Lecture 5 - Clinical aspects of schizophrenia

Question 1

What is psychosis?

Answer 1

An umbrella term for a set of conditions where there has been a loss of contact with reality.

Question 2

What are some biological reasons for developing schizophrenia?

Answer 2

Neurochemical (dopamine, glutamate)
Structure of the brain (brain volume changes, more grey than white matter, decreased frontal lobe)
Genetics
Neurodevelopment (born at 32 weeks or earlier increases risk 2-fold, low birth weight and a lack of oxygen during birth)

Question 3

What are some psychological reasons for developing schizophrenia?

Answer 3

Stress
Drugs
Adverse childhood experiences

Question 4

What are some social reasons for developing schizophrenia?

Answer 4

Urban upbringing
Migration

Question 5

What are some positive symptoms of schizophrenia?

Answer 5

Added to everyday experiences.
Delusions.
Hallucinations.
Disorganised thoughts.

Question 6

What are some negative symptoms of schizophrenia?

Answer 6

Things that are taken away from everyday experiences.
Poverty of thought.
Poverty of affect that leads to social and emotional withdrawal.

Question 7

What are some cognitive symptoms of schizophrenia?

Answer 7

Hard to concentrate on things.
Memory, attention, executive function and decision making all impaired.

Question 8

What are affective symptoms of schizophrenia?

Answer 8

Dysphoria and depression.

Question 9

What is used to diagnose schizophrenia?

Answer 9

ICD-11 need 2 or more of the symptoms that are persistent for a period of 1 month or more.

Question 10

Describe the biopsychosocial model of treatment for schizophrenia.

Answer 10

Bio - antipsychotics to protect against relapse in short, medium and long term. If they are reduced too quickly, a chance of relapse is significantly increased.
Psycho - support and reduction of stress, CBT.
Social - rehabilitation, living skills training.

Question 11

What are some first generation (typical) antipsychotics?

Answer 11

chlorpromazine
flupenthixol
haloperidol

Question 12

What are some second generation (atypical) antipsychotics?

Answer 12

clozapine
amisulpride
olanzapine
risperidone
quetiapine

Question 13

What is the distinction between giving someone a typical or an atypical antipsychotic?

Answer 13

Incidence of side effects, efficacy in treating treatment resistant patients and efficacy against negative symptoms.

Question 14

What medication has the highest efficacy but the most side effects?

Answer 14

Clozapine.
Good for those who have not found any good medication yet but has more side effects such as agranulocytosis and bowel and heart problems.