Schizophrenia Overview and Treatment

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Questions and Answers

What is the main goal of psychotherapy?

To diagnose psychological disorders

To administer medication for mental illness

To perform surgical interventions for treatment

To engage in intensive exchanges to correct psychological problems (correct)

Which symptom is classified as a positive symptom of schizophrenia?

Alogia

Anhedonia

Disturbed perceptions (hallucinations) (correct)

Social withdrawal

Which demographic shows a higher prevalence of schizophrenia according to the described statistics?

Young individuals in inner cities (correct)

Older adults in rural areas

Equally mixed-gender populations

Caucasians in urban settings

In the context of schizophrenia treatment, which therapeutic approach was historically considered?

Psychoanalysis Signup and view all the answers

What does 'dysphoria' encompass as a mood symptom in schizophrenia?

Anxiety and depression Signup and view all the answers

What are cognitive symptoms of schizophrenia primarily characterized by?

Impaired memory and attention Signup and view all the answers

Which of the following is NOT considered a negative symptom of schizophrenia?

Disorganized thoughts Signup and view all the answers

What term did Emil Kraeplin use to initially describe schizophrenia?

Dementia praecox Signup and view all the answers

What is a characteristic symptom of mania that differentiates it from depression?

Delight in everything Signup and view all the answers

Which of the following describes a potential side effect of lithium treatment?

Sedation Signup and view all the answers

What is the therapeutic index of lithium, indicating its safety margin?

2-3 Signup and view all the answers

Which treatment approach for major depression involves electrically induced seizures?

Electroconvulsive therapy Signup and view all the answers

What mechanism is thought to be involved in how lithium stabilizes mood in bipolar disorder?

Alteration of ionic flow through membranes Signup and view all the answers

Which of the following is a significant downside of Monamine Oxidase Inhibitors (MAOIs)?

They can cause major hypertensive crisis. Signup and view all the answers

What is a primary effect of Tricyclic antidepressants?

Reduction of suicidal ideation. Signup and view all the answers

What year was the introduction of Selective Serotonin Reuptake Inhibitors (SSRIs)?

1987 Signup and view all the answers

Which class of antidepressants is noted for a relatively low therapeutic index?

Tricyclics Signup and view all the answers

What are MAO inhibitors primarily responsible for?

Deactivating catecholamines and serotonin. Signup and view all the answers

Which treatment method for depression is considered the most effective?

Combination of medication and therapy Signup and view all the answers

What kind of side effects might be caused by Tricyclic antidepressants?

Seizures and cardiac arrhythmia. Signup and view all the answers

Which statement is true regarding antidepressant treatment as mentioned?

Care must be taken with diet when using MAOIs. Signup and view all the answers

Which neurotransmitter is primarily targeted by SSRIs to block reuptake?

Serotonin Signup and view all the answers

What is a common risk associated with combining SSRIs and other serotoninergic medications?

Serotonin Syndrome Signup and view all the answers

Which antidepressant class is known for typically having mild side effects?

Selective serotonin reuptake inhibitors Signup and view all the answers

What is the duration of action typically recommended for SSRIs before assessing their effectiveness?

4 to 6 weeks Signup and view all the answers

What was the primary assumption about mental illness in prehistoric times?

Abnormal behavior was due to 'evil spirits'. Signup and view all the answers

What characteristic differentiates St. John's Wort from conventional antidepressant medications?

It is classified as a herbal supplement Signup and view all the answers

Which procedure was associated with treating mental illness by making drastic alterations to the brain?

Lobotomy Signup and view all the answers

Which of the following medications is specifically categorized as a norepinephrine-dopamine reuptake inhibitor?

Bupropion Signup and view all the answers

Who developed Insulin Shock Therapy and in what year?

Manfred Sakel in 1927 Signup and view all the answers

What is the main effect of St. John's Wort in the treatment of depression?

Comparable efficacy to tricyclics and SSRIs for mild to moderate depression Signup and view all the answers

Which of the following conditions is NOT commonly treated with SSRIs?

Chronic nerve pain Signup and view all the answers

What was the main goal of treatments like Insulin Shock Therapy and Electroconvulsive Therapy?

To restore normal brain functioning through physical shock. Signup and view all the answers

Which method was claimed to falsely show a 70% improvement rate in mental health but is no longer practiced?

Insulin Shock Therapy Signup and view all the answers

Who is credited with popularizing the Transorbital Lobotomy in the United States?

