Week 9
Nursing School at Platt College
BIOL300 Pathophysiology

CHAPTER 48 – NEUROBIOLOGY OF PSYCHOTIC ILLNESSES
CHAPTER 49 – NEUROBIOLOGY OF NONPSYCHOTIC ILLNESSES
CHAPTER 50 – STRUCTURE AND FUNCTION OF MUSCULOSKELETAL SYSTE
CHAPTER 51 – MUSCULOSKELETAL: TRAUMA, INFECTION AND DISEASE
CHAPTER 52 – MUSCULOSKELETAL: RHEUMATIC DISORDERS

Copyright © 2014, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

Chapter 48
Neurobiology of Psychotic
Illnesses

Copyright © 2014, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

Schizophrenia
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“Split mind”—split or separation among normally well-synchronized brain functions
Results in thought, behaviors, and feelings that are disordered, disorganized, and disconnected from reality (psychosis)
Characterized by altered perceptions of reality and disordered thinking
Many different issues that together makes schizophrenia Copyright © 2013, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

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Schizophrenia (Cont.)
Etiology
 First diagnosed typically between 15 and
54 years of age
 Women usually have symptom onset between 25 and 35 years of age
 Men have symptom onset usually between
15 and 25 years of age
 Women have better outcomes

Copyright © 2013, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

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Schizophrenia (Cont.)
Clinical Manifestations
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Positive symptoms (reality distortion and disorganization)
 Talk and function normally
 Has disorganized thinking or abnormal thoughts
 They are highly functional and can function normally for schizophrenia
 Reflect the excess or distortion of normal functions
 Result from excessive dopamine D2 receptor activity
• Drugs target dopamine receptions (Klonopin)
 Distortions in thought content (delusions)
• Systematic, fixed (cant be altered), false beliefs (not true to reality)
 20 year old that claims he was in WW2
• Usually involve themes of persecution (someone is out to get you, something is preventing you success), Delusion of reference
(something that means nothing they take it as a huge deal, it is a significant sign), somatization, religiosity (carrying a huge crucifix on his chest, he believed he could communicate with god), grandiosity
(they believe they are important, savor of the human race or think they are a actor in the moving if they are homeless), or controlling
Copyright © 2013, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

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Schizophrenia (Cont.)
Clinical Manifestations
 Positive symptoms (reality distortion and disorganization) 

Distortions in perception (hallucinations)
• Sensory perceptions with no apparent stimulus
• Occur in any sensory system (auditory, visual, olfactory, gustatory, tactile); auditory is most common

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Disorganized thinking and speech
• Characterized by frequent derailment or loose associations, invented words, tangential idea, and when most severe, incomprehensible speech
• Having a train of though that goes off track
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Telling a story of your childhood the go off onto a random topic
Copyright © 2013, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

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Schizophrenia (Cont.)
Clinical Manifestations
 Positive symptoms (reality distortion and disorganization) 

Grossly disorganized behavior
• Range from childlike silliness to unpredictable agitation; impairs tasks of daily living
• Catatonic motor behaviors: decrease in reactivity to environmental events, to such an extreme that they can maintain a rigid posture and resist efforts to be moved Copyright © 2013, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

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Schizophrenia (Cont.)
Clinical Manifestations
 Negative symptoms
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Reflect a decrease, deficit, or loss of normal functions Considered to be restricted affect; avolition and asociality Associated with dopamine D1 receptor activity
Manifestations include social withdrawal and isolation, dull or blunted emotional affect, poverty of speech, posturing, and autism

Copyright © 2013, 2010, 2005 by Saunders, an imprint of Elsevier Inc.

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