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Patho of Schizophrenia Cheat Sheet (DRAFT) by

This is a draft cheat sheet. It is a work in progress and is not finished yet.


A Sx of mental illness charac­terized by the loss of contact with reality
Disorg­anized thoughts and speech
Emotions exhibited in an abnormal manner
────────── Causes ──────────
Manic phase of bipolar disorders
Psychotic depression
Alzhei­mer's Disease
Other causes of dementia
Brain tumors
Drug Abuse
PCP ("angel dust")


Decreased cortical thickness in the absence of gliosis
Reduction in the volume of the frontal love, medial temporal lobe, thalamus, and hippoc­ampus ➩ increased ventri­cular size
Decreased blood flow and glucose metabolism in the frontal lobe and left temporal lobe
Abnormal (excessive) synaptic pruning ➩ decreased umber of glutam­atergic dendritic spines in PFC
Risk is increased if a specific variant in a gene related to synaptic pruning ➩ Complement Component 4 (C4)
Gliosis: the prolif­eration of glial cells ➩ occurs as a compen­satory change in the degene­rative diseases in the brain (typically later in life)

Synaptic Pruning: the process of synapse elimin­ation that occurs between age 2 and onset of puberty

C4: plays a role in the immune system and also in brain develo­pment


Multiple NT systems interact to cause the signs and sx of SZ
Functional abnorm­alities are related to altera­tions in:

Positive Symptoms

Disorg­anized speech, thoughts, and beliefs
• May lose track of their ideas, meanings, and words (word salad)
• Thought processes are discon­nected (loose associ­ations)
• Ideas and images may become jumbled or linked together illogi­cally
• Words and meanings that should be linked may become diconn­ected
Disorg­anized Movement and Behaviors
• May use exagge­rated or repeated gestures
• May seem to be fidgeting, hypera­ctive, or preocc­upied with meanin­gless physical movements

Cogn­itive Symptoms

Impaired Attention
• Trouble focusing or paying attention
Impaired Working Memory
• Ability to use inform­ation immedi­ately after learning it
Poor Executive Function
• Ability to understand inform­ation and use it to make decisions
Patients often have difficulty learning from their experi­ences and can repeatedly make the same mistakes in situations requiring judgment

Poor insight into the severity of their disorder; tend to d/c therapy


Most common in young adults
Onset before adoles­cence or after 40 yr is extremely rare
Onset in males occurs earlier than females
Equal (male vs female)
In general, better outcomes in females
~ 15%
Cause is multif­act­orial
Signif­icant genetic component with a complex, non-Me­ndelian inheri­tance
Greatest risk factor ➩ positive family hx
Many genes involved ➩ pt's inherit several risk genes
➩ SNP's and CNVs
Pt's more likely to experi­ence:
• premature birth
• low birth weight
• perinatal hypoxia
Maternal viral infxn during pregnancy (especially during the 2nd trimester)
Early Neurod­eve­lop­mental Defect
Brain vulner­ability by genetic predis­pos­ition
Combined with enviro­nmental factors or stressors
➩ Abnormal migration of neurons during CNS develo­pment
➩ Results in Abnormal neuronal connec­tivity and abnormal brain circuits
SZ is more frequent in people born in cities and born between January and April (northern hemisp­here)

SNPs: single nucleotide polymo­rphisms
CNVs: Specific copy number variations

Dopami­nergic Pathways in the Brain

Originates in the substantia nigra
Projects to the striatum

Negative Symptoms

Alogia and Poverty of Speech
• May speak very little
• Speech may have little meaningful content
• May have long delays between words and sentences
Flattening or Blunting of Affect
• May have reduced emotional expression
• May not smile or frown in response to happy or sad events
• Voices may not change tone or pitch
• May not maintain eye contact or other kinds of emotional links with people
Anhedonia and Avolition
• May seem to lose interest in and energy for pleasu­rable activities and achiev­ements
• Lack of desire, drive, or motivation to pursue meaningful goals
Catatonia and Posturing
• May freeze into unusual body positions
• May stop moving entirely
• Sometimes hold rigid poses for hours and will ignore external stimuli
• May show stereo­typed repetitive movements
Lack of Motivation and Social Withdrawal
• Contribute to poor-self care skills
• Diffic­ulties mainta­ining employment and living indepe­ndently