Walter Freeman Signup and view all the answers

What assumption was prevalent in later historical medical interventions regarding the brain?

The brain is fixed and requires drastic measures. Signup and view all the answers

Which therapy remains a widely used approach for the treatment of depression?

Electroconvulsive Therapy Signup and view all the answers

What was a significant outcome of the Chlorpromazine Revolution?

Demonstration that mental illness could be treated pharmacologically Signup and view all the answers

Which system did typical antipsychotics primarily target?

D2 receptors Signup and view all the answers

What defines Major Depression according to the criteria presented?

Symptoms not caused by any identifiable factors Signup and view all the answers

What is a common side effect associated with the use of Chlorpromazine?

Tardive Dyskinesia Signup and view all the answers

What was the peak population of mental hospital residents before deinstitutionalization?

560,000 Signup and view all the answers

Which area is NOT affected by Chlorpromazine as part of its action?

Cerebellar Signup and view all the answers

What therapeutic approach was characterized as having mixed success after Freud's time?

Psychosurgery Signup and view all the answers

Which characteristic is commonly associated with people suffering from Major Depression?

Disturbed emotional regulation Signup and view all the answers

What do atypical antipsychotics generally have a lower risk of compared to typical antipsychotics?

Motor disturbances Signup and view all the answers

What psychological effect does chronic depression tend to exacerbate?

Stressful experiences Signup and view all the answers

Which of the following conditions is NOT treated by Chlorpromazine?

Anxiety disorders Signup and view all the answers

What defines atypical antipsychotics compared to typical ones?

Broader clinical efficacy Signup and view all the answers

Which of the following neurotransmitter activities is partially reduced by Chlorpromazine?

Dopamine Signup and view all the answers

What percentage of patients typically respond with significant improvement when treated with Chlorpromazine for schizophrenia?

70% Signup and view all the answers

Study Notes

Psychopharmacology

Psychopharmacology is the study of the effects of drugs on the mind and behavior.
It particularly focuses on psychotherapeutic medications used to treat mental illnesses.

Prehistoric Approaches to Treating Mental Illness

Prehistoric cultures believed abnormal behavior was caused by evil spirits.
Treatments involved removing these spirits through methods such as beating, trephining (drilling holes in the skull), and bleeding.

Later Approaches: Isolation and Constraint

Later approaches involved isolating and restraining individuals perceived as mentally ill.
Examples included hanging individuals by ropes, placing individuals in cages or confined spaces.

Later Approaches: Sensory Based Sensory Deprivation

Sensory deprivation involved isolating individuals from sensory stimuli.
Methods included the use of sensory deprivation apparatus, sensory shock.

Historical Medical Interventions

Insulin shock therapy, electroconvulsive therapy, convulsant drugs were used to treat mental illness in the past.
These therapies were often drastic, aimed at shocking the brain into normalcy and causing seizures.

Medical Interventions: Pre-Frontal Lobotomies

Pre-frontal lobotomies were surgical procedures performed to sever connections in the prefrontal cortex.
They were popular therapies, but now considered unethical and inhumane.

A New Style Intervention: Psychotherapy

Psychotherapy is an interactive experience with a trained professional to understand and change behaviors, thoughts, relationships, and emotions.
Major forms include psychoanalysis, humanistic, cognitive, and behavioral therapy.

Schizophrenia: Description and Symptoms

Schizophrenia affects around 1% of the population.
It is diagnosed by loss of contact with reality.
Multiple behaviors, outcomes, and etiologies associated.

Schizophrenia: Symptoms

Positive symptoms are behaviors that are present but should not be there.
- This includes disorganized thoughts and delusions, disturbed perceptions (hallucinations, disorganized speech), and unusual movements
Negative symptoms are behaviors that should be present but are absent.
- Examples are social withdrawal, anhedonia (loss of pleasure), alogia (loss of speech), and amotivational (loss of motivation).
Social or occupational dysfunction, self care, and cognitive impairments are also important manifestations of the disorder.

Schizophrenia: Treatment Options

Treatment options for schizophrenia were initially scarce and ineffective.
Psychoanalysis and psychosurgery proved ineffective.
The chlorpromazine revolution marked a significant advancement.

The Chlorpromazine Revolution

The introduction of chlorpromazine marked a significant turning point in the treatment of psychiatric disorders.
It led to deinstitutionalization due to improved treatment.
It has positive effects in improving the lives of patients with schizophrenia.

Chlorpromazine Side Effects

Notable side effects of chlorpromazine include motion side effects mediated by basal ganglia (tardive dyskinesia) and parkinson-like symptoms (the Thorazine shuffle).
Acute dystonia and akathisia are also possible side effects.

Antipsychotics (Major Tranquilizers)

First-generation (typical) antipsychotics target dopamine receptors and can produce movement disorders.
Second-generation (atypical) antipsychotics have broader mechanisms and effects and are more likely to be less toxic
Concerns about treatment noncompliance persist.

The Mood Disorders

Major depressive disorder is characterized by depressed mood lasting at least two weeks, diminished interest in activities, and other symptoms.
Bipolar disorder involves alternating periods of mania and depression.
Dysthymic disorder is a less severe and shorter-duration form of depressive disorder.

Major Depression

Major depression is a mental condition characterized by feelings of severe despondency and dejection.
It encompasses feelings of inadequacy, guilt, and lack of energy, appetite, and sleep.
Biological, psychological, and social factors contribute to the development and progression of depression.

Causes of Major Depression

Causes of major depression are multifaceted and include biological, psychological, and social-cultural factors.
Factors like genetic predispositions, changes in brain chemistry, and negative past experiences play a role.

Psychotherapeutic Medications for Major Depression

Antidepressants are a direct consequence of the chlorpromazine revolution
Most effective treatment is a combination of medication and therapy.
Different types of antidepressants are available (MAOIs, tricyclics, SSRIs, SNRIs, etc).

Three Major Classes of Antidepressants

MAO inhibitors (MAOIs) prevent the deactivation of neurotransmitters.
Tricyclic antidepressants (TCAs) inhibit the reuptake of neurotransmitters.
Selective serotonin reuptake inhibitors (SSRIs) target serotonin specifically.
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are designed to inhibit both serotonin reuptake.

Monamine Oxidase Inhibitors (MAOIs)

MAOIs are potentially effective but have severe side effects, especially when combined with particular foods or other medications
Considered the third-line treatment due to safety concerns.

Tricyclics: The Second Generation

Tricyclics are antidepressants with a low therapeutic index.
They are associated with side effects such as constipation, dry mouth, and blurred vision.
The risks of fatal overdose, seizures, and cardiac arrhythmia have reduced their use.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are the most commonly used antidepressants, due to better tolerated side effects.
SSRIs typically take 4-6 weeks of consistent use to see improvements.

Benefits and Side Effects of SSRIs

Typical side effects of SSRIs are generally mild.
Potential for serotonin syndrome, a life-threatening complication that can occur in combination with other serotonergic medications.

An Herbal Approach: St. John's Wort

St. John's Wort is an herbal supplement, not a drug, used for mild to moderate depression.
It may function as a serotonergic reuptake inhibitor, but its mechanism of action isn't fully understood.
It is generally considered as effective as mild to moderate depression as tricyclics or SSRIs

Other Re-Available Antidepressants

Other types of antidepressants include norepinephrine reuptake inhibitors (NRIs), norepinephrine-dopamine reuptake inhibitors (NDRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and serotonin-norepinephrine-dopamine reuptake inhibitors (SNDRI's).

The Mood Disorders: Bipolar Disorder

Bipolar disorder is characterized by wild mood swings between depression and mania.
Depression involves feelings of despondency and dejection.
Mania involves hyper-elevated mood, euphoric feelings, and grandiosity.

Treatment for Bipolar Disorder

Lithium is an effective mood stabilizer for bipolar disorder.
It may stabilize the rate of receptor activity, lowering or raising neuronal excitement
It has a low therapeutic index and potentially toxic side effects.

Treatment Approaches to Major Depression

Pharmacologic intervention includes medications designed to target biochemical imbalances in the brain
Electroconvulsive therapy is an electrically induced seizure used for severe cases of depression.
Psychotherapy, or talk therapy, is a method for treating depression through psychological means.

What Works Best? A Biopsychosocial Approach

Bio-medical therapies for depression include drug therapies, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS).
Psychological approaches include insight-oriented psychotherapy, psychoanalysis, humanistic, cognitive, and behavioral-oriented psychotherapy.
Social/community approaches include family therapy, community treatment, and prevention programs.

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Description

Test your knowledge on schizophrenia, including its symptoms, demographics, and various treatment approaches. This quiz explores both positive and negative symptoms and historical perspectives in psychotherapy. Expand your understanding of this complex mental health disorder.