Schizophrenia: Definition, Pathophysiology, Etiology, Symptoms, Treatment and MCQs for NEET, GPAT, CSIR NET JRF

“Schizophrenia refers to a group of mental illness, it is characterized by disturbance of thinking, mood and motor activities.”

1.] The word schizophrenia is derived from a Greek word called Schizo – split, phrenia – mind.

PATHOPHYSIOLOGY: –

1.] Increased ventricular size and decreased gray matter, have been reported.

2.] Schizophrenia causation theories include genetic predisposition, obstetric complications,increased neuronal pruning, immune system abnormalities, neurodevelopmental disorders, neurodegenerative theories, dopamine receptor defect, and regional brain abnormalities including hyper- or hypo-activity of dopaminergic processes in specific brain regions.

3.] Positive symptoms may be more closely associated with dopamine receptor hyperactivity in the mesocaudate, whereas negative and cognitive symptoms may be most closely related to dopamine receptor hypofunction in the prefrontal cortex.

4.] Glutamatergic dysfunction. A deficiency of glutamatergic activity produces symptoms similar to those of dopaminergic hyperactivity and possibly schizophrenic symptoms.

5.] Serotonin (5-hydroxytriptamine [5-HT]) abnormalities. Schizophrenic patients with abnormal brain scans have higher whole blood 5-HT concentrations, which correlate with increased ventricular size.

ETIOLOGY: –

Schizophrenia probably results from combination of genetic and non – genetic factors:

A.] Biological factors: – It includes:

• Genetics
• Neuro – transmitted related abnormalities
• Neuro – anatomic causes
• Neuro – developmental causes

B.] Psychological factor: –

• Personality: 64% patients have schizoid personality.
• Oversensitive individuals.
• Low intelligence people are more prone to Schizophrenia.

C.] Social factors: – Schizophrenia is found associated with socio – economic condition, family patterns etc. The factors responsible are:

• Social isolation.
• Disorganization of family.
• Broken family.
• Over – crowding.
• Living in urban area.
• Socio – economic deprivation.
• Excess of life events like mental death / natural disaster / migration generally before 3 weeks of acute symptoms.
• Person is living in a family having over involved relatives and making critical comments.

SYMPTOMS: –

Following are the symptoms of Schizophrenia:

• Delusion
• Hallucination
• Aggression
• Suspiciousness
• Disorganized speech
• Apathy (lack of feelings, emotions and concern about something)
• Avolition (total lack of motivation towards anything)
• Social withdrawal
• Mutism (inability to speak)
• Hopelessness
• Suicidal tendencies

^{The above image is taken for education purpose only from verywellmind.com}

TREATMENT: –

Following are the anti psychotic drugs used in the drug therapy for Schizophrenia:

• Chlorpromazine (Thoraxine)
• Fluphenazine (Prolixine)
• Haloperidol (Haldol)
• Loxapine (Loxitane)
• Clozapine (Clozaril)
• Thioridazine (Mellaril)

MULTIPLE CHOICE QUESTIONS: –

1.] Schizophrenia is most disabling mental illness?

a. True

b. False

2.] Schizophrenia is often called “split personality disorder”?

a. True

b. False

3.] In schizophrenia when an individual believe they are in danger, this is re3ffered to as?

a. Delusion of grandeur

b. Delusion of persecution

c. Delusion of control

d. Nihilistic delusion

4.] Which of the following way might hallucination be experienced?

a. Auditory

b. Olfactory

c. Gustatory

d. All of the above

5.] In the active stage in schizophrenia which of the following symptoms are evident?

a. Delusion

b. Disordered speech and communication

c. Hallucination

d. All of the above

6.] The most common hallucination in schizophrenia is?

a. Visualizing shadows

b. Smelling smoke

c. Feeling cold

d. Hearing voices

7.] Who has more severe symptom at the onset of schizophrenia?

a. Men

b. Women

c. Children

d. Elderly

8.] Many schizophrenics believes that this would ease their symptoms?

a. Silence

b. Eating

c. Screaming

d. Smoking

9.] Individuals with schizophrenia who cannot infers the believes, altitudes and intentions of others are said to lack?

a. Theory on mind

b. Intelligence

c. Self esteem

d. Sense of self

10.] There are 50 million people with schizophrenia in America?

a. True

b. False

SOLUTIONS: –

1.] (a)

2.] (a)

3.] (b) Delusion of persecution

4.] (d)

5.] (d)

6.] (d) Hearing voices

7.] (a) Men

8.] (d) Smoking

9.] (a) Theory of mind

10.] (b)

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REFERENCES: –

1.] Mental Health and Psychiatric Nursing by Deepak Patel and Gokul Patel; 6^th Edition; Page No. 168 – 180.