Schizophrenia

Question 1

Schizophrenia triggering factors

Answer 1

Intrauterine factors - oxygen deficiency, effect of drugs and trauma during fetal brain development esp during first trimester
Pregnancy complications and birth complication resulting to lack of nutrition of oxygenation to the brain
Psychological trauma - affecting maturation
Drug use - affecting maturation
Living in a town - crowded area due to lack of social support network
Viral infection
Nutritional effect
Immigrants with lack of social support, strange culture
Early absence of father
Communication deviance (parents communication with children non-consistent)
Month of birth - due to high influenza rates (Winter month Dec-Mar)
Viral / antibody load during birth\
Males > females

Question 2

Model of schizophrenia (to get onset of schizophrenia)

Answer 2

Genetic loading of suspectable gene + triggering factor = manifestation of genes

Question 3

Highest risk of genetic loading according to relationships within family

Answer 3

Monozygotic twins - 46%
Both parents - 46%
Highest risk

Question 4

Criteria as per DSM V for schizophrenia

Answer 4

A- Two or more of the following: delusions, hallucinations, disorganised speech, grossly disorganised or catatonic behaviour or negative symptoms
B- A significant portion of the time since the onset of disturbance, level of functioning in one or more major areas such as work, interpersonal relations or self care is markedly below the level achieved prior to the onset
C- Cont signs of disturhance for atleast 6 months with one month meeting criteria A
D- Rule of ddx- schizoaffective and depression or bipolar
E- Effect- not due to physiological affect of drug or other medical condition
F- Neurodevelopment dx the prodominant feature needs to be hallucinations or delusions

Question 5

What symptoms occur first in schizophrenia (positive or negative)

Answer 5

Onset of psychosis is often preceded by a prolonged period of disurbance of cognition, affect and behaviour, the importance of a through exploration of the person’s developmental and premorbid personality is required

Question 6

First rank symptoms

Answer 6

Thought insertion, withdrawal or broadcasting
Hallcuinatory voices commenting on person’s behaviour
Passivity experiences

Question 7

Main domains of deficits in schizophrenia

Answer 7

Symptom severity
Functional impairment (cognitive deficits)
Social and occupational disability