Schizophrenia: Prevalence and Etiology

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Questions and Answers

What is one of the observable signs at birth that may indicate a higher risk of developing schizophrenia?

  • Improved facial symmetry
  • Higher rates of left-handedness (correct)
  • Faster development of motor skills
  • Increased head circumference

What is a potential contribution from the fetus's environment during the first trimester?

  • Exercise routine of the mother
  • Exposure to positive social interactions
  • Maternal stress (correct)
  • Increased nutrition from the mother

What is the role of microglia in the context of neuronal development and schizophrenia?

  • Protecting neurons from damaged cells
  • Performing repair only after birth
  • Enhancing the growth of neurotransmitters
  • Overactive in removing essential cells (correct)

Which factor is considered a birth complication that increases the risk of developing schizophrenia?

<p>Hypoxia (B)</p> Signup and view all the answers

What psychosocial aspect may contribute to the likelihood of schizophrenia recurrences?

<p>Stressful life events (D)</p> Signup and view all the answers

During which phase of development is the onset of schizophrenia most likely to occur?

<p>Adolescence (B)</p> Signup and view all the answers

What does the 'multiple hit model' suggest about the development of schizophrenia?

<p>It occurs due to various contributors over time. (A)</p> Signup and view all the answers

Which factor has been shown to NOT significantly impact the risk of developing schizophrenia in children?

<p>Having a mother with a schizophrenia diagnosis (C)</p> Signup and view all the answers

What is the primary genetic contribution to the development of schizophrenia?

<p>17% chance if one parent has schizophrenia (C), 46% chance if both parents have schizophrenia (D)</p> Signup and view all the answers

Which theory is most widely accepted regarding the biochemical factors in schizophrenia?

<p>Dopamine theory (A)</p> Signup and view all the answers

What is a noted limitation of dopamine antagonists in treating schizophrenia?

<p>They can exacerbate negative symptoms. (A)</p> Signup and view all the answers

What brain structure changes are correlated with schizophrenia according to FMRI findings?

<p>Hypofrontality and enlarged ventricles (D)</p> Signup and view all the answers

What role does excessive dopamine play according to the Two Factor Theory?

<p>It results in excessive dopamine at D2 receptor sites. (D)</p> Signup and view all the answers

What is indicated by the glutamate theory in relation to schizophrenia?

<p>Excessive dopamine activity leads to underactivity at NMDA receptors. (C)</p> Signup and view all the answers

Which drug is mentioned as a weak dopamine antagonist that has shown effectiveness?

<p>Clozapine (C)</p> Signup and view all the answers

What is apathy?

<p>Inability to begin or continue an activity. (A)</p> Signup and view all the answers

What is akinesia?& what is Tardive dyskinesia?

<p>Both are side effects of first gen. Akinesia is very common. Akinesia is slow motor movement, motonous speech &amp; expressionless face. Other is involuntary movement of jaw, tongue and cheeks. All are extra pyramidal symptoms.</p> Signup and view all the answers

What is their definitions? Breuler discovered schizophrenia.

<p>dementia praecox = Excited agitation Hepebphrenia = combination of three problems by kraeplin Catatonia = persecution and grandeur paranoia = immature/silly emotionality</p> Signup and view all the answers

Research shows that schizophrenia involve more than one gene. Gene 8, 6,22.

<p>True (A)</p> Signup and view all the answers

Waxy flexibility is tendency to keep one's body in position someone else put. It's a disorganized sypmyom that very rare from catatonic immobility. (Disorganized behavior)

<p>True (A)</p> Signup and view all the answers

What is the prodromal stage?

<p>The early stage of schizophrenia • has less severe symptoms for 1-2 years. Before serious symptoms occur.</p> Signup and view all the answers

Which case has higher vulnerability for schizophrenia diagnosis?

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The likelihood of child diagnosed with schizophrenia does not depend on parent’s severity of schizophrenia.

<p>False (B)</p> Signup and view all the answers

Adopted child with biological schizophrenic parents has a greater chance of diagnosis than average .

<p>True (A)</p> Signup and view all the answers

Flat effect is researched. Flat effect is an expression but does not mean lack of feeling.

<p>True (A)</p> Signup and view all the answers

Flashcards

Schizophrenia Prevalence

Schizophrenia is a rare condition, affecting approximately 0.3% of the population.

Genetic Influence on Schizophrenia

Family history plays a significant role in schizophrenia risk. Having two parents with schizophrenia increases the chance of developing the condition to 46%, while having one parent with it increases the risk to 17%. Identical twins have a higher chance than fraternal twins.

Dopamine Theory of Schizophrenia

This theory suggests that schizophrenia is caused by an imbalance in dopamine levels in the brain. Specifically, there might be too much dopamine in certain areas (striatal), and too little in others (prefrontal).

Dopamine Antagonists in Schizophrenia Treatment

These medications work by blocking the effects of dopamine, aiming to reduce symptoms of schizophrenia. They are not always effective and might have side effects.

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Glutamate Theory of Schizophrenia

This theory proposes that schizophrenia involves dysfunction in the glutamate system, possibly caused by GABA problems or excessive dopamine. It's linked to underactivity at NMDA receptors.

