Schizophrenia Flashcards
(24 cards)
What is schizophrenia
Type of psychosis
May not be able to distinguish their own thoughts and feelings from reality
What are the positive symptoms of schizophrenia
Hallucinations - mainly auditory. Can be 2nd person or 3rd person, can have command hallucinations
Delusions
Disordered thoughts - formal thought disorder
Disorders of self - inability to differentiate self from others - thought insertion and thought broadcast
Thought echo and thought withdrawal
What are the negative symptoms of schizophrenia
Flat expression Little emotion Poverty of speech Inability to experience pleasure Lack of desire to form relationships Lack of motivation Lack of will and interest
How do negative symptoms affect a patients life
Contribute to poor quality of life
Impaired functional ability
These symptoms often less responsive to medications
How long must patients have symptoms for
Symptoms for 1 month
What are the different types of delusions
Guilt - large amounts of guilt at minor things
Erotomanic - believing people are in love with you
Grandiose - thinking you are royalty/Jesus/God, have magical powers
Persecutory - thinking people are persecuting you/are out to get you
Hypochondriacal - thinking you have an illness
Reference - believing everyday events have a massive significance - blowing coincidences out of proportion
What is schizophrenia?
Psychotic disorder
may not be able to distinguish their own thoughts and feelings from reality
What are the positive symptoms?
Hallucinations Delusions Disordered thoughts - formal thought disorder Thought echo Thought insertion Thought withdrawal Thought broadcast
What is disorder of self
inability to differentiate self from others
What are the negative symptoms of Schizophrenia
Flat expression Little emotion Poverty of speech Inability to experience pleasure Lack of desire to form relationships Lack of motivation Lack of will and interest
Which symptoms are less responsive to medication
negative symptoms which contribute more to poor quality of life and functional ability
What are the symptoms of cognitive impairment in schizophrenic patients?
Unable to sustain attention
Memory problems
Unable to take on information
Poor decision making
What are 2nd person auditory hallucinations?
When the voice addresses the patient
What are 3rd person auditory hallucinations?
Voice(s) talk about the patient, do not talk to the patient
What is the diagnostic criteria for schizophrenia?
Patient must have had symptoms for 1 month
1+ clear cut positive symptom
or
either 2 or more mild positive symptoms or one or more mild positive symptoms accompanied by negative symptoms
What are the different types of delusions
Guilt - feeling large amounts of guilt at minor things
Erotomatic - believing people are in love with you
Grandiose - thinking you are superior may think they have magical powers
Persecutory - think someone is out to get you
hypochondriacal - thinking you have an illness
reference - believing everyday events have a massive significance. Blowing coincidences out of proportion
What is a hallucination?
perception in absence of an external stimulus
most common is auditory and tactile
olfactory = problems with olfactory nerve or frontal lobe
visual = more common in delirium
What are the differentials for psychosis?
Organic causes - dementia, endocrine Delirium Epilepsy Space Occupying Lesion Drug induced Functional psychosis Encephalitis
How can you distinguish between schizophrenia and severe depression with psychosis?
In depression the hallucinations an delusions will be mood congruent whereas in schizophrenia they will not be mood congruent
Which investigations should be arranged for psychosis?
Bio: CT Head, if recent head trauma or hx of seizures
Bloods
FBC, U+Es, LFTs, Creatinine, Drug screen, Vit B12 and folate, TFTs, blood glucose
Possibly blood and urine cultures if infection suspected
Look for any endocrine causes - cushingoid appearance, hypo/hyperthyroidism
Cranial nerve examination if neurological symptoms
What types of schizophrenia are there?
Hebephenic/disorganised schizophrenia Paranoid schizophrenia Catatonic schizophrenia Childhood schizophrenia Schizoaffective disorder
What is hebephrenic schizophrenia
appears around puberty, disorganised behaviour and speech, inappropriate emotional responses e.g. laughing during bad news, acting childish/silly
What is schizoaffective disorder?
A disorder where the patient meets the criteria for both schizophrenia and a mood disorder (either manic or depression). Both equally affect the patient
How is schizophrenia managed?
RISK ASSESSMENT - could be risk of harm to themselves or others BIO - antipsychotics - weight taken prior to antipsychotics - bloods taken: FBC, blood lipids and glucose, U+Es, LFTs - ECG TR schizophrenia - clozapine (monitor metabolic abnormalities) Weekly blood test due to risk of agranulocytosis PSYCHO - brief psychoeducation - Suicide prevention - Family therapy - Patient education SOCIAL - Support from CPN - Support from social care - Supported employment - Skills training - substance misuse help
