed

The hypothesis stating that positive symptoms arise from excessive dopamine release in the limbic system is called the... a. dopamine hypothesis. b. serotonin-dopamine hypothesis. c. glutamate hypothesis. d. hypofrontal hypothesis.

a. dopamine hypothesis

The antiemetic effects of antipsychotic drugs derive from a. interrupted signalling from the chemoreceptor trigger zone to the area postrema. b. activating pathways from the amygdala to the chemoreceptor trigger zone. c. blockade of dopamine receptors in the mesolimbic dopamine pathway. d. antagonism of dopamine receptors in the hypothalamus.

a. interrupted signalling from the chemoreceptor trigger zone to the area postrema

Severe flu-like symptoms associated with autonomic nervous regularities from taking antipsychotic medication are referred to as... a. neuroleptic malignant syndrome. b. emesis. c. neuroleptic withdrawal syndrome. d. hyperprolactinemia.

a. neuroleptic malignant syndrome

According to the glutamate hypothesis of schizophrenia, which of the following actions would be expected to treat both the positive and negative symptoms of schizophrenia?

agonism of NMDA receptors

The primary mechanism of action for a typical antipsychotic drug is

antagonism of D2 receptors

What are extrapyramidal side effects? What causes these side effects?

Extrapyramidal side effects (EPS) consist of tremor, muscle rigidity, and involuntary movements. The nigrostriatal dopamine pathway, which terminates in the basal ganglia, likely functions normally in schizophrenia. D2 receptor antagonism reduces dopamine neurotransmission in this pathway, causing diminished control of movement.

The first antipsychotic drug that was discovered was a. haloperidol. b. chlorpromazine. c. clozapine. d. chlordiazepoxide.

b. chlorpromazine

The effective clinical dose of an antipsychotic drug... a. correlates with its binding affinity for NMDA receptors. b. correlates with its binding affinity for D2 receptors. c. is typically as effective as placebo. d. is not related to any known neurological actions.

b. correlates with its binding affinity for D2 receptors

The two neurotransmitters most implicated in the symptoms of schizophrenia are... a. serotonin and GABA. b. dopamine and glutamate. c. dopamine and serotonin. d. GABA and glutamate.

b. dopamine and glutamate

The result of a frontal lobotomy was typically a. a complete recovery from symptoms of schizophrenia. b. drowsiness and disorientation. c. highly aggressive behavior. d. an inability to recall long-term memories.

b. drowsiness and disorientation

A hypothesis for how to develop an atypical antipsychotic drug states that an antagonist for D2 receptors that quickly separates from the receptor is called the... a. serotonin-dopamine hypothesis. b. fast D2-off hypothesis. c. D2 partial agonism hypothesis d. D2 agonist-antagonist hypothesis

b. fast D2-off hypothesis

Patients with catatonic schizophrenia can be prescribed _______________________ to treat catatonia.

benzodiazepines

What is the role of H1 histamine receptors in atypical antipsychotic drug effects?

For some antipsychotic drugs, muscarine receptor antagonism causes dry mouth, dry eyes, and other anticholinergic effects. Clozapine's antagonism of histamine H1 receptors causes drowsiness during the first few days of treatment. Receptor binding studies also implicate H1 receptors, as well as 5-HT2C receptors, in antipsychotic drug-induced weight gain.

What are functional outcomes?

Functional outcomes consist of a patient's inclusion into a community, behaving normally in social situations, and successfully employing psychosocial skills. Examples of functional outcomes include employability, ability to conduct daily living activities, and the ability to form friendships.

What is the prodromal phase of schizophrenia?

In the years before a first diagnosis of schizophrenia, patients usually exhibit subtle, early signs of schizophrenia. These pre-schizophrenia signs are collectively known as the prodromal phase of schizophrenia, which is characterized by symptoms that occur less frequently and with less severity than the symptoms found in schizophrenia.

Post-Chlorpromazine Declines in Psychiatric Inpatients What happened to the patients?

