Schizophrenia

Question 1

What is schizophrenia?

Answer 1

a group of brain disorders characterised by distortions of though, emotion, behaviour and perception

Question 2

What is the common pathognomonic symptom in Schizophrenia?

Answer 2

There isnt one!

Question 3

What is the criteria for schizophrenia diagnosis?

Answer 3

one of:
thought interference 
passivity phenomena 
hallucinatory voices giving a running commentary or discussing the patient 
impossible persistent delusions 

or two of: 
formal thought disorder 
catatonic behaviour 
negative symptoms 
loss of interest, idleness, social withdrawal

Question 4

How long should a patients symptoms be present before i diagnosis is made?

Answer 4

1 month

Question 5

What are schneiders first rank symptoms of schizophrenia?

Answer 5

thoughts spoken aloud
third person voices
running commentary

passivity phenomena - acts, impulses, volition, feelings

delusional perceptions

thought broadcasting, thought withdrawal, thought insertion

Question 6

What are examples of auditory hallucinations?

Answer 6

hearing own thoughts aloud
voices talking about them in third person
voices giving them a running commentary

Question 7

What is passivity?

Answer 7

a feeling then explained by delusions - e.g. acts, impulses and feelings are being imposed by an outside agency.

Question 8

What is a delusion?

Answer 8

A fixed belief, not amenable to logical thought or argument.

not founded by logic and not related to cultural beliefs of the person.

Question 9

What is a true hallucination?

Answer 9

perceptual experience not based on an actual object

as vivid as a real perception

exists in external space and is believed to be public

often explained that others cannot see/hear them by another delusion e.g. forcefields

Question 10

What kind of hallucination is most common in schizophrenia?

Answer 10

Auditory

Question 11

What other types of hallucinations can occur in SZD?

Answer 11

visual
olfactory 
gustatory 
tactile 
kinaesthetic

Question 12

What is thought disorder?

Answer 12

disruption of the thinking process

Question 13

What is disruption of associations?

Answer 13

a lack of association between thoughts so what they are saying doesn’t make sense - move from one topic to the next

Question 14

What is thought blocking?

Answer 14

When the chain of thought unexpectedly breaks off (- not caused by other distractions)

Question 15

What is crowding of thought?

Answer 15

thoughts feel passively concentrated and compressed with a quality of “outside control”

Question 16

What is thought insertion?

Answer 16

thoughts being put into the mind by an external agency

Question 17

what is Thought withdrawal?

Answer 17

thoughts being taken out of the mind by an external agency- can be delusional explanation for thought blocking

Question 18

What is thought broadcasting?

Answer 18

thoughts being broadcast to other people/shared

Question 19

What things are involved in emotional disorder?

Answer 19

blunting of affect - limited emotional range

Incongruent affect - affect incongruent with circumstances

Apathy - lack of feelings/care

anhedonia

social withdrawal

Question 20

What is apathy?

Answer 20

Lack of feelings/care

Question 21

What is catatonia?

Answer 21

State of increased tone in muscles at rest which is abolished by voluntary activities

Question 22

What is stupor?

Answer 22

state of increased tone in muscles at rest

Question 23

What are stereotypies?

Answer 23

non-goal directed movements (can involve unusual postures which can be held for a long time), or mannerisms

Question 24

What conveys good prognosis in SZD?

Answer 24

older age at onset
female gender
marked mood disturbance
family history of mood disorder

Question 25

What conveys poor prognosis in SZD?

Answer 25

longer duration of untreated psychosis 
poor pre-morbid adjustment 
insidious onset 
early onset 
cognitive impairment 
enlarged ventricles

Question 26

What is important to remember about SZD and physical health?

Answer 26

people with schizophrenia are more prone to other physical illness

Question 27

Can physical illness precipitate psychiatric symptoms?

Answer 27

YES

Question 28

What are “positive” symptoms?

Answer 28

delusions
hallucinations
thought disorder

Question 29

What are “negative” symptoms?

Answer 29

apathy
lack of volition
social withdrawal
cognitive impairment

Question 30

What is the difference between + and - symptoms?

Answer 30

positive symptoms tend to respond better to treatment

Some evidence that negative symptoms have more impact on functionality