Schizophrenia and Psychotic Disorders Flashcards
(53 cards)
What is Schizophrenia?
Severe mental illness characterised by fundamental distortions of thinking, perception, emotion and behaviour
Describe the pathphysiology of schizophrenia
Unknown, dopamine hypothesis
What gender does schizophrenia effect more?
M=F although males tend to present earlier
What is the typical age of onset of schizophrenia?
15-35 years
What are the causes of schizophrenia?
Genetics/FH
Adverse/traumatic life event
Obstetric complications
Maternal influenza
Malnutrition and famine
Winter birth
Cannabis use, can’t cause schizophrenia but can modify the course of established illness
What are the good prognostic factors for schizophrenia?
Absence of family members
Good premorbid function: Stable personality and relationships
Clear precipitant
Acute onset
Late onset
Mood disturbance
Prompt treatment
Maintenance of initiative and motivation
What are the poor prognostic factors for schizophrenia?
Slow, insidious onset
Childhood onset
Prominent negative symptoms
FH
Prodromal phase of social withdrawal
Low IQ
Lack of obvious precipitant
What are the main symptoms of schizophrenia, according to ICD-10?
At least one of the following, for more than a month:
Alienation of thought
Delusions of control, influence or passivity
Hallucinatory voices
Persistent delusions
What are the types of alienation of thought?
Thought echo: Hears own thoughts out loud
Insertion: Feels someone else put thoughts in their head
Withdrawal: Feels thoughts are being stolen from head
Broadcasting: Feels that other people can hear their thoughts
What are the secondary symptoms of schizophrenia, according to ICD-10?
At least two of the following, for more than a month:
Persistent hallucinations
Speech symptoms, such as neologisms, alogia, incoherent or irrelevant speech
Catatonic behaviour
Negative symptoms
Give examples of negative symptoms
Marked apathy
Anhedonia
Poverty of speech/Alogia
Blunting
Withdrawal
Incongruity of emotional responses
What is incongruity?
There is an unpredictable and contradictory emotional response to events
Give examples of catatonic behaviour
Excitement
Posturing or waxy flexibility
Negativism
Mutism
Stupor
What are Schnyder’s first rank symptoms?
Delusions of thought alienation: Withdrawal, insertion, broadcasting
Auditory third person hallucinations
Passivity Phenomena: Delusions of control
Somatic passivity: Physical sensations
Delusional perception
How is schizophrenia managed?
Anti-psychotics: 6-8 week trial of each drug
Psychological interventions
Early intervention services/social services
Perinatal care
What class of anti-psychotics are first line in schizophrenia management?
Atypical
Give examples of atypical anti-psychotics
Olanzapine
Quetiapine
What anti-psychotic is given to treatment resistant schizophrenia?
Clozapine
What psychological interventions are used in schizophrenia management?
Social skills training
CBT
Cognitive remediation
What issues to early intervention services address in schizophrenia management?
Address substance abuse
Social skills training
Employment
Housing
Why is perinatal care essential in schizophrenia management?
Anti-psychotics are teratogenic
High risk of relapse in post-partum
What is psychosis?
Represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality (lack of insight)
What 4 factors define a hallucination?
Have the full force and clarity of true perception, whereas illusions you are fully aware it is not real
Located in external space
No external stimulus, whereas illusions there is external stimuli making it look like something it is not
Not willed or controlled
What are second person hallucinations?
1 person is speaking to you, more likely with depression or personality disorder
