Schizophrenia Flashcards

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1
Q

What are the different types of schizophrenia?

A

Paranoid- persecutory, systematised delusions, hallucinations, auditory. Commonest.

Disorganised- hebephrenic- bizarre delusions

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2
Q

What are the CFs of chronic schizophrenia?

A
Burn out disease. - negative sx.
Acute- +ve sx. Can be both anytime.
Negative sx: flattened (low)mood
Apathy, loss of drive, - avolotion
Social isolation
Poverty of speech
Poor self care

+ve sx persist or recur at time of stress

Mild cognitive impairment is common

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3
Q

Some +ve sx?

Sx that are usually not there

A

Reality distortion - delusions (fixed unshakable belief), hallucinations

Disorganization (thought disorder)

Psychomotor poverty- like retardation- similar to negative sx.

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4
Q

Prognosis

A

The more years the higher the chances of suicide. 1 in 10

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5
Q

Tx?

A

Acute vs chronic.
Physical, psychological, social

Admission- under mental health act if necessary and dangerous
Antipsychotics- sx tx for 2-3W
Benzodiazepines- for sedation if distressed or difficult
Establish context disorder
Asses needs and risk
Educate family,

Following a svhizophrenic episode, post-schizophrenic depression is common.

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6
Q

Management of chronic schizo?

A

Prevent relapse
Oprimise functioning

Antipsychotic meds- reduce relapse for 2Y after episode from 70-50%
Adherence?
MDT
Care program approach- medical and social needs met
Readmit during relapse- stabilise
Cognitive therapy- reduce sx
Social skills training- to improve social functioning

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7
Q

What are the main typical of antipsychotics?

A

typical and atypical
Also used to treat aggitated behaviour or violence.

All are dopamine D2 receptor antagonists - alliviate +ve sx of schizo.
Early dx imp, the longer the untreated psychosis, the worse the outocme.

Typical:
Haloperidol
Chloropromazine
Fluphenazine

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8
Q

SE of typical antipsychotics?

A

Rspestlensness, constipation, tardive dyskinesia, sedation, hypotension.

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9
Q

When are the atypical antipsychotics used? Give some examples

A

Better at treating schizo and less likely to cause extra pyramidal motor side effects like rigidity and tremors.

Clozapine (GOLD STANDARD) but can obly be presceibed when 2 other antipsychotics have failed

Risepiridone
Quetiapine

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10
Q

Why is clozapine used after 2 antipsychotics have failed?

A

Can cause serious agranulocytosis and requires blood monitoring

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11
Q

What are some SE of atypical antipsychotics?

A

Wt gain
Nausea
Impaired glucose tolerance

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12
Q

Whats the schizoaffective disorder?

A

Both features of schizo and mood disorder, can be either bipolar or major depressive disorder, but not meeting criteria for both.

Onset usually young adulthood.

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13
Q

What is it? Whatbare the clinical features?

A

Closer to madness- psychotic.
If paranoid- then dangerous.

Characteristic sx:
1st rank sx:
Thought insertion, echo, (hear ur thoughts like u hear me?) withdrawal, broadcasting.
3rd person auditory hallucinations- talking about u
Passivity of thoughts- thoughts controlled by somone else??
Delusional perception (association)
Thought disorder
Lack of insight (reality distortion- here and now)
Soacial withdrawal

Duration: at least 1 M

Exclusion: Not secondary to elevation or depression

No organic causes- amfetamines, temporal lobe epilepsy.

The more sx there are the more likely it is.

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