[2] Schizophrenia Flashcards
What is the most common psychotic condition?
Schizophrenia
What is schizophrenia characterised by?
Hallucinations, delusions, and thought disorders, which lead to functional impairment
What does schizophrenia occur in the absence of?
Organic disease, alcohol, and drug-related disoders
Can schizophrenia be secondary to an elevation or depression of mood?
No
What factors does the development of schizophrenia involve>
Both biological (including genetic) and environmental factors
What does the dopamine hypothesis of schizophrenia state?
That schizophrenia is secondary to over-activity of the mesolimbic dopamine pathways in the brain
What evidence supports the dopamine hypothesis of schizophrenia?
- Conventional antipyschotics work by blocking dopamine receptors
- Drugs that potentiate the pathway, for example anti-parkinonian drugs, cause psychotic symptoms
What is the stress-vulnerability model of schizophrenia?
The stress-vulnerability model predicts that schizophrenia occurs due to environmental factors interacting with a genetic predisposition (or brain injury). Patients have different vulnerabilities, so different individuals need to be exposed to different levels of environmental factors to become psychotic
What can the risk factors for schizophrenia be categorised into?
Biological, psychological, and social, or predisposing, precipitating, and perputating
What are the biological predisposing risk factors for schizophrenia?
- Genetic predisposition
- Neurodevelopmental problems, including intrauterine infection, premature birth, fetal brain injury, or obstetric complications
- Age 15-35
- Extremes of parental age (<20 years or >35 years)
What are the biological precipitating risk factors for schizophrenia?
Smoking cannabis or using psychostimulants
What are the biological perpetuating risk factors for schizophrenia?
- Substance misuse
- Poor compliance to medication
What are the psychological predisposing risk factors for schizophrenia?
- Family history (due to exposure to the person with schizophrenia)
- Childhood abuse
What are the psychological precipitating risk factors for schizophrenia?
- Adverse life events
- Poor coping style
What are the psychological perpetuating risk factors for schizophrenia?
Adverse life events
What are the social predisposing risk factors for schizophrenia?
- Substance misuse
- Low socioeconmic status
- Migrant population
- Living in an urban area
What are the social precipitating risk factors for schizophrenia?
Adverse live events
What are the social perpetuating risk factors for schizophrenia?
- Lack of social support
- Expressed emotions
What can the symptoms of schizophrenia be divided into?
- The positive symptoms (acute syndrome), where there is appearance of hallucinations and delusions
- Negative symptoms (the chronic syndrome), which refers to loss of function
What do the clinical features of schizophrenia depend on?
The type of schizophrenia
What are the positive symptoms of schizophrenia?
- Delusions
- Hallucinations
- Formal thought disorder
- Passitivity phenomenon
What is a delusion?
A fixed false belief, which is firmly held despite evidence to the contrary, and goes against the individuals normal social and cultural belief system
Of what nature are the delusions in schizophrenia often?
Persecutory, grandiose, nihilistic, or religious
What are ideas of reference?
Thoughts where a person thinks that common events refer to them directly, e.g. personal messages on TV