Schizophrenia Flashcards
Familial prevalences for schizophrenia
Prevalence of schizophrenia in:
General population: 1%
Non-twin sibling of schizophrenia patient: 8%
Child with one parent with schizophrenia: 12%
Dizygotic twin of a schizophrenia patient: 12%
Child with two parents with schizophrenia: 40%
Monozygotic twin of a schizophrenia patient: 47%
Definition of late onset schizophrenia
Onset > 45
Prognostic significance of mood symptoms in schizophrenia
Good prognostic indicator
The commonest cause of early mortality in schizophrenia
Cardiovascular
Thinking a stranger is someone you know
Fregoli delusion
The prevalence of schizophrenia is roughly equal in men and women T/F
T
What has the CPA set as an acceptable waiting time for assessment in non-urgent first episode of psychosis referrals? #CanMed
Two weeks
Neurocognitive testing is a robust predictor of functioning in first episode psychosis and should be undertaken at initial assessment T/F #CanMed
T
What proportion of individuals with q2211.2 deletion have schizophrenia? #CanMed
25%
What is the lifetime risk for suicide in schizophrenia? #CanMed
Around 5%
Antipsychotic therapy reduces the risk of violence and crime in individuals with schizophrenia T/F #CanMed
T
Psychotic symptoms like persecutory delusions are associated with violence in schizophrenia T/F #Canmed
T
When should you change antipsychotic if there is no response in first episode? #CanMed
Four weeks
For how long should treatment with antipsychotics be continued after resolution of positive symptoms in FEP? #CanMed
18 months
How do CanMed define an adequate trial of clozapine?
At least 8 but preferably 12 weeks of Rx at 400mg/d with trough levels over 350ng/ml for once day dosing or 250ng/ml for twice day
What proportion of individuals with schizophrenia meet criteria for TRS? #CanMed
25-30%
Treatment of choice for schizophrenia with aggression #CanMed
Clozapine
According to CanMed what is the minimum effective dose of family intervention in schizophrenia for individuals in close contact w family members?
Ten sessions over a three month period
According to CanMed what should be offered to all patients who have not adequately responded to antipsychotic medication?
CBT for psychosis
Lifetime prevalence of delusional disorder
0.2% DSM V
Delusional disorder may be more prevalent in older individuals T/F
T DSM V
Duration of episode of disturbance in brief psychotic disorder in DSM V
At least 1 day but less than 1 month
Two of which 5 criteria for a schizophrenia diagnosis in DSM V
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganised or catatonic behaviour
- Negative symptoms
Length of duration of symptoms for a diagnosis of delusional disorder in DSM V
One month
According to K&S what characterizes the delusions of delusional disorder?
They are non-bizarre, ie about potentially normal scenarios like being in love, being followed etc. In contract to delusions in schizophrenia which are more likely to be bizarre
Mean age of onset in delusional disorder
About 40
There is a slight preponderance of female pts in delusional disorder T/F
T (K&S)
Schizophrenia in elderly ppl respond poorly to medication T/F
F (K&S)
Lifetime prevalence of schizoaffective disorder
0.5-0.8%
Which schizoaffective ppl do better, affective or psychotic predominant?
Affective
Mood and psychotic symptoms have to co-exist for how long for a diagnosis of schizoaffective disorder in DSM V?
2/52
The most important risk factor for suicide in schizophrenia
MDE (K&S)
What percentage of pts with post-partum psychosis have a family psychiatric history (& what is it of?)
50% fam hx of mood disorders
Rate of postpartum psychosis
1-2/1000 births
When does postpartum psychosis arise?
Always within 8 wks of delivery, mean onset is after 2-3 weeks, can occur after a few days
In late onset schizophrenia symptoms become less marked as the pt ages T/F
T (K&S)
Command hallucinations are a risk factor for suicide in schizophrenia T/F
T
By definition ppl with delusional disorder do not have prominent or sustained hallucinations T/F
T (K&S). But they might rarely have auditory
Most common types of delusion in delusional disorder (2)
Persecutory and jealous-type (K&S)
Morbid jealousy in schizophrenia- women predominate T/F
T
Othello syndrome men predominate T/F
T
What characterizes de clerambault syndrome (erotomania)?
The delusional conviction that another person, usually of higher status, is in love with him or her. Often has a sudden onset. Object of a higher rank, and is the first to fall in love, and is the first to make advances. Pt rationalises paradoxical behaviour of object. Hallucinations are absent. Can occur with schizophrenia, mood disorders, or organic pathology
Men with erotomania predominate in forensic populations and women in community samples T/F
T
Insidious onset is typical in delusional disorder T/F
F, it’s usually sudden onset according to K&S
Good prognostic factors in delusional disorder
- Being female
- Good premorbid functioning
- Onset before age 30
- Sudden onset
- Short duration of illness
- Presence of precipitating factors
Time cutoffs for brief psychotic disorder
One day to one month
