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Yr 5 - Psych > Revision - Schizophrenia > Flashcards

Revision - Schizophrenia Flashcards

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1
Q

What is the % of risk of schizophrenia with one affected parent or sibling

A

10%

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2
Q

What is the % of risk of schizophrenia if both parents affected or identical twin is affected?

A

50%

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3
Q

What are the 6 subtypes of schizhophrenia?

A

1) paranoid

2) hebephrenic

3) catatonic

4) simple

5) residual

6) undifferentiated

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4
Q

What 2 features characterise PARANOID schizophrenia?

A

1) Paranoid delusions

2) Auditory hallucinations

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5
Q

What type of schizophrenia is typically diagnosed in adolescents/younger adults?

A

Hebephrenic

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6
Q

Why is the outlook for hebephrenic schizophrenia poor?

A

As negative symptoms develop rapidly

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7
Q

What 4 characteristics are seen in hebephrenic schizophrenia?

A
  1. Mood changes
  2. Fragmentary hallcuinations
  3. Shallow affect
  4. Unpredictable behaviour
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8
Q

What 3 §psychomotor features are seen in catatonic schizophrenia?

A

1) posturing

2) rigidity

3) stupor

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9
Q

What is posturing?

A

when a person holds a specific position, which would often be uncomfortable to people who aren’t experiencing catatonia

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10
Q

What is stupor?

A

a state close to unconsciousness

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11
Q

What is undifferentiated schizophrenia?

A

When patients’ symptoms do not fit neatly into one of the other categories

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12
Q

What is residual schizophrenia?

A

The individual has suffered an episode of schizophrenia but there are no longer any delusions, hallucinations, disorganized speech or behavior

  • Characterised by negative symptoms
  • Positive symptoms have ‘burnt out’
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13
Q

What type of schizophrenia is characterised by negative symptoms and patients have never experienced positive symptoms?

A

Simple

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14
Q

What is delusional perception?

A

A true perception to which an individual attributes a false meaning.

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15
Q

What are Schneider’s first-rank symptoms?

(6)

A

1) Thought insertion or withdrawal

2) Thought echo

3) Thought broadcasting

4) Delusional perception

5) Passivity/somatic passivity

6) 3rd person auditory hallucinations

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16
Q

What are negative symptoms in schizophrenia? Give examples

A

1) Blunted affect (affect is a person’s expression of their emotional state)

2) Apathy

3) Social isolation / anhedonia (lack of interest/enjoyment from life’s experiences)

4) Poverty of speech (alogia)

5) Poor self-care

6) Avolition (severe lack of motivation/inability to complete purposeful tasks)

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17
Q

How long must symptoms be present for before diagnosis of schizophrenia?

A

Requires a first rank symptom or persistent delusion to be present for at least one month AND no other cause for psychosis (e.g. drug intoxication).

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18
Q

What class of drug is used in schizophrenia?

A

D2 (dopamine) receptor antagonists

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19
Q

Give 3 examples of ‘typical’ antipsychotics

A

1) haloperidol

2) chlorpromazine

3) flupentixol decanoate (depot injection)

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20
Q

Give 5 key side effects of typical antipsychotics

A

1) EPSEs

2) Raised prolactin

3) Metabolic

4) Anticholinergic

5) Neurological

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21
Q

What extrapyramidal side effects are seen with ‘typical’ D2 receptor antagonist use?

A

1) parkinsonism

2) akathisia

3) dystonia

4) tardive dyskinesia

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22
Q

What can hyperprolactinaemia due to ‘typical’ D2 receptor antagonist use cause?

A

Sexual dysfunction, risk of osteoporosis, amenorrhoea in women, galactorrhoea, gynaecomastia and hypogonadism in men

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23
Q

What are the neurological side effects of ‘typical’ D2 receptor antagonist use?

A

1) seizures

2) NMS

24
Q

Give some examples of ‘atypical’ D2 receptor antagonists

(6)

A

1) Olanzapine

2) Risperidone (depot)

3) Clozapine

4) Quetiapine

5) Aripiprazole

6) Amisulpride

25
Q

Which antipsychotic is less likely to cause EPSEs than others? Why?

