Lecture 3 'Schizophrenia' Flashcards
Eugene Bleuler (1911) described four core disturbances of people with schizophrenia, what are they?
- Affect
- Ambivalence
- Association
- Preference for fantasy over reality
The prevalence for schizophrenia in the population is _____%?
Peak age of onset for
Males = ________
Females = _______
1%
Males = 15-25 years Females = 25-35 years
Males are ____% more likely to develop schizophrenia than females
30-40%
What is the most expensive of all mental disorders in terms of direct treatment costs, loss of productivity and public assistance costs?
Schizophrenia
What are the characteristic symptoms of schizophrenia of which at least one must be met for diagnosis?
Delusions
Hallucinations
Disorganised speech (frequent derailment or incohorerence)
What are the two exclusionary criteria for schizophrenia?
Symptoms cannot be better explained by 1) schizoaffective or mood disorder or) substance use / medical condition
What are the two types of disturbances in thought as characteristic of schizophrenia?
Disturbances in CONTENT of thought (delusions)
Disturbances in FORM of thought (loosening of associations)
List five examples of loosening of associations in schizophrenia?
Neologism - random words Preservation - repeat same idea Word salad - not making sense Circumstantiality - going off topic Tangentiality - never get back to finishing point
What are the characteristics of schizophrenia?
Disturbances in content of thought (delusions)
Disturbances in form of thought (loosening associations)
Disturbances in perception (hallucinations)
Disturbances in affect
Disturbances in psychomotor behaviour
Positive symptoms
Negative symptoms
What are examples of positive symptoms of schizophrenia?
Delusions
Hallucinations
Loose associations
Disorganised behaviour
What are some examples of negative symptoms of schizophrenia?
Flat affect
Apathy
Social withdrawal
Poor attention
Hat is the difference between type 1 and type 2 schizophrenia?
Type 1= sudden onset, normal intellect, no brain damage, no negative symptoms, good drug response
Type 2= slower onset, intellectual deterioration, brain abnormality, prominent negative symptoms, poor drug response
What are the three phases of schizophrenia?
Prodromal phase
Active phase
Residual phase
What are good outcome predictors for schizophrenia?
- good pre morbid adjustment
- no family history
- sudden onset
- precipitating stress
- good response to medication
- later age of onset
- positive symptoms
- female gender
What are poor outcome predictors of schizophrenia?
- poor pre morbid adjustment
- family history
- slow onset
- early age of onset
- negative symptoms
- no precipitating stress
- male gender
Schizophreniform disorder is characterised by what?
Duration: at least one month but less than six months
Schizoaffective disorder is characterised by what?
Prominent episode of mood disturbance concurrent with Criterion A for schizophrenia
Family studies of schizophrenia indicate ____% concordance rates of monozygotic twins, what does this mean?
~50% (48%)
Indicates genetics likely plays a large role in the aetiology of the disorder
Biochemical hypothesis of schizophrenia aetiology suggests symptoms are caused by too much what?
Dopamine, this is a problem because drugs to treat schizophrenia can treat other disorders as well
What are the structural brain differences and group averages of schizophrenia patients?
Enlarged brain ventricles, decreased frontal / temporaral / whole brain volume
What are Neurodevelopment theories of schizophrenia aetiology
> Fetal neurodevelopment = obstetric complications + maternal infection (winter causes more maternal sickness) + maternal stress (acute)
What are the four major limitations of the biological view of the aetiology of schizophrenia?
- biological abnormalities correlational
- difficult to determine if abnormality is related to disease process or to treatment
- pathology identified in one area of the brain does not mean primary area of pathology has been identified
- a single pathological process in the brain can cause a wide range of phenomena in different individuals
Psychosocial factors of schizophrenia focus on what?
Reciprocal transaction between patient and their family
Explain the Darcis – stress model of schizophrenia?
Predisposition of factors (diathesis) mixed with stresses and lead to schizophrenia
What are the treatment options for schizophrenia?
Psychosocial Interventions: > cognitive behaviour therapy > broad rehab therapy > family interventions > social skills training
Somatic treatments
> anti psychotics
Multifaceted approach
> community approach
> effective community care