Institutionalization in the United States (per 100,000 adults) According to a 2003 Human Rights Watch study, on any given day, there are about 300,000 inmates who are seriously mentally ill, and about 70,000 who are actively psychotic At any given time, between 11% and 16% of state inmates are receiving mental health services It is estimated that 20% to 25% of jail inmates have a serious mental illness

What finding supports the neurodevelopmental hypothesis?

It has been found that the DISC1 gene is implicated in abnormal connectivity and myelin sheathing.

Is schizophrenia curable?

Longitudinal studies find that 50-70% of individuals with schizophrenia exhibit chronic symptoms. The remaining 30-50% tend to exhibit residual features of schizophrenia. Approximately 1/3 of those with schizophrenia qualify as treatment-resistant, who are patients with schizophrenia who exhibit minimal or no improvements after two trials with either typical or atypical psychotic drugs.

A patient with schizophrenia is normally first diagnosed around age... a. 30. b. 40. c. 20. d. 10.

c. 20

some atypical antipsychotic drugs produce a severe decline in white blood cell counts referred to as... a. neuroleptic malignant immune system disorder. b. neuroleptic-associated immune syndrome. c. agranulocytosis. d. QT interval prolongation.

c. agranulocytosis

Cognitive impairment in schizophrenia consists of a. impaired attention. b. deficits in working memory. c. all of these. d. reduced reference memory.

c. all of these

The first antipsychotic drugs, including chlorpromazine and haloperidol, are known by all of the following except... a. first-generation antipsychotics. b. neuroleptics. c. early antipsychotics. d. classical antipsychotics

c. early antipsychotics

For someone exhibiting prodromal features of schizophrenia, schizophrenia may develop from... a. reading fantasy novels. b. a genetic trigger at a certain stage of development. c. factors such as stress. d. a physical injury.

c. factors such as stress

While anticholinergic drugs reduce extrapyramidal side effects, they do not prevent the development of... Select one: a. acute dystonia. b. cardiovascular dementia. c. tardive dyskinesia. d. extrapyramidal dyskinesia.

c. tardive dyskinesia

Haloperidol is a/an... a. atypical antipsychotic drug. b. second-generation antipsychotic drug. c. typical antipsychotic drug. d. novel antipsychotic drug.

c. typical antipsychotic drug

The first antipyschotic drug that was discovered was

chlorpromazine

What was the first typical antipsychotic drug?

chlorpromazine

Many schizophrenia patients demonstrate a sensory-gating deficit. What is that?

Many patients demonstrate a sensory-gating deficit that is characterized by a diminished capacity to filter out unimportant stimuli in their environment. Attendance to these unimportant stimuli may lead to misperceptions in their environment, possibly facilitating delusional behavior.

In schizophrenia, functional outcomes...

consist of the capabilities a patient has to perform normal everyday activities.

The effective clinical dose of an antipsychotic drug...

correlates with its binding affinity for D2 receptors

How do typical antipsychotics act as an antiemetic?

Nausea and vomiting occur form activation of the chemoreceptor trigger zone, an area in the medulla unprotected by the blood-brain barrier that receives inputs from substances in the blood. The chemoreceptor zone sends signals, involving in part dopamine neurotransmission mediated by dopamine D2 receptors, to the area postrema in the medulla, which elicits vomiting. Many typical antipsychotics drugs, which again serve as dopamine D2 receptor antagonists, may block signals from the chemoreceptor trigger zone to area postrema, thereby preventing vomiting.

What are the negative symptoms of schizophrenia?

