8 - Clinical Management of SZ Flashcards
how does substance misuse relate to SZ?
(except tobacco)
- have great chance of persistant low grade psychotic symptoms
- have worse outcomes in every respect
how does cannabis use relate to SZ?
- moderae use lfrom 18 doubles risk os SZ
- high use from age 15 increases risk by x10
how does the global function of SZ pts differ from non SZ peers?
- gradual decline in global function
- slower development - walking, talking, potty training
when is the most common onset of SZ?
20-25
what is the ratio of male:female for SZ?
2:1
when is the 2nd peak of SZ?
40-50s
what is the correlation between severity of psychosis at presentation and age & sex?
no correlation
what is the correlation between negative symptom severity at presentation and age & sex?
- more severe at a younger age
- men are worse than women
what is the correlation between disorganisation severity at presentation and age & sex?
- less severe in older pts
- no difference in men and women
how does commencement of treatment correlate to response to treatment?
- longer that pt is ill with no treatment, the harder the symptoms are to treat
- not linear
- most profound in the first year
what % of SZ pts commit suicide?
- almost 1% per year initially
- eventually 4-6%
what is the mechanism of action of all antipsychotic drugs?
D2 receptor antagonists
what is the optimum % occupancy of D2 for antipsychotic effects?
- > 60% occupancy in associative striatum has antipsychotic effect
- > 75% occupancy causes motor SE & hyperprolactinaemia
what other medication can SZ pts be given for agitation?
benzodiazepines
what other medication can SZ pts be given for motor side effects?
- anticholinergics - parkinsonisms
- propranolol - akathisia