A

Aripiprazole - a partial dopamine agonist and so is less likely to cause EPSEs than others

26
Q

What 2 side effects are less common with atypical antipsychotics compared to typical?

A

1) EPSEs

2) Hyperprolactinaemia

27
Q

Difference between an illusion and a hallucination?

A

An illusion is based on a real sensory stimulus that is interpreted incorrectly whereas a hallucination is created by the mind without any stimulus

28
Q

What are the 3 types of illusions?

A

1) Affect

2) Completion

3) Pareidolia

29
Q

What is a ‘pareidolia’ illusion?

A

Seeing shapes in inanimate objects (e.g. faces in clouds)

30
Q

What is a ‘completion’ illusion?

A

The mind completes partial images (e.g. triangles optical illusion)

31
Q

what is an ‘affect’ illusion?

A

Based on current affect (e.g. see a monster in the cupboard when scared)

32
Q

What are the 3 clusters of psychotic symptoms?

A

1) hallucinations

2) delusions

3) thought disorder

33
Q

What 4 neural pathways can dopamine be implicated in in schizophrenia?

A

1) Mesolimbic

2) Nigrostriatal

3) Tuberoinfundibular

4) Mesocortical

34
Q

Positive symptoms of schizophrenia are due to increased dopamine activity in which neural pathway?

A

Mesolimbic

35
Q

Stopping an antipsychotic within 6 months increases risk of relapse by how much in schizophrenia?

A

4x

36
Q

What is acute psychotic disorder?

A

Psychotic symptoms last <28 days

37
Q

What is schizoaffective disorder?

A

Psychotic and affective symptoms are simultaneously present and equally prominent

38
Q

What is delusional disorder?

A

Delusional disorder is a type of psychotic disorder. Its main symptom is the presence of one or more delusions.

39
Q

Are hallucinations present in delusional disorder?

A

No, or are only fleeting

40
Q

Examples of delusional disorders:

(7)

A

1) Othello syndrome

2) Folie a deux

3) Cotards syndrome

4) Capgras syndrome

5) Fregoli’s syndrome

6) De Clerambault’s syndrome

7) Ekbom’s syndrome

41
Q

What delusional disorder involves the belief that someone from a higher social standing is in love with them and sends them secret messages to convey their love?

A

De Clerambault’s aka erotomania

42
Q

What is Fregoli’s syndrome?

A

They believe multiple people are actually one individual in disguise who is persecuting them

43
Q

What delusional disorder involves the belief that a relative has been replaced by an imposter?

A

Capgras syndrome

44
Q

Prior to commencing antipsychotics, investigations need to be completed.

What observations need to be completed? Why?

A

1) BP & BMI –> metabolic side effects

2) ECG –> some can cause QT prolongation

45
Q

What neural pathway is the intended site of action of antipsychotics?

A

Mesolimbic

46
Q

In which neural pathway does dopamine antagonism cause elevated prolactin?

A

Tuberoinfundibular

47
Q

In which neural pathway does dopamine antagonism cause EPSEs?

A

Nigrostriatal

48
Q

Give 3 examples of ACUTE extra-pyramidal side effects (EPSEs) from antipsychotics

A

1) Parkinsonism

2) Acute dystonia

3) Akathisia

49
Q

Give an example of a CHRONIC EPSE from antipsychotics

A

Tardive dyskinesia

50
Q

What class of drug is acute dystonia as a result of antipsychotics managed with?

A

Anticholinergics e.g. procyclidine

51
Q

What class of drug is parkinsonism as a result of antipsychotics managed with?

A

An§ticholinergics

52
Q

What is akathisia as a result of antipsychotics managed with?

A

Sedatives or medication change

53
Q

What is tardive dyskinesia?

A

Tardive dyskinesia (TD) is a condition where your face, body or both make sudden, irregular movements which you cannot control.

I.e. choreoathetoid movements

54
Q

How do anticholinergics affect tardive dyskinesia as a result of antipsychotics?

A

Make it WORSE

55
Q

What is the recurrence rate of postnatal psychosis?

A

25-50%

56
Q

What treatment is recommended for ALL people with schizophrenia?

A

CBT

57
Q
A

Yr 5 - Psych (4 decks)

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