Schizophrenia

Question 1

What are the risk factors for schizophrenia?

Answer 1

• Birth complications
• Family Hx
• Smoking cannabis

Question 2

What are the first rank symptoms?

Answer 2

• Hallucinations (Auditory and Somatic)
• Thought blocking
• Thought withdrawal
• Thought insertion
• Thought broadcasting
• Passivity
• Delusions

Question 3

What are examples of positive symptoms?

Answer 3

o Hallucinations
o Delusions (fixed or falsely held beliefs)
o Disorganised behaviour, speech and thoughts

Question 4

What are examples of negative symptoms?

Answer 4

o	Emotional blunting
o	Reduced speech
o	Loss of motivation
o	Self-neglect
o	Anhedonia
o	Alogia (poverty of speech)
o	Avolition (poor motivation)
o	Social withdrawal

Question 5

How do you manage schizophrenia?

Answer 5

• Oral atypical antipsychotics (2nd gen)
• CBT
• CV risk factor modification

Question 6

Why do you need to manage CV risk factors?

Answer 6

Antipsychotic medication and high smoking rates

Question 7

What are the features of neuroleptic malignant syndrome?

Answer 7

• pyrexia
• muscle rigidity
• autonomic lability: typical features include hypertension, tachycardia and tachypnoea
• agitated delirium with confusion

Question 8

How do you manage neuroleptic malignant syndrome?

Answer 8

• Stop antipsychotic
• Patients should be transferred to a medical ward if they are on a psychiatric ward and often they are nursed in intensive care units
• IV fluids to prevent renal failure
• Dantrolene

Question 9

What is section 135?

Answer 9

One doctor, AMHP and police

Warrant to gain access to premises to remove patient to place of safety

Question 10

What is section 136?

Answer 10

Police

Allows police to remove person from public place to place of safety

Question 11

What is section 2?

Answer 11

AMHP or nearest relative

Recommendation by 2 doctors (at least 1 has to be section 12 approved)

Admission for assessment and treatment for 28 days

Question 12

What is section 3?

Answer 12

AMHP or nearest relative

Recommendation by 2 doctors (at least 1 has to be section 12 approved)

Admission for treatment for 6 months

Question 13

What is section 4?

Answer 13

AMHP or nearest relative

Recommendation by any doctor

Emergency admission for assessment for 72hrs

Question 14

What is section 5(2)?

Answer 14

Recommendation from the doctor or approved clinician in charge of the patient’s care or their nominated deputy

Emergency holding order (patient already admitted to hospital on an informal basis) 72hrs

Question 15

What is section 5(4)?

Answer 15

Recommendation from registered nurse for 6hrs