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Schizophrenia

Learn about schizophrenia, a mental disorder characterized by disordered thoughts and bizarre behavior. Explore the symptoms, including positive and negative symptoms, anatomical indicators, heritability, the dopamine hypothesis, and treatment options.

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Schizophrenia

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  1. Schizophrenia Lesson 26

  2. Schizophrenia • Disordered thoughts & bizarre behavior • 1 percent of population • equal among sexes • Progressive? • can only manage symptoms • Symptoms > 6 mo • 2 classes of symptoms • Positive • Negative ~

  3. Positive Symptoms • Thought disorders • incoherence • loose associations • Delusions • bizarre beliefs • persecution, grandeur • Hallucinations • sensory experiences • no external stimuli ~

  4. Negative Symptoms • Poverty of speech • little spontaneous speech • Poverty of emotion • Flattened, inappropriate affect • Social withdrawal • lack of personal hygiene ~

  5. Positive Symptoms • Thought disorders • incoherence • loose associations • Delusions • bizarre beliefs • persecution, grandeur • Hallucinations • sensory experiences • no external stimuli ~

  6. Negative Symptoms • Poverty of speech • little spontaneous speech • Poverty of emotion • Flattened, inappropriate affect • Social withdrawal • lack of personal hygiene ~

  7. Anatomical Indicators S • Increased ventricle size • 67% of cases • brain atrophy • HC • thalamus (Nancy Andresen, UI) • general atrophy ~ S N

  8. Heritability • General Population 1% • One parent schiz. 17% • DZ twins 17% • MZ twins 50% • Strong genetic component • predisposition + stressor • Adoption Studies • risks more like biological parents • Evidence of gene(s) elusive ~

  9. The Dopamine Hypothesis • Positive symptoms • too much DA activity • Not excessive DA levels • Maybe overabundance of receptors • 2 major DA systems • Mesolimbic • Nigrostriatal ~

  10. Major DA Pathways Limbic System Striatum Nucleus Accumbens Nigrostriatal pathway Mesolimbic pathway VTA SN Ventral Tegmental Area Substantia Nigra

  11. DA Hypothesis: Evidence • Therapeutic Drugs • Neuroleptics (Antipsychotics) • DA antagonists • DA agonists • amphetamines, cocaine, etc. • induce symptoms • Problem: delay in effects ~

  12. 1st Generation Neuroleptics • Relieve only positive symptoms • Chlorpromazine (Thorazine) • phenothiazines • primarily blocks D1 & D2 • Haloperidol (Haldol) • butyrophenones • primarily blocks D2 • D2-R affinity and clinical potency ~

  13. Spiroperidol Hi Lo Haloperidol Therapeutic effects Chlorpromazine Strength of D2 binding

  14. 1st Generation: Side Effects • Motor • Nigrostriatal pathway • Tardive Dyskinesia • Parkinson-like symptoms • Sedation • low compliance ~

  15. 2nd Generation Neuroleptics • Block DA and 5-HT receptors • Relieve positive & negative symptoms • Lower Parkinson’s-like side effects • Clozapine (Clozaril) • high risk agranulocytosis • Risperidone (Risperidal) • low risk of agranulocytosis ~

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