schizophrenia Flashcards
How are the symptoms of schizophrenia classified?
Positive - defined as symptoms that should not be present
Negative - defines as a lack of characteristics that should be present
Cognitive deficits
Give examples of positive symptoms
Hallucination
Delusions
Disorganised thoughts e.g. thoughts being put in their heads
Give examples of negative symptoms
o Reduced speech even when encourages to interact
o Lack of emotional and facial expression
o Diminished ability to begin and sustain activities (avolition)
o Decreased ability to find pleasure in everyday
o Social withdrawal
Give examples of cognitive deficits
o Memory
o Attention
o Panning
o Decision making
Is schizophrenia a rare illness?
No a rare illness is when its occurrence is 0.05% where as Schizophrenia is present in 1% of population
% wise how many people find AP helpful?
Medication only helps 60 - 80% of people.
1 in 4 people find it unhelpful
Do all people suffering from SP need medication?
No, people have recovered without medication.
Talking therapies can help some people
How many types of SP is there?
5 types
- Paranoid schizophrenia
- Disorganised schizophrenia
Is it true that men are more likely to develop SP then women
yes, 1.4 times.
One of Albert Einesein children developed SP
Yes
Does SP mean ‘split personality’?
No it means ‘split from reality’
Does SP mean that are dangerous to others?
No, but they are more likely to hurt themselves
Can smoking and drinking alcohol affect medication
Yes
esp smoking and is recommended you stop
What is the chemical in the brain that is thought to effect SP?
Having too much dopamine
When are people most likely to be diagnosed with SP?
18 and 35
Lifestyle advice for SP?
Try to get enough sleep.
Try to eat a balanced diet
Reduce stress
Do things you enjoy
Maintain relationships
Peer support
Look out for warning signs
Plan for more difficult times
Apart from medication, what other therapies are available?
CBT
Family intervention
Art therapy
Complication of SP?
An increased risk of premature death due to an increased risk of suicide, cardiovascular disease, and type 2 diabetes.
Difficulties in social functioning.
Substance misuse.
What information should be provided to the patient of the drugs?
rovide information and discuss the likely benefits and possible side effects of each drug, including:
metabolic (including weight gain and diabetes)
extrapyramidal (including akathisia, dyskinesia and dystonia)
cardiovascular (including prolonging the QT interval)
hormonal (including increasing plasma prolactin)
other (including unpleasant subjective experiences)
How to use AP medication?
Before starting antipsychotic medication, undertake and record the following baseline investigations:
weight (plotted on a chart)
waist circumference
pulse and blood pressure
fasting blood glucose, glycosylated haemoglobin (HbA1c), blood lipid profile and prolactin levels
assessment of any movement disorders
assessment of nutritional status, diet and level of physical activity.
ECG is the SPC says so or has CVD risk or inpatient
How to trial AP?
Discuss and record the side effects that the person is most willing to tolerate.
Record the indications and expected benefits and risks of AP, and the expected time for a change in symptoms and appearance of side effects.
At the start of treatment give a dose at the lower end of the licensed range and slowly titrate upwards within the dose range given in the British national formulary (BNF) or SPC.
Justify and record reasons for dosages outside the range given in the BNF or SPC.
Record the rationale for continuing, changing or stopping medication, and the effects of such changes.
Carry out a trial of the medication at optimum dosage for 4–6 weeks
