Schizophrenia Flashcards
What is Schizophrenia the most common cause of?
Psychosis
What 2 ways can Schizophrenia present?
Chronic
Relapsing remitting
What is Schizophrenia
Severe mental illness affecting emotions, thinking and behaviour
What are the features of schizophrenia classed under?
Schneider’s first rank symptoms
What are the 4 classifications of symptoms
Auditory hallucinations
Thought disorder
Passivity phenomenon
Negative symptoms
What do the auditory hallucinations include?
• two or more voices discussing the patient in the third person
• thought echo
• voices commenting on the patient’s behaviour
What do though disorders include?
• thought insertion
• thought withdrawal
• thought broadcasting
What is thought insertion?
Someone putting thoughts in their minds)
What is thought withdrawal?
Thoughts being taken out of their mind
What is thought broadcasting?
Others can hear their thoughts
What is Passivity phenomenon?
• bodily sensations being controlled by external influence
• actions/impulses/feelings - imposