Schizophrenia

Question 1

Schizophrenia presentation

Answer 1

positive symps (added features)

• delusions - fixed beliefs, arrived at illogically, not amenable to reason , and no accepetd in the patient’st cultural background
• hallucinations - perceptions that occur in the absnce of external stimuli
• thought disorder is speech that is so disorgansed that communication is imapired
• negative symps - apathy , poverty of thought / speech, blunted affect, social isolation, poor self care

Question 2

scheneider’s first rank symptoms

Answer 2

1. auditory hallucinations - thought echo, discussion of patient/ voices arguing, running commentary.
2. delusions of control - passivity ot mood/ feelings,impulse, action and bodily sensations.
3. delusions of thought control - insertion, withdrawal, braodcast.
4. delusional perception - true perception of external stimulus interpreted in a delusional way.

Question 3

schizophrenia like disorder definition

Answer 3

when symps have resolved or not been present for long enough for a schizophrenia diagnosis to be made

Question 4

schizoaffective disorder def.

Answer 4

psychotic symps w prominent mood disorder in same episode

Question 5

delusional disorder def.

Answer 5

when a patient only has delusional beliefs - last longer than 3 months and no other features.

Question 6

organic causes of psychosis

Answer 6

urological and endocrine disorders

substance use

Question 7

ICD diagnositic criteria for schizophrenia

Answer 7

ONE OR MORE OF

• though echo, insertion, withdrawal or broadcats.
• delusions of control, passivity, delusional perception/
• hallucinatory voices giving a running commentary discussing the patient
• bizarre delusions

TWO OR MORE OF

• other hallucination that ooccur every day for weeks or that are association w fleeting delusions or sustained overvalued ideas.
• though disorganisation
• catatonia
• negtaive symps
• changes in personal behavious - loss of interst, aimlessness, social withdrawal

symps sshould be preseny for most of the time during at least 1 month

Question 8

investigations to do for schizophrenia

Answer 8

history
- usual plus substance use and collateral
exam - neuro/ endo exam
investigations - bloods (FBC, Us and Es, LFTs, TFTs, glucose, lipids, calcium) , urine drug screen and infectin serology, ECG in patients w cardiac problems (or familial sudden death)

Question 9

Schizophrenia management

Answer 9

Bio - long term antipsychotics, benzos for aggression, regualr health screens - esp cardiac.
Psycho - CBT, family psychological interventions
Social - accom, finances, occupation, social support.
Legal - can be detained under the MHA.

Question 10

treatment resistance schiz def.

Answer 10

pts who don’t respond to 2 diff antipsychotics at apporpriate dose and for long enough time - one of which should be 2nd gen

Question 11

treatment resistant schizophrenia treatment

Answer 11

clozapine

Question 12

acute behavioural disturbance in schizo management

Answer 12

de escalation techniques before using benzos.