Introduction

Question 1

What is schizophrenia?

Answer 1

Schizophrenia is a psychotic disorder. This means it is a severe mental illness where contact with reality and insight are impaired

Question 2

How much of the population does schizophrenia affect?

Answer 2

1% - roughly 1 in every 100 people

Question 3

When does schizophrenia tend to be diagnosed in males?

Answer 3

Mid-20’s

Question 4

When does schizophrenia tend to be diagnosed in females?

Answer 4

Early 30s

Question 5

Bleuler (1978)

Answer 5

Longitudinal study of 2000 schizophrenics. Found that symptoms are most severe in early adulthood, during the first 5 years after onset.

Question 6

What are the 3 key percentages on outcomes of schizophrenia?

Answer 6

1. 40% of individuals recover from positive symptoms
2. 20% make a full recovery if diagnosed early
3. 40% continue to suffer from symptoms and distress for the rest of their lives

Question 7

Stirling and Hellewell

Answer 7

About 25% of sufferers will get better after only one episode of illness. 50-65% will improve but continue to have boughts. The remainder will have persistant difficulties

Question 8

What is the chance of sufferers dying by their own hand?

Answer 8

5-10%

Question 9

What are sufferers at a higher risk of developing?

Answer 9

Preventable physical diseases such as CVD, metabolic disease and infections

Question 10

What are hallucinations?

Answer 10

A positive symptom, false sensory experiences that may not have an identifiable source.
- Auditory (hearing voices)
- Visual (seeing things that aren’t there)
- Olfactory (smelling things that aren’t there)
- Tactile (feeling things that aren’t there)
-

Question 11

What are delusions?

Answer 11

A positive symptom, false beliefs, not based on facts or evidence.
- Persecution (belief that one is victimised or spied on)
- Grandeur (belief of great power and importance)
- Control (belief that their thoughts are being controlled)

Question 12

What is disorganised thinking and speech?

Answer 12

A positive symptom, sufferers find it hard to concentrate on anything, thoughts drift from one thing to another often with no connection. E.g. Trouble finishing a book or TV programme and with college work. Words may also become jumbled or confused.

Question 13

What is speech poverty (alogia)?

Answer 13

A negative symptom. - Reduction in communication.
- Short, empty replies to questions
- Patient has difficulty starting a conversation and finds it hard to speak to people
- They have lost spontaneity
- Results from the slowing/blocking of thoughts

Question 14

What is lack of emotion (flat effect)?

Answer 14

A negative symptom. A reduction or flattening of emotions. The range and intensity of facial expressions, tone of voice and eye contact are reduced. Body language becomes difficult to interpret.

Question 15

What is avolition (social withdrawal)?

Answer 15

A negative symptom.
- Lack of motivation
- Severe lack of initiative to accomplish tasks
- Could neglect household chores, personal grooming and hygiene
- Likely to have very low sex drive

Question 16

What is apathy?

Answer 16

A negative symptom.
- Difficulty in planning and setting goals.
- No interest in socialising or hobbies
- Does not want to do anything and will sit in the house for hours or even days

Question 17

What is the inappropriate effect?

Answer 17

Emotional expressions are unsuitable for the situation. E.g. laughing at serious things

Question 18

Incidence of schizophrenia is __x higher amongst males

Answer 18

2-3x

Question 19

Percentage of sufferers with work in the UK

Answer 19

13%

Question 20

Percentage of rough sleeping individuals with schizophrenia in the UK

Answer 20

10%

Question 21

Percentage of sufferers not receiving appropriate care

Answer 21

69%

Question 22

What are the secondary symptoms of schizophrenia?

Answer 22

• Depression
• Loss of employment
• Breakdown of relationships

Question 23

Characteristic symptoms for classifying schizophrenia?

Answer 23

Two or more of the following are present for 1 month
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganised or catatonic behaviour
- Negative symptoms such as diminished emotional expression

Question 24

Social/occupational dysfunction for classifying schizophrenia?

Answer 24

Impairment in one of the major areas of functioning for a significant period of time since the onset of the disturbance. Work, interpersonal relations, or self-care

Question 25

Duration for classifying schizophrenia?

Answer 25

Signs of the disorder must last for a continuous period of at least 6 months. The 6 month period must include at least one month of symptoms that meet active phase symptoms and may include periods of residual symptoms

Question 26

Schizoaffective and mood disorder exclusion in classifying schizophrenia?

Answer 26

Schizophrenia if: schizophrenia affective disorder and mood disorder has been ruled out because the patient has not experienced any depressive, manic or mixed episodes at the same time as category A symptoms

Question 27

Exclusion of known organic causes in classifying schizophrenia?

Answer 27

The disturbance is not due to the effects of a substance or any other medical conditions

Question 28

Relationship to autistic spectrum (if any) when classifying schizophrenia?

Answer 28

If there is a history of autism or a communication disorder then the diagnosis of schizophrenia is only made if prominent delusions or hallucinations along with other symptoms are present for at least one month.