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SCHIZOPHRENIA - Coggle Diagram
SCHIZOPHRENIA
Biological explanations
Genetic inheritance of schizophrenia: predisposition, condition is partly inherited due to faulty genes. No one gene - polygenic.
Ripke et al (2014) reported 108 genetic variants, variations on chromosome 8 & 11 and the C4 gene.
Dopamine hypothesis: elevated dopamine at key synaptic sites within subcortical regions, mesolimbic pathway & the limbic system. Mesolimbic pathway dopamine - positive symptoms. Mesocortical pathway dopamine - negative symptoms.
Not enough dopamine could be being broken down after transmission, too much dopamine in surrounding cells.
Re-uptake processes may be impaired leaving too much dopamine in the synapse.
C4 gene: found at the synapses in the CNIS & mediates the pruning of synapses that normally takes place during development. Variant C4 is a clear risk factor.
Gottesman & Shields (1991) found that children with 2 schiz parents who share 100% genetic sim have a 46% chance of developing the disorder. MZ twins have a 48% chance of development if one is diagnosed.
Enlarged ventricles: in the brain, difference around 15%, found in unmedicated patients as well, not a result of drugs. Appear at the onset of the disorder. Linked to avolition, flat affect.
Issues in the diagnosis
Symptoms: positive & negative, must have 2 or more, one must be either a hallucination, delusion or disorganised speech/thinking. Symptoms present continuously during a 1 month period for 6 months.
Negative symptoms: alogia, flat affect, social withdrawal & apathy.
Symptoms have to interfere with social or occupational dysfunction: work, relationships & self-care.
Schizoaffective & mood disorders have to be ruled out first. Symptoms cannot be due to organic causes e.g substances.
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Inter-rater reliability: clinicians make indentical, independent diagnosis of the same patient. This is affected by overlapping symptoms. Copeland (1970)
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Comorbidity: lowers the validity of diagnosis, it refers to when one disorder/disease exists alongside the primary disorder. Comorbidity rates between schizophrenia & depression is 50%. (Buckley)
Symptom overlap: none of the schizophrenia symptoms are exclusive to the disorder. Bipolar, OCD and autism have high levels of overlapping symptoms making it hard to achieve a valid diagnosis.
Treatments
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Anti-psychotics, reduce mainly positive symptoms. Not a cure.
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CBT - long term cure, needs a good client/therapist relationship.
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