Negative symptoms include reduced emotional responsiveness social withdrawal reduced movement lack of motivation alogia (lack of speech) avolition (lack of interest)

Hyperprolactinemia occurs from a. antagonism of NMDA receptors. b. agonism of D1 receptors. c. antagonism of 5-HT2A receptors. d. antagonism of D2 receptors.

d. antagonism of D2 receptors

The primary mechanism of action for a typical antipsychotic drug is a. antagonism for 5-HT2A receptors. b. antagonism of NMDA receptors. c. agonism of D2 receptors. d. antagonism of D2 receptors.

d. antagonism of D2 receptors

Most evidence for a genetic basis of schizophrenia points to the... a. dopamine transporter gene. b. serotonin transporter gene. c. Finnish schizophrenia gene. d. disrupted schizophrenia 1 gene.

d. disrupted schizophrenia 1 gene

All of the following are found from typical antipsychotic drug treatment except... a. effectiveness for positive symptoms. b. little efficacy for cognitive impairment. c. risk of extrapyramidal side effects. d. effectiveness for negative symptoms.

d. effectiveness for negative symptoms

All of the following are found from typical antipsychotic drug treatment except... a. little efficacy for cognitive impairment. b. effectiveness for positive symptoms. c. risk of extrapyramidal side effects. d. effectivenss for negative symptoms.

d. effectiveness for negative symptoms

Blocking glutamate (NMDA) receptors on GABA neurons in the VTA would be expected to a. diminish positive symptoms of schizophrenia b. diminish typical antipsychotic-induced EPS c. exacerbate typical antipsychotic-induced EPS d. exacerbate positive symptoms of schizophrenia

d. exacerbate positive symptoms of schizophrenia

Tremor, muscle rigidity, and involuntary movements caused by antipsychotic drugs are called... a. Parkinson's disease b. motor inhibition syndrome. c. negative symptoms. d. extrapyramidal side effects

d. extrapyramidal side effects

All of the following are examples of functional outcomes in schizophrenia except... a. picking out appropriate clothing to wear. b. carrying out daily hygienic practices. c. making sense of a checking account. d. having fewer depressive thoughts.

d. having fewer depressive thoughts.

Third-generation antipsychotic drugs generally act as a. D2 fast-off drugs. b. inverse antagonists for 5-HT2A receptors. c. partial agonists for 5-HT2A receptors. d. partial D2 receptor agonists.

d. partial D2 receptor agonists.

Increasing GABA levels in the VTA might be expected to a. decrease EPS due to typical antipsychotics b. increase positive symptoms of schizophrenia c. increase cognitive impairment in schizophrenia d. reduce positive symptoms of schizophrenia

d. reduce positive symptoms of schizophrenia

A motor disorder that affects muscles primarily around the mouth or other parts of face is called... a. acute dystonia. b. extrapyramidal dyskinesia. c. cardiovascular dementia. d. tardive dyskinesia.

d. tardive dyskinesia

After completion of a treatment regimen with a typical antipsychotic that produced tardive dyskinesia, compared to prior to the treatment regimen, one might expect which of the following? a. the effects of dopamine D1 receptor agonists on the nigrostriatal pathway would be increased b. a GABA-A receptor positive modulator would produce increased nigrostriatal activation c. the effects of dopamine D2 receptor agonists on the nigrostriatal pathway would be decreased d. the effects of dopamine D2 receptor agonists on the nigrostriatal pathway would be increased e. the effects of dopamine D1 receptor agonists on the nigrostriatal pathway would be decreased

d. the effects of dopamine D2 receptor agonists on the nigrostriatal pathway would be increased

Chlorpromazine is a/an a. novel antipsychotic drug. b. atypical antipsychotic drug. c. second-generation antipsychotic drug. d. typical antipsychotic drug.

d. typical antipsychotic drug

What are other symptoms of schizophrenia?

depression neurocognitive deficits

The two neurotransmitters most implicated in the symptoms of schizophrenia are...

dopamine and glutamate

The hypothesis stating that positive symptoms arise from excessive dopamine release in the limbic system is called the...

dopamine hypothesis

The result of a frontal lobotomy was typically

drowsiness and disorientation

The first antipsychotic drugs, including chlorpromazine and haloperidol, are known by all of the following except...

early antipsychotics

At therapeutic doses, typical antipsychotic drugs produce ________________________ ______ _________.

extrapyramidal (EPS) side effects

Tremor, muscle rigidity, and involuntary movements caused by antipsychotic drugs are called...

