cont.: Different Types of Schizophrenics (prior to DSM changes) Hope everyone had a Happy Canada Day

To be continued: Different Types of Schizophrenics 1. Paranoid preoccupation with one or more delusions or frequent auditory hallucinations. none of the following is prominent; disorganized speech, disorganized or canonic behavior or flat or inappropriate affect. 2. Disorganized Type a. all of the following are prominent: (1) disorganized speech (2) disorganized behavior (3) flat or inappropriate affect 3. Catatonic Type A type of Schizophrenia in which the clinical picture is dominated by at least two of the following: motoric immobility as evidenced by catalepsy, excessive motor activity, extreme negativism (or rigid posture), peculiarities of voluntary as evidenced by posturing movements, prominent mannerisms or prominent grimacing. Echopraxia (repeat what you say or they say over and over again). 4. Residual Type (nothing fits alone) A. Absence of prominent delusions, hallucinations, disorganized speech and catonic behavior. B. There is continuing evidence of disturbance - negatives symptoms or two or more symptoms listed in criteria a. for Schizophrenia, present in an attenuated form ( eg. odd beliefs, unusual perceptual experience. History Reactive Schizophrenia - stress motivated. Where does it come from? Data - runs in families. Prof never dealt with first generation family of schizophrenia. Have I? No. Not even if not called Schizophrenia in the past eg. nervous breakdown and hospitalized for 11 years. Twin Studies - much higher concordance in M twins than D twins and much more between siblings than non siblings. Higher in adoptees of biological parents rather than adopting parents. Biological than adoptive siblings. It is quite clear that there is genetic influence. Nature - nurture < sibling interaction. Genetic studies come from Scandinavian studies - reason because they keep registers of people from birth to death and note conditions/jobs/arrested alcoholics etc… Data is there to look at. If have credentials/study/finding will share date. One study : 80% Schizophrenics born in Scandinavia born between Dec and Mar (25% of year) so started think what might it be also? Schizophrenics tend to be born in schizophrenic families. - not entirely determined by genetics, otherwise not important in what birthdays. Does not fit pattern of genetic dominant or not —obviously some predisposition but some environment condition to trigger it. What is it that occurs in these four months? - a virus called sygomadis virus, a slow acting virus - does not show directly eg. syphilis. It takes years to show symptoms latent phase, than 20 years later develops and psychotic, memory loss and death. So decided to look at twins. One has it and one does not. D 2 different eggs share half genetics. M - identical genes. If entirely genetic then not expected to be any discordance between M Twins because M should all be Schizophrenics or neither. Therefore should not be any difference so took M-twins discordant from Schizophrenic. Spinal taps for fluids and this fluid contains fluid from the brain. Looked for antibodies against virus. What was found was twins who were Schizophrenic had antibodies against this virus and vice versa. _both twins had antibodies of virus therefore at some point exposed to brain. Somehow, virus got into the brain. Prof’s hypothesis - blood brain barrier - glio cells that come between blood vessel and neurons - all kind of molecules that are harmful to the brain. Blood brain barrier protects the brain so that if exposed to this environmental virus then gets into the brain and 20 years later sees effects of schizophrenia - if no tendacy of late born barrier will be in body but not into brain because protected by blood brain barrier. Depends also on nutrition of fetus and sometimes on position of fetus. P twins might get more or less nutrition and that tips balance would explain why (theory only so far). One percent of population where ever studied. Females do better. Higher in males but slightly. To be continued with : Neurological Basis to Schizophrenia