Psychosis

Question 1

define schizophrenia

Answer 1

a form of psychosis that can either be chronic or relapsing and remitting

Question 2

risk factors of schizophrenia

Answer 2

family history
childhood trauma
birth trauma
poor maternal health

Question 3

first rank features of schizophrenia

Answer 3

auditory hallucinations 
thought disorders (thought insertion, withdrawal and broadcasting) 
delusional perceptions 
passivity phenomena

Question 4

negative symptoms of schizophrenia

Answer 4

anhedonia
alogia (poverty of speech)
avolition
blunting of affect

Question 5

ICD-10 diagnosis of schizophrenia

Answer 5

requires one first-rank symptoms plus two of:

• breaks in thought train
• catatonic behaviour
• ‘negative’ symptoms
• significant and consistent overall personality change and quality

Question 6

investigations considered in schizophrenia presentation

Answer 6

CT/MRI head
HIV and syphilis screen
drug testing
routine bloods (FBC + TFTs)

Question 7

treatment of schizophrenia

Answer 7

atypical antipsychotic (e.g. risperidone) 
can use sedative drugs (e.g. lorazepam) if acute behavioural disturbance

Question 8

treatment of treatment-resistant schizophrenia

Answer 8

if patient fails to respond to 2 other antipsychotics after 6-8wks, provide clozapine

Question 9

why are atypical antipsychotics favoured over typical?

Answer 9

reduce the risk of extra-pyramidal symptoms

Question 10

what are factors for a good prognosis in schizophrenic patients?

Answer 10

high IQ 
good support system 
acute onset 
postive symptoms predominant
obvious precipitating factor

Question 11

define delirium

Answer 11

an acute fluctuating syndrome of encephalopathy causing disturbed consciousness, attention and cognition