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Schizophrenia 2


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What characteristic symptoms (2 or more) must be present and for how long must they be present to diagnose Schizophrenia?
Delusions, hallucinations, disorganized speech, grossly disorganized, negative symptoms
What is the exception to the two or more characteristic rule?
If the delusions are bizarre or if hallucinations comment or person or if two or more voices converse.
What is a Schizoaffective Disorder?
Persons with schizoaffective disorder have periods of psychosis in the absence of mood symptoms. The periods of mood disturbance that are NOT brief relative to the duration of the entire disorder.
What are the symptoms of schizophrenia?
Positive symptoms, negative symtpoms, disorganization, problems with social relations, and cognitive dysfunction.
What are positive symptoms?
Excess or distortion of normal fxn. (Examples: delusions and hallucinations)
What are negative symptoms?
definition: dimunition of loss of normal functions (examples: blunted affect, alogia, avolition)
What is used to determine if medications change or improve cognitive functioning?
The MATRICS, a battery of standardized assessments, is used. It includes 6 components.
What are the two subtypes of Schizophrenia?
Deficit and Non-defecit schizophrenia.
Patients with deficit schizophrenia have what?
Enduring and primary negative symptoms.
Explain the NMDA receptor hypofunction hypothesis.
There is an observation that hypofunction of NMDA receptors induced by various NMDA antagonist drugs (PCP) precipitates a transiet psychotic state in healthy subjects.
What is the expected result of increasing the availability of glycine as it relates to the NMDA receptor hypofunction hypothesis?
It may improve primary negative symptoms.
What is the most widely replicated pathological anatomical finding in both postmorten and mortem studies?
Increased volume of the lateral and third ventricles when compared to controls.
Where is pathology generally seen and what is used to demonstrate this? (brain location)
In the prefrontal area; persons with schizophrenia fail to increase blood flow to the frontal lobes while performing the Wisconsin card test
Schizophrenia tends to develop between what ages?
Age 16 to 25
What is usually the first sign of illness?
Social withdrawl and decline in functioning.
Is the course of schizophrenia progressive?
No, the level of disability stabilizes after 5 - 10 years.
What is the treatment recommendation for persons with multi-episode schizophrenia who is experiencing an acute exacerbation of their illness?
Antipsychotic medications, other than clozapine, should be used as a first-line treatment to reduce positive psychotic symptoms.
What is the recommended treatment for a person experiencing their first acute positive symptom episode?
They should be treated with an antipsychotic medication, other than clozapine, but dosages should be started on the lower end of the recommended range.
What is the basis for clonzapine use?
Clonzapine should be used only when patients experience persisent and clinically significant positive symptoms in spite of adequate treatment with antipsychotic agents.
What are the exceptions for clonzapine use, when it should be called for?
History of blood dyscrasia or cardiac arrythmias.

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