Schizophrenia Flashcards
(37 cards)
cluster A PDs
- paranoid
- schizoid
- schizotypal
cluster B PDs
- anti-social
- borderline
- histrionic
- narcissistic
cluster C PDs
- avoidant
- dependent
- obsessive-compulsive
def: schizophrenia
long term MH problem affecting thinking, perception and affect
* M diagnosed 15-25
* F diagnosed 25-35
at least 1 month
aetiology: schizophrenia
- unknown
- ?consequence of combination of psychological, environmental, biological and genetic factors
- illness triggered by emotional life experinces
neurodevelpmental hypothesis: schizophrenia
higher risk if:
* experienced hypoxic birth injury
* viral illness in-utero
* temporal lobe epilepsy
* smoke canabis
imaging shows: enlgarged vernticles, small amount grey matter loss, smaller and lighter brains
neurotransmitter hypothesis: schizophrenia
- excess dopamine and overactivity in mesocorticolimbic system causing +ve symptoms
- hence why doapmine antagonists used in tx but more successful treating +ve symptoms
- loss of dopamine activity in mesocorticolimbic tracts causing -ve symptoms
other neurotransmitters in schizophrenia:
* increased serotonin
* decreased glutamate
psychotic symptoms: parkinson’s patients
use of dopamine agonists (Levodopa) over treatment causes increased amounts of dopamine in brain causing psychosis
6 types: schizophrenia
Please Help Carol Really Understand Schizophrenia
6 types: schizophrenia
Please Help Carol Really Understnad Schizophrenia
1. paranoid
2. hebrphrenic
3. catatonic
4. residual
5. undifferentiated
6. simple
def: paranoid schizophrenia
- most common
- characterised by auditory hallucinations and paranoid dellusions
def: hebephrenic schizophrenia
- diagnosed in adolescents and young adults
characterised by mainly negative symptoms: - mood changes
- unpredictable behaviour
- shallow affect
- fragmentary hallucinations
def: simple schizophrenia
characterised by negative symptoms
NEVER positve symptoms
def: catatonic schizophrenia
psychomotor features:
* posturing
* rigidity
* stupor
def: undifferentiated schizophrenia
symptoms do not fit neatly into one of the other catagories
def: residual schizophrenia
characterised by negative symptoms whrn +ve symptoms have “burtn out”
RFs: schizophrenia
- family hx and genetics (esp twins - 50% if monozygotic)
- 48% chance if both parents affected
- > increased risk if father >55
- pregnancy: malnutrition and viral infections, pre-eclampsia and EMCS
- drug abuse: cannabis (esp in teenage use) also cocaine, LSD and amphetamines
- social environment: lower socioeconimic classes and stressful life experiences
- ethnicity: afrocarribean men more affected
clinical features: schizophrenia
HD BS Network
* hallucinations
* delusions (broadcasting/insertion/withdrawal/control)
* behaviour disorganisation (loosening/clang associations
* speech disorganisation (neologisims/echolalia/perseveration/word salad)
* negative symptoms (5As)
schizophrenia: negative symptoms
5As
1. affect (no affect)
2. ambivalence (can’t make decisions)
3. alogia (reductions in amount of speech/mute for months or years)
4. anhedonia (amotivation - no goals, can’t hold job, can’t take care of basic needs)
5. asociality (difficult to relate to people/disinterested)
ix: schizophrenia
- basline bloods: FBC, LFTs, U+E, CRP, TFTs and fasting glucose
- urine culture: UTI causing delirium
- urine drug screen: intoxication
- HIV testing
- syphilis serology
- serum lipids before antipsychotics
(ruling out other causes)
ix: before commencing antipsychotics
serum lipids
diagnosis: schizophrenia
- first rank symptoms for at least one month: delusional perception, passiity, delusions of thought interference, auditory hallucinations
- no other cause for psychosis
rx: schizophrenia
- early intervention team (after 1st episode), community mental health team, and crisis resolution team
- CPA - care programme approach 4 stages 1. assessing health and social needs, 2. creating care plan 3. appointing key worked as POC and 4 reviewing tx
- antipsychotic medication
- psychological tx
tx: schizophrenia summary
atypical dopamine receptor antagonist 1st line - risperidone
2nd line add typical D2 antagonist - olanzapine
if both fail - clozapine
