Schizophrenia Flashcards
(29 cards)
What is schizophrenia?
A disorder characterised by psychotic symptoms plus functional impairment
- Is chronic and relapsing
Define positive symptoms
Delusions
Hallucinations
Agitation
Thought disorder
Define negative symptoms
Lack of will Lack of interest Isolation Social and occupational withdrawal Intellectual decline Poor memory and attention
Give some causes of schizophrenia
Predisposing
- Biological = genetic
- Psychological = ?parenting
- Social = ?immigration
Precipitating
Bio = Drug use, poor compliance
Psycho = stress
Perpetuating
- Psycho = relationship
- Social = role in society
When does schizophrenia usually present?
Late adolescence or early adulthood
Give the prevalence of schizophrenia
3/1000 of the population
What are the main ways the schizophrenia progresses?
1/3 = single episode 1/3 = relapsing illness with minimal residual damage 1/3 = progressive deterioration
What pre-mormid factors give rise to a poorer prognosis?
- FH schizophrenia
- Personal history of any psychiatric disorder
- Eccentric shy personality
- Poor social and psychosexual adjustment
- Single civil status
- Unstable work record
- Young age
What clinical indicators give an indication of a poorer prognosis?
- Insidious onset
- Blunted affect
- Prolonged episode
What types of delusions can people with schizophrenia have?
Delusions of reference
Delusions of persecution
Delusions of passivity
Define delusion of reference
An event or action has a special meaning to the patient - believe things are meant specifically just for them e.g. messages in the paper, voices on the radio
Define a delusion of persecution
Patient feels that they are being followed.
Are paranoid.
Define a delusion of passivity
Delusion in which the person feels that their actions are under control of other people.
What kind of auditory hallucinations do people with schizophrenia have?
- Thought spoken aloud
- Third person hallucinations
- Commentary
What are the first rank symptoms of schizophrenia?
Auditory hallucinations Thought withdrawal Thought insertion Thought broadcasting Somatic hallucinations Delusional perception Feelings or actions which are experienced as being by external sources
Define thought withdrawal
The delusion that thoughts have been removed from a patients mind
Define thought insertion
The delusion that thoughts are not their own but have been implanted by an external source.
Define thought broadcasting
Patient believe that their thoughts are being broadcasts to the outside world. Can be via: Telepathy Radio broadcasting Newspaper is reporting their thoughts
Define a delusional perception
Real perceptions gives rise to a false meaning
Define somatic hallucinations
Tactile hallucinations such as insects crawling over their skin, the feeling of being touched or strangled
Define a thought disorder
Cognitive processing is scrambled and gives rise to a number of different factors.
What kind of things can arise in thought disorders?
- Neologisms - create new words
- Stock phrases
- Clang associations - thoughts are connected by the words sounding the same
- Concrete thinking
- Derailment - changing from one subject to another
- Knight’s move thinking - leaping rapidly from one to another
- Omission
- Drivelling
- Over-inclusive thinking
What are the differential diagnoses for schizophrenia?
Brief psychotic reaction Severe depression with psychosis Bipolar with psychosis Schizoid personality disorder Schizoaffective disorder Drug induced psychosis Organic symptoms
What is the first line treatment for schizophrenia?
Oral atypical antipsychotics such as:
- Olanzapine
- Risperidone
- Quetiapine
- Amisulpiride
