Clinical Topic 3: Psychotic Symptoms Flashcards
Give some examples of Positive Symptoms seen in Schizophrenia
Hallucinations
Delusions
Behaviour disturbances
Give some examples of Negative Symptoms seen in Schizophrenia
Lack of motivation Underactivity Reduced speech Reduced emotion Social withdrawal Thought disorder
When do men and women typically develop Schizophrenia? In which is it more common?
Men: 15-30
Women: 25-35
More common in males
Being born in which seasons increases your risk of schizophrenia development?
Winter and early Spring (virus exposure)
Which type of hallucination is most likely to occur in delirium and substance misuse?
Visual
In schizophrenia, there is often a reduction in the amount of grey matter seen on imaging. What lobes of the brain is this most likely to affect?
Temporal and Frontal
When is suicide most likely to be attempted in patients with schizophrenia? When insight is lost or preserved?
Commonly after discharge from hospital, when insight is preserved
How long must symptoms be present for before a diagnosis of Schizophrenia can be made? If symptoms are less than this, what can be an alternative diagnosis?
> 1 month
If < 1 month, Acute Psychotic Disorder
Acute and Chronic Schizophrenia are associated with what kinds of symptoms?
Acute: Positive
Chronic: Negative
What are the first rank symptoms of Schizophrenia?
Auditory hallucinations, Delusions, Thought disorder, Passivity Phenoma
What is Passivity phenomena?
Bodily sensations being controlled by external influence
Actions/impulses/feelings - experiences which are imposed on the individual or influenced by others
What are the specific auditory hallucinations characteristically found in Schizophrenia?
- Two or more voices discussing the patient in the third person
- Voices commenting on the patient’s behaviour
- Thought echo
What is the strongest risk factor associated with Schizophrenia? What are other risk factors?
Family history
Being black, migration, urban environment, cannabis use
What factors are associated with poor prognosis in patients with Schizophrenia?
Strong family history, gradual onset, low IQ, premorbid history of social withdrawal, lack of obvious precipitant
What is first-line treatment of patients with Schizophrenia?
Oral atypical antipsychotics
All patients should be offered CBT also
What is a “Delusion”?
A false, firm, fixed belief
What is “Delusions of control”?
False belief that another person, group of people, or external force controls one’s general thoughts, feelings, impulses, or behavior
What is the “Cotard delusion”?
False belief that one does not exist or has died
What is “Othello syndrome”?
A person believes that their spouse or sexual partner is being unfaithful without having any real proof
What is a “Delusion of reference”?
False belief that insignificant remarks, events, or objects in one’s environment have personal meaning or significance
What are the three phases of Schizophrenia?
Prodromal
Active
Residual
What is the mechanism of Clozapine?
5-HT2A antagonist D2 antagonist (weak)
What is “Waxy flexibility”?
A type of symptom of Catatonia associated with Schizophrenia. Patients are unresponsive to stimuli and tend to be remain still. Attempts at moving / repositioning them and patient will remain in new position
What is “Schizoaffective disorder”?
Patients present with delusions and hallucinations and symptoms of a mood disorder, i.e. accompanied by either a depressive or a manic mood state
