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Schizophrenia and Bipolar Pathophysiology (Dr. Bessac)

Terms in this set (47)

____ and ____ determine diagnosis for schizophrenia.
Signs and symptoms
3 different groups of signs and symptoms for similarities in mental state.
1. Positive
2. Negative
3. Cognitive
Positive, Negative, and Cognitive mental states are associated with dysfunction of _______ (3).
1. The prefrontal cortex
2. The limbic areas
3. Pathways of dopamine
Positive symptoms are also called...
Added symptoms
What are some positive symptoms?
1. Delusions
2. Auditory hallucinations
3. Disordered speech
Negative symptoms are also called...
Subtracted symptoms
What are some negative symptoms?
- Flat affect
- Withdraw socially
- Lack of motivation and initiative
- Impaired judgement
- Suicidal
Cognitive symptoms are also called....
Low thinking symptoms
What are some cognitive symptoms?
- Poor planning
- Disorganized or slow thinking
- Difficulty understanding
- Poor concentration and memory
- Poor comprehension
- Difficulty expressing thoughts
- Can not complete cognitive tasks
Schizophrenia symptoms involve ______ released from _____ nuclei neurons.
Dopamine
Ventral Tegmental Area (VTA)
There is a _____ of D2 receptor activity in the _____ areas.
Gain (increase)
Limbic
There is a ___ of dopamine receptor activity in the ____.
Loss
Prefrontal cortex
Mesolimbic role in SZD.
Increase in DA activity in the limbic areas leads to positive (+) symptoms
Mesocortical role in SZD.
Decreased DA activity in the prefrontal cortex leads to negative (-) symptoms
Dysfunctional dopaminergic pathways are believed to be from low regulation of the VTA by:
1. Fewer glutamate connections from the PFC that regulate the VTA
2. Fewer GABA interneuron connections within the VTA
Many antipsychotic drugs are _____ (MOA).
D2 blockers
High D2 receptors in the limbic area are also associated with ______.
Positive symptoms
So, either ____ is high or there are too many ____ in the limbic area, or both.
1. Dopamine
2. D2 receptors
Many side effects of antipsychotic drugs are due to ______ acting on non-VTA innervated pathways
D2R- blockers
_____ neurons often regulate DA release.
5HT
Low glutamate connections from ____ to the ____ lead to schizophrenia
Prefrontal cortex
VTA
Low dopamine from the ___ to the ____ leads to schizophrenia
VTA
Prefrontal cortex
High dopamine from the ____ to the ____ leads to schizophrenia.
VTA
Limbic areas
Low ______ VTA interneuron activity can lead to schizophrenia
GABA
Why do SZD symptoms not occur until after puberty?
SZD dendrites are thought to have excessive pruning of Glu neuron synaptic connections and low sprouting of GABA interneuron synaptic connections
____ and ____ are funtionally and structurally abnormal in SZD.
Prefrontal cortex
Limbic areas
Overall ______ loss and enlarged ______.
Brain gray matter
Ventricles
Hippocampal _____ reduction and _____ in schizophrenia
Volume
disorganization
What are the risks for developing SZD?
1. Environmental stressors
2. Genetic mutations of proteins involved in neuronal migration bringing axon/dendrites together
3. Genetic mutations of proteins involved in neurotransmitter signaling.
T/F: There is a specific SZD gene?
False; there are only genes that increase "risk"
Dysbindin
Axonal protein believed to be involved in synapse formation, especially in the hippocampus of limbic system
Neuregulin
Protein interacts with tyrosine-kinase receptors important for synapse formation
DISC1
(Disrupted-In-Schizoprenia) protein involved with neurite growth and dendrite formation
SZD risk genes of neurotransmitters
Dopamine
Glutamate
In utero/neonatal insults that weaken neuronal synapses
- Immune, inflammatory or other stressors
(pregnant mother respiratory infections, influenza, toxoplama gondii)
- Hypoxia and poor nutrition
- Preeclampsia-placenta problems
Bipolar disorder is also called...
Manic depression
Bipolar disorder is considered a ____ disorder.
Spectrum
Agnosia
Patient can not recognize that they are "out there"
Instilling a _____ and ____ are essential for bipolar patients.
Wellness Recovery Plan (WRAP)
Mood cop
The best predictor of level of functioning during a person's lifetime is...
Adherence to medication
Substance abuse co-morbidity with bipolar disorder.
- Nicotine
- Alcohol
- Marijuana
- Opiates
- Stimulants
- Sugar
Percent of major depressives and bipolar patients that die by suicide?
15%
_____ appear to have a BIG role in bipolar disorder.
Genetics
Genetics thus far indicate a dysfunctional _______ and ______.
- Neuronal synapse
- Signal transduction
Bipolar occur by dysfunction of the ___ and ___ regulation of the ___.
OFC
VMPFC
Amygdala
Bipolar disorder is similar to _____ without the trauma.
PTSD
Bipolar and Schizophrenia share ____.
Gene mutations
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