Knowledge Check Module 6 Student Response Only Edit Type You

Knowledge Check Module 6student Responseonly Edit Type Your Response

Describe the positive symptoms of schizophrenia and relate those symptoms to the case study patient.

Explain the genetics of schizophrenia.

The APRN reviews recent literature and reads that neurotransmitters are involved in the development of schizophrenia. What roles do neurotransmitters play in the development of schizophrenia?

The APRN reviews recent literature and reads that structural problems in the brain may be involved in the development of schizophrenia. Explain what structural abnormalities are seen in people with schizophrenia.

Paper For Above instruction

Schizophrenia is a complex psychiatric disorder characterized by a variety of symptoms that affect perception, thinking, and behavior. The positive symptoms of schizophrenia include hallucinations, delusions, disorganized thinking, and abnormal motor behavior. Hallucinations are sensory perceptions without external stimuli, most commonly auditory, where the patient hears voices that are not present. Delusions are fixed false beliefs that are resistant to reasoning and are often paranoid or grandiose. Disorganized thinking manifests as incoherent speech or erratic behavior, and abnormal motor behaviors may include agitation or catatonia. These symptoms significantly impair a patient's ability to function in daily life, as illustrated by the case study patient who exhibits auditory hallucinations (“hearing voices”), delusional beliefs (“voices told him he was not smart enough”), and disorganized speech (rambling conversation). His episodes of rage and emotional crying further exemplify the emotional dysregulation associated with positive symptoms.

Genetic factors play a substantial role in the etiology of schizophrenia. Research indicates a polygenic inheritance pattern, where multiple genes contribute to the risk. Family studies show that first-degree relatives of individuals with schizophrenia have a 10% risk compared to the general population risk of about 1%. Specific genes implicated include those involved in dopamine regulation, such as DRD2, as well as genes associated with neurodevelopment, synaptic functioning, and immune response. The presence of a first cousin with mental health issues, as in the case study, suggests a familial genetic predisposition. Nonetheless, environmental factors interact with genetic vulnerability, influencing the likelihood of developing schizophrenia.

Neurotransmitters play a pivotal role in the pathophysiology of schizophrenia. Dopamine dysregulation is the most well-established mechanism, with hyperactivity in the mesolimbic pathway contributing to positive symptoms such as hallucinations and delusions. Conversely, hypofunction of dopamine in the prefrontal cortex has been linked to negative symptoms, including social withdrawal and cognitive deficits. Serotonin and glutamate neurotransmitter systems are also involved, with evidence suggesting altered serotonin function influencing mood and perception, while glutamate pathways, especially via NMDA receptors, are implicated in cognitive deficits. The imbalance of these neurotransmitter systems results in the symptomatic spectrum observed in schizophrenia—specifically, the positive symptoms in the case study reflect increased dopaminergic activity.

Structural abnormalities in the brains of individuals with schizophrenia include enlarged lateral and third ventricles, reduced size of specific brain regions such as the hippocampus, amygdala, and prefrontal cortex, as well as cortical thinning. These anatomical changes are indicative of progressive neurodevelopmental alterations and neuronal loss or reduced synaptic density. Functional imaging studies often reveal hypometabolism and abnormal activity in the prefrontal cortex, impairing executive functioning, and hyperactivity in the limbic regions, associated with emotional disturbances and hallucinations. The neurodevelopmental deficits in these regions contribute to the core symptoms of schizophrenia, including perception distortions and disorganized cognition, as seen in the case study's behavioral and perceptual abnormalities.

References

• Fusar-Poli, P., et al. (2012). Brain imaging of the prodromal stage of schizophrenia: a systematic review. Neuroscience & Biobehavioral Reviews, 36(4), 1143-1155.
• Lewis, D. A., & Lieberman, J. A. (2000). Catching up on schizophrenia.: Neurobiology of Schizophrenia. Nature, 468(7321), 203–209.
• Howes, O. D., & Kapur, S. (2009). The dopamine hypothesis of schizophrenia: version III—the final common pathway. Schizophrenia Bulletin, 35(3), 549–562.