Schizophrenia Flashcards
(21 cards)
What is schizophrenia?
A severe long-term mental health disorder characterized by psychosis, most often presenting between ages 15-30, and earlier in men than women.
How long must the symptoms be present before a diagnosis is made?
6 months
What is schizoaffective disorder?
- Combines the symptoms of schizophrenia with bipolar disorder
- Patients have psychosis and symptoms of depression and mania. - Need to give antipsychotic and mood stabilizer.
What is schizophreniform disorder?
Presents with the same features as schizophrenia but lasts less than 6 months.
- Treated with antipsychotics.
What is schizotypal disorder?
A personality disorder which has partial expression of schizophrenia.
- Patients lack close friends other than family and can have odd or eccentric behavior, speech, and beliefs.
- Treated without medication.
What is schizoid personality disorder?
Displays the negative symptoms of schizophrenia without psychotic symptoms.
What are first rank symptoms?
- specific types of auditory hallucination: hearing thoughts spoken aloud (thought echo) or 3rd person hallucinations discussing the patient or giving a running commentary
- thought interference: withdrawal, insertion, interruption, broadcasting
- passivity: feelings, impulses, action controlled by external force or sensations on body imposed by outside forces (somatic passivity)
- delusional perception
What are the different subtypes of schizophrenia?
Paranoid, hebephrenic, catatonic, undifferentiated, simple, and residual - negative symptoms predominate.
What are some differentials of psychosis?
- mania
- psychotic depression
- drugs (eg. hallucinogens and cannabis)
- stroke
- brain tumours
- Cushing’s syndrome eg. patients taking systemic steroids
- hyperthyroidism
- Huntington’s disease
- dementia and depression
What are some potential causes and risk factors?
Result of genetic and environmental factors. Specific genes that increase the risk of schizophrenia have been identified. Having an affected family member is a risk factor.
What often precedes the symptoms?
- a prodrome phase - usually upto 18 months before 1st episode of psychosis
- gradual deterioration in function
- this is where the patient may experience subtle symptoms such as poor memory, reduced concentration, mood swings, suspicion of others, loss of appetite, difficulty sleeping, social withdrawal and decreased motivation
What is one of the central features of psychosis?
-
psychosis is a central feature of schizophrenia. The key features of psychosis, called positive symptoms are:
- delusions - beliefs that are strongly held and clearly untrue
- hallucinations - perceiving things that aren’t real
- thought disorder - disorganised thoughts causing abnormal speech and behaviour
- lack of insight is an important feature of psychosis(also known as active phase symptoms)
What are key positive symptoms that are typical in schizophrenia?
- auditory hallucinations
- somatic passivity - believing that an external entity is controlling their sensations and actions
- thought insertion or thought withdrawal
- thought broadcasting
- persecutory delusions
- ideas of reference - a false belief that unconnected events or details in the world directly relate to them
- delusional perceptions
What is delusional perception?
When the patient experiences an ordinary and unremarkable perception that triggers a sudden, often self-related delusion.
What are the negative symptoms of schizophrenia? 4As
- affective flattening - minimal emotional reaction to emotive subjects or events
- alogia - poverty of speech - reduced speech
- anhedonia (lack of interest)
- avolition - lack of motivation in working towards goals or completing tasks
What is another important feature?
A reduced level of function, including reduced/impaired social engagement, productivity and achievement at work or school, and self-care.
What are some different patterns of symptoms that it can present as?
The active phase symptoms of psychosis may be continuous, episodic (relapsing and remitting), or a single episode only.
How is it diagnosed?
Using DSM 5 criteria
- the symptoms (including the prodrome phase) have to be present for at least 6 months, with the symptoms of the active phase (delusions, hallucinations, and thought disorder) present for at least 1 month.
What is the management?
- early invention in psychosis services are available for first episodes of psychosis
- crisis resolution and home treatment teams provide urgent support for patents in crisis
- acute hospital admission
- community mental health team for ongoing monitoring and management
- antipsychotic meds
- CBT
What are some key associations with schizophrenia and antipsychotic drugs?
Metabolic syndrome and cardiovascular disease.
What is monitored?
Physical health, smoking status, alcohol, illicit drugs, weight, activity levels, blood lipids, and glucose.
