Psychosis - 2 Flashcards
Sleep changes in schizophrenia?
short REM latency
Recuded Slow wave sleep
male to female ration schizo
1:1
international annual prevalence of schizophrenia
0.33%
annual prevalence of psychotic disorders in the UK
.4%
the incidence of schizophrenia internationally
.20/1000/year
what increases risk of psychosis in an individual?
-Person distressed
-Decline in social functioning
in addition to
transient or attenuated psychotic symptoms OR
Family history of psychosis OR
Behaviours suggestive of psychosis
what is 1st line of treatment in acute psychosis?
antipsychotics (1st or 2nd gen)
CBT w/ or w/out family intervention
what assessments to be done before Rx in acute psychosis?
- Weight
- Waist circumstance
- Pulse and blood pressure
- FBG, HbA1c, Lipid profile and Prolactine
-Assess any movement disorder
-Assess any nutritional status
when do we assess ECG too before Rx of acute psychosis?
IF required by medication’s SPC
IF there is a cardiovascular risk
IF a patient is being admitted
is loading dose recommended in acute psychosis?
no?
how long antipsychotic trial takes in acute psychosis?
4-6 weeks
what should you tell patient if you initiate chlorpromazine?
it may cause photosensitivity
so patient might need to apply sun screen
when can you offer clozapine?
if patient did not responded well to adequest dose of two antipsychotic (one at least non-clozapine)
how long Rx should last?
- 1-2 years following initiation or there is resk of relapse
what are options for smoking cessation in acute psychotics?
-Nicotine replacement therapy
-Bupropion
-Varenicline
what non-pharma approach can reduce psychotic symptoms?
CBT
TMS
Family and patient psychoeducation
Social skill training
Early intervention
enumerate negative sympomts one more time?
social withdrawal
apathy
lack of energy
alogia
flattening of affect
anhedonia
which antipsychotic has most robust support for effectiveness with primary negative symptoms?
Amisulpride
low or high social class a risk for schizophrenia?
low
what hypotheses have tried to explain relation between low social class and schizophrenia?
- Environmental exposure higher in low class (workplace conditions, nutrition..)
- Selection drift hypothesis = inability to compete for good jobs etc.
Learning disability and schizophrenia?
LD has 3 times more risk than public
is there any racial difference for schizophrenia prevalence?
no?
what did AESOP study found about ethnic difference in schizophrenia prevalence?
African-Caribbean population has high rates
male : female ratio for schizophrenia
maybe female more