extrapyramidal side effects

Rank the factors below in terms of risk for developing schizophrenia from highest risk to lowest risk: having a non-twin sibling with schizophrenia having a monozygotic twin with schizophrenia having a dizygotic twin with schizophrenia

highest risk - having a monozygotic twin with schizophrenia second highest risk - having a dizygotic twin with schizophrenia third highest risk - having a non-twin sibling with schizophrenia

1. Federica is unable to feel sad despite the loss of her beloved sibling...

negative symptom

4. Freddy lacks to the motivation to complete personal hygiene tasks.

negative symptom

Eric used to love playing piano but now has no interest in playing Eric used to feel intense emotions when discussing his children, but now he experiences very little emotion when discussing his children

negative symptoms

A reduction in normal behaviors, such as reduced emotional responsiveness, is called...

negative symptoms.

A patient who displays mostly positive symptoms including suspiciousness would likely by identified as having...

paranoid schizophrenia.

Cognitive impairment may be present before the first episode of schizophrenia, contributing to _______________________.

poor functional outcomes

2. Federica believes that her neighbors have placed listening devices around her home to listen to her thoughts.

positive symptom

3. Freddy hears voices telling him to do things he doesn't want to do.

positive symptom

In schizophrenia, the addition of abnormal behaviors such as hallucinations are considered...

positive symptom

Eric reports seeing little green aliens that tell him what to do Eric hears voices when no one is around

positive symptoms

The symptoms of schizophrenia can either be _________________________________ or ___________________________.

positive; negative

Schizophrenia Spectrum and Other Psychotic Disorders

refers to disorders defined by delusions, hallucinations, disorganized speech and thinking, disorganized behavior, abnormal motor behavior, and/or negative symptoms

Long-term usage with a typical anti-psychotic drug, even when also prescribed with an anticholinergic drug, may result in an EPS-related condition called __________________________.

tardive dyskinesia

What is meant by the positive and negative symptoms of schizophrenia?

the terms positive or negative refer to the presence of abnormal behaviors or the reduction in normal behaviors respectively.

Why is a muscarinic receptor antagonist typically prescribed with a typical antipsychotic drug?

Physicians usually prescribe a muscarinic receptor antagonist such as benztropine to reduce EPS severity. In the striatum, dopamine neurons synapse with cholinergic receptors. Cholinergic receptors synapse with M1 muscarinic receptors. A D2 antagonist causes overstimulation of the muscarinic receptors. However, when a anticholinergic drug is administered, then stimulation of the M1 receptors are prevented from overstimulation.

What are the positive symptoms of schizophrenia?

Positive symptoms can include hallucinations delusions disorganized speech and behavior thoughts of persecution.

How are sensory-gating deficits assessed by researchers?

Researchers assess sensory-gating deficits by using a prepulse inhibition procedure.

What is a consistent finding among schizophrenia patients?

Researchers find consistent impairments in cognitive functioning. Nearly all individuals with schizophrenia have moderate to severe deficits in cognitive functioning, including working memory, reference memory, attention, and executive functioning.

Does schizophrenia have a genetic basis?

Schizophrenia clearly has a genetic basis, although this is not the only determining factor. The risk factor increases slightly to 2-4% when there is a cousin, uncle or aunt, or nephew or niece with schizophrenia. However, having one parent with schizophrenia increases the risk to 13% and having both parents with schizophrenia increases the risk to about 50%. Having an identical twin with schizophrenia also provides a 50% chance of developing schizophrenia.

The DSM-5 includes schizophrenia in the category "Schizophrenia Spectrum and Other Psychotic Disorders," which overall refers to disorders defined by delusions, hallucinations, disorganized speech and thinking, disorganized behavior, abnormal motor behavior, and/or negative symptoms. What is required to be diagnosed with schizophrenia?

Schizophrenia consists of the most severe of these disorders and... 1. has at least two of the features listed in each category and 2. the symptoms expressed must be highly disruptive for a period of at least 6 months.

What is the neurobiological profile of schizophrenia?

Schizophrenia derives from a complexity of neurobiological traits, including genetic abnormalities, reduced volume of brain structures, and abnormal connectivity among brain structures.