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Brain Structure Changes in Schizophrenia

People with schizophrenia often have abnormalities in brain structures, including less activity in the frontal lobe (hypofrontality) and enlarged ventricles. However, it's unclear if these changes cause the disorder or are a result of other factors.

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What is Hypofrontality?

Hypofrontality refers to reduced activity in the frontal lobe, a part of the brain responsible for executive functions, planning, and decision-making.

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Enlarged Ventricles: A Sign of Schizophrenia?

Enlarged ventricles, the fluid-filled spaces in the brain, might be associated with schizophrenia. This could be due to a decrease in the volume of brain tissue.

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Neurodevelopmental Dysfunction

Problems in how the brain develops early on, especially in the outer layer (cortex), leading to a higher chance of developing schizophrenia later in life, especially during adolescence when the brain rewires.

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Early Signs of Schizophrenia

Some babies show signs of potential schizophrenia from birth, like smaller head size, slower development, being left-handed, and unusual physical features.

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Microglia Dysfunction

A theory suggesting that schizophrenia might involve problems with microglia cells, which clean up brain debris. Microglia might be overactive in the frontal lobe, harming necessary cells.

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Birth Complications

Problems during birth, like being born early (premature) or having less oxygen (hypoxia), can increase the risk of developing schizophrenia.

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Fetal Stress

Problems during pregnancy, like a stressful environment for the mother in the first trimester or exposure to flu/viruses in the second trimester, can affect the developing fetus and increase schizophrenia risk.

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Multiple Hit Model

This model suggests that schizophrenia develops from a combination of factors, such as genetic predisposition, birth complications, and environmental stressors, that 'hit' the brain throughout life.

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Psychosocial Factors

These are environmental factors that don't directly cause schizophrenia but increase the risk of developing or relapsing. Examples include stressful life events and difficult family dynamics.

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Hostile or Overcontrolling Families

Studies have shown that families with a hostile, negative, or overly controlling environment can contribute to relapses in individuals with schizophrenia.

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Study Notes

Prevalence and Etiology of Schizophrenia

  • Prevalence is very low, at 0.3%.
  • Etiology is most closely associated with schizophrenia, not the broader spectrum.
  • Genetic contributions play a significant role.
    • Family heritability is 46% (two parents) and 17% (one parent).
    • Identical twins have a higher percentage of developing schizophrenia (40-60%, or 80% for spectrum disorders).
    • Adoption studies show that if biological parents have schizophrenia, adopted children still have a higher chance of developing the disorder.
  • Biochemical factors (dopamine) are also involved.
    • Neurochemical circuit differences are present in schizophrenia.
    • The dopamine theory is the most widely accepted theory.
      • Excessive dopamine is a factor.
      • Insufficient dopamine in the prefrontal area and excessive dopamine in striatal areas (D2 receptor sites) are contributing factors in the two-factor theory.

Treatment for Schizophrenia

  • Dopamine antagonists are used as treatments.

Contrary Evidence

  • Dopamine antagonists are not always effective.
  • Clozapine, a dopamine antagonist, is effective but weak.
  • Dopamine reduces symptoms and might not cause an immediate impact.
  • Reducing negative symptoms (less effective) compared to positive symptoms.

Biochemical Factors

  • Glutamate is an important contributor.
    • Underactivity at NMDA receptors and excessive dopamine may lead to glutamate deficiencies.
    • GABA is another crucial factor, with possible dysfunction.

Brain Structure and Function

  • Brain activity, particularly in the frontal areas, is often reduced in people with schizophrenia.
  • Hypofrontality (low frontal activity) and enlarged ventricles (fluid-filled areas) are observed.
  • Changes in brain structure may be correlated with schizophrenia, but the cause-and-effect relationship is still unclear.
  • Medications or lifestyle changes might influence brain function.

Contemporary Models

  • Neurodevelopmental models suggest early cortical development dysfunction is a contributing factor.
    • Children with certain behaviors have a higher chance of developing schizophrenia later in life.
    • Onset is commonly observed during adolescence.

Factors Associated With Schizophrenia During Birth or Fetal Development

  • Smaller head circumference, slower developmental milestones, higher rates of left-handedness, and minor facial/physical anomalies are observed in some cases.
  • Premature birth, hypoxia, and other obstetric complications are also risk factors.
  • Fetal complications: mother's physical stress during the first trimester, and maternal flu or virus exposure during the second trimester.

Microglia Theory

  • Microglia dysfunction is a critical factor.
  • Microglia are overactive in the frontal lobes and remove essential cells. Microlia function influences GABA and glutamate signaling.

Neurodevelopmental Model

  • Genetic and epigenetic factors influence brain development.
  • Brain development, from conception to adulthood, is affected.
  • Disruption in neuronal connectivity, communication, and cognitive processing (dysmetria) may lead to schizophrenia symptoms.
  • The process of developing schizophrenia is complex and multifactorial.

Psychosocial Contributions

  • Stressful life events and complex familial processes increase the risk of schizophrenia recurrence following treatment.
  • A study showed that a child with schizophrenia returning home to live with their mother, especially in challenging familial circumstances, can cause relapse.

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