Please enable JavaScript.
Coggle requires JavaScript to display documents.
NS 41 - Schizophrenia (ii) (`Cognitive impairment in Schiz (broad range of…
NS 41 - Schizophrenia (ii)
DSM5 criteria
2+ of these for 1 month
@ least 1 must be
delusions
hallucinations
disorganised speech
grossly disorganised/catatonic behaviour
-ve symptoms
decreased functioning
continuous disturbance for @ least 6 months
`Cognitive impairment in Schiz
broad range of deficits
attention
working memory (available for processing)
semantic memory (general knowledge)
social cognition
processes used to acquire + interpret information about others
leads to social withdrawal, which exacerbates -ve symptoms
exacerbates paranoia + delusions due to falsely interpreting others as being harmful
language
theory of mind (ability to look @ things from a different perspective)
crucial for social interaction + behaviour interpretation
stable
determine functional outcome (along with -ve symptoms)
= endophenotype (marker that increases schiz risk)
more in schiz than AD!
associated with environmental induced epigenetics
e.g. stress, HPA axis
can change gametes (increase risk before conception)
Prognosis
3 groups
small no. treated successfully
most partially recover with relapses
some are chronic (longterm hospitalisation required)
20% attempt suicide, 5% die by suicide
increased mortality from other conditions
schiz + BPD share genetic risk factors
BPD less severe, but still has response inhibition difficulties
Brain abnormalities in schiz
small cortex (less grey matter)
enlarged ventricles (cause or consequence?)
small thal, temporal lobe (esp hippocampus), prefrontal cortex
not caused by medication
mild findings in unaffected 1st degree relatives
Brain chemistry in schiz
dopaminergic overactivity
sometimes overactive in one area (e.g. temporal lobe) but underachieve in another area (e.g. frontal lobe)
antipsychotics block dopamine Rs
Ach, glutamate, NA, serotonin affected
treatment
antipsychotics
good for +ve symptoms
little effect on -ve symptoms
significant SEs (sedation, obesity)
ineffective alone (need counselling, family involvement, support, care advice, job skills training)
CBT
modified for schiz, some success
social skills training
increases community engagement
decreases relapses
cognitive remediation
computerised training modules