Schizophrenia causes & treatment (abnormal, test 3) Crossword
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
                                                          
 
 
Down: 2) thorazine and haldol4) obstetrical complications (e.g. hypoxia); maternal infection (increased risk if born after flu epidemic; "season-of-birth effect": Nov-Jan (+8%); maternal stress during pregnancy (husbands died = prenatal bereavement; Nazis invaded); childhood head injury7) cannabis use appears to precipitate schizophrenia or exacerbate its symptoms; 44.5% of people with cannabis induced psychotic episode develop schizophrenia within 3 years8) does content of hallucinations, delusions, and disorganized speech have meaning? CBT for psychosis 10) no cure (poor prognosis after hospitalization; longer DURATION of UNTREATED PSYCHOSIS = worse prognosis); 50% have limited insight into illness; 50% (clinical) and 90% (forensic) comorbid substance abuse (including nicotine); high rates of suicide attempts (50%) and completions (15%)11) (biochemistry of SCZ); positive symptoms thought to result from EXCESSIVE dopamine (or extra sensitive or more numerous dopamine receptors);13) a neurodevelopmental disorder; striking DECREASES in gray matter volume and INCREASES in ventricular sizes over course of illness; brain changes PRECEDE onset of illness; however, no brain abnormality has been shown to be SPECIFIC to schizophrenia or to characterize all patients; the brains of identical twins differ somewhat in structure and more substantially in function14) (sociogenic hypothesis); stressors associated with being in lower class, cause or contribute to the development of schizophrenia15) no SMOOTH OCULAR PURSUIT (50-85% of pts): frontal lobe?; emotions: limbic system?; odd motor movements: basal ganglia?; excessive blink rate: ???; memory intact, usually oriented, poor impulse control; hallucinations experienced during full wakefullness17) hostility, intrusiveness, overly critical behavior by family members towards the patient20) teach about SCZ; provide informaiont about side effects of drugs; monitor adherence; instill hope that things can improve21) insulin-coma therapy; ECT; psychosurgery;25) restless agitation31) minimally effective for SCZ Across: 1) potentially fatal side effect of anti-psychotic medication (neuroleptics); severe muscular rigidity develops, accompanied by fever, racing heart, increased blood pressure; patient may lapse into coma; 1% incidence; 5% mortality (2000 pts - 20 NMS - 1 death)3) prevalence rates of 1-2% WORLDWIDE; no changes in rates as culture change (e.g. 1920s to 1980s); in developing countries, onset more acute, clinical course shorter, more likely full remission5) (48% or .48); also = 25-50%6) includes DOPAMINE hypothesis (1976); "the true picture of the neurochemical abnormalities in SCZ may be more complex than we would like to assume"9) schizophrenia causes people to be in lower class12) basic life-skills; how to interact successfully with others; role-playing, modeling, positive reinforcement; studies show this helps patients function better (even if severely disturbed) -- (employment skills training similar?)16) sustained muscle contractions18) "the true picture of the neurochemical abnormalities in SCZ may be more complex than we would like to assume"19) born with a certain level of vulnerability to develop the disorder, then exposed to certain level of environmental stress; life stress (esp. noted in 10 weeks prior to psychotic break); e.g. = going away to college; military basic training; sever, chronic parental marital discord22) "people with (familial) vulnerability should avoid cannabis like the plague."23) effective with positive symptoms, reducing rehospitilizatoin rates, and MAYBE negative symptoms; 90% response rate; fewer side effects -- especially less chance of tardive dyskinesia (higher adherence?); examples: risperdal, zyprexa, seroquel, clozaril (risk of agranulocytosis in about 1% of patients);24) large difference between rates in lowest class and those above; SOCIAL CAUSATION (sociogenic hypothesis); "DOWNWARD DRIFT" hypothesis; (results inconsistent on which one of these it is);26) prefrontal lobotomy -- destroys tracts connecting frontal lobes to lower centers of the brain; managed behavior for some violent patients; after surgery, patients often became dull and listless; loss of cognitive abilities27) use began in 1930; eventually abandoned; serious risks to health, including death28) (MID); family studies: concordance rate for MZ twins = 25-50%; DZ twins = 10-15%; relatives also at risk for other disorders (including less sever forms of psychoticism); BUT - up to 60% of SCZ patients have no family history of psychosis; "unexpressed genetic vulnerabilities to schizophrenia may be common in the general population"29) psychoeducation; individual psychotherapy; social-skills training; employment-skills training; family therapy (expressed emotion; EE)30) antipsychotic drugs block dopamine receptors; amphetamine intoxication (increased dopamine) can be psychomimetic31) co-founder of NAMI32) 10-15%
 

 

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