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Lecture 8,9,10 (final notes).docx

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Konstantine Zakzanis

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 In Schizophrenia Predictor of positive outcome if patient has early remission if within first 3 months of symptoms they go away they have a much better chance for a good outcome  Predictor of poor outcome is high cognitive impairment, which tends to hurt their job prospects etc.  Positive symptoms of Schizophrenia means excessive or more behaviour than normal people have -> Excesses or distortions -> Disorganized Speech Incoherence: doesn’t make sense? Loose associations: sometimes lose track of what they are saying Echolalia: is when they repeat what is said to them -> Delusions: thoughts or beliefs that are not true -> Hallucinations: most common type is auditory (hearing voices) or seeing things when nothing there  Negative Symptoms (strong predictor of quality of life negative symptoms = perform worse) -> Avolition – lack of energy or cant finish a task or activity (lack of motivation?) don’t care ie. Lack of hygiene etc. -> Alogia – poverty of speech, patient is either lacking in amount of speech or poverty of speech content meaning words are there but it doesn’t really mean shit. -> Anhedonia – inability to experience pleasure in activities etc. However even though externally they may seem like they have no emotion or pleasure but some studies have shown they can experience pleasure but can’t express themselves. Internally they do feel emotions -> Flat Affect – no emotion on face etc -> Asociality – little social relationship, few friends. May stem from paranoid in their delusions  Other Symptoms -> Catatonia – motor abnormalities, hysterical postures and wailing hands and feet. -> Catatonic immobility – sitting and couldn’t “move” sitting in some kind of posture for a long time -> Waxy flexibility – person in a catatonic state and you can put them in a bizarre posture and they will stay like that for a long time and not move -> Inappropriate affect- wrong emotion for situation  Must have symptoms for at least 6 months with 1 month of an active phase having at least 2 symptoms (ie. Delusions, disorganize speech, hallucinations etc). However only 1 symptom is needed if is hearing voices or delusions are bizarre.  Schizophreniform disorder: same as schizophrenia but only one to 6 months  Brief psychotic disorder: one day to one month  Subtypes of Schizophrenia  Disorganized Schizophrenia – disorganized from speech thought etc, not goal directed. Neglect appearances and responsibilities.  Catatonic Schizoprenia – symptom is predominately catatonic symptoms  Paranoid Schizophrenia – most common type, various type of delusions -> Persecution: thinking people after them or something bad happening -> Grandiose: felt like they were amazing etc -> Delusional jealousy: thinking your spouse always cheating on you etc -> Ideas of reference: A delusion with ideas of reference is when a patient incorporates unimportant events and sees more than there is to it. Or reading into trivial things and attaching random significance to them.  Undifferentiated schizophrenia: just doesn’t really… belong to them. The “wastebasket” when they patients don’t really follow into one of the subtypes.  Residual Schizophrenia: when patient no longer meets full criteria but still has signs of the disorder  People with schizophrenia are at increased risk, and the risk increases as proband (person with illness) and relative become closer. The more genetic overlap with someone with illness more likely you get it too.  Reasons for Dopamine Theory of Dopamine Drugs that are effective in reducing Schizophrenia reduce dopamine. Antipsychotic drugs that can treat schizophrenia cause symptoms of Parkinson’s disease. Amphetemines can cause a state similar to schizophrenia and we know amphetem
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