Broad Symptom clusters
Psychotic Disorders are viewed across a ___________ with schizophrenia being the most ______________
spectrum
extreme
Describe positive sx
Sx ppl with psychotic disorder HAVE and other ppl do not have
ex.
hallucinations, Delusions, and paranoia/suspiciousness
Research on this prevalence (proportion of population who have a specific characteristics in a given period of time ) __________ and ___________ changes compared to other psychotic disorders
some view psychotic disorders through the ______ of schizophrenia
neurochemical & neuroanatomical
lens
Name the DA auto receptor and it's role?
D2 ****** remember autoreceptors sit on a presynaptic neurons and suck back some of the NTS. if there is decreased activity of the presynaptic neuron. it a good idea to get a presynaptic autoreceptors going were we are going to have excess amt of NTs in the synaptic fat
the hypoactivity or lower DA fxn in the Mesocortical pathway causes negative sxms which became worse when chlorpromazine was given. that is how the DA theory came about
This NT receptor has a direct and indirect effect on the release of DA depending on the receptor.
5HT
____________ separates schizophrenia, brief psychotic disorder, and schizophreniform
Timelines
Describe negative sx
Sx that most ppl have but ppl with schizophrenia do not have
flat affect-outward expression of mood
Anhedonia-not able to experience joy or pleasure
decreased social engagement-
poor hygiene/self care
Alogia- poverty of speech (1 word answers)
Avolition-without motivation
___________ was developed as a general anesthesia and found to be calming
This lead to the research that led to the _______ hypothesis
Chlorpromazine/Thorazine
DA
Glutamate is an __________ NTs and is found globally in the brain
excitatory
Explain what happens when 5HT2A receptors are stimulated
when 5HT binds to 5HT2A receptor and stops release of DA-
does this directly when 5HT binds to DA and indirectly when 5HT binds to GABA
Schizoaffective IS or IS NOT a mixture of schizophrenia and bipolar
IS NOT
Describe disorganization cluster
thoughts or behaviors
disorganized thoughts or behavior
purposeless movements, bizarre behavior, odd mannerisms, motor activity, or thought process
can effect ability to attend social events, problem solve, IQ performance-low , and information processing
more isolating tend to look and sound bizarre
**** assoc. with a worse prognosis
Explain the DA hypothesis?
Hyper Activity in the mesolimbic pathway = excess of DA and positive sx. possibly related to decreased activity of the presynaptic D2 auto receptors
Hypoactivity of the Mesocortical pathway: decreased DA causes negative sx (flat affect, anhedonia)
especially a deceit in PFC
Glutamate works in a balanced relationship with _______
GABA
Explain what happens when 5HT1A receptors are stimulated
causes DA release and stops stops 5HT release
5HT binds to 5ht1A receptor and causes INCREASE in DA output and decrease of 5HT output
Pt with schizotypal personality disorder can __________ into acute psychosis and ca be viewed under the schizophrenia spectrum
decompensate
Describe Cognitive Impairment
may be result of other sxm
lower IQ
struggles to process information
executive fxn deficits
social cognition is poor
Working memory is impaired
**** assoc. with a worse prognosis
Name the 4 DA pathways and their fxn
DA pathways:
1. Mesolimbic= behavior, pleasure, and + sxm( process emotion and helps mount a response
2.Mesocortical cognitive sxm, affective sx and negative sx relevant to cognition/executive fxning
3. Tuberoinfundibular- controls prolactin( from the anterior pit to hypothalamus. DA should prevent prolactin release. block DA = INCREASED prolactin
4. Nigrostriatal- extrapyramidal nervous system motor fxn and movement
Expalinthe Glutamate and Schizophrenia hypothesis
descending cortico brainstem glutamate pathway works with GABA to stop mesolimbic DA.
if glutamate is hypoactive, DA in the mesolimbic pathway is not stopped and can become HYPERACTIVE (positive sxm)
ventral area glutamate excites the Mesocortical DA pathway if glutamate is hypoactive it can cause hypofxning of the Mesocortical pathway (negative sx)
By observing effect of chemicals on individuals with ________ other NTs have been implicated in this disease process
schizophrenia
Name the sx cluster of psychotic disorders
1.break in reality-not in touch with reality
2. positive sms-hallucinations, delusions, paranoia
3. negative sxms
4. disorganization
5. Cognitive Impairment
Schizophrenia is the ___________ of psychiatric disorders
cornerstone
Name the important DA receptors and fxn
D2 type:
D2:upregaltion in the striatal pathway causes positive sx
D3: Antagonism/partial agonism thought to improve negative sxms and plays a role in pleasure/reward
NMDA Receptor Hypothesis
N-methyl-d-aspartate (NMDA) is a glutamate receptor
PCP is a NMDA antagonist and causes hallucinations
hypoactive NMDA receptors could lead to hyperactivity in the mesolimbic pathway and cause positive sxm (again Increased DA)
this came about d/t the observation of effects of PCP
Brain Development and Schizophrenia thought to be __________ and _________ neurodegeneration
Abnormal ( d/t prenatal infections, obstetric complications, malnutrition, childhood viral infection,
increased
(progressive brain degeneration-pruning, loss of brain mass, decreased gray & white matter, reduced volume of amygdala, hippocampus, and front and temporal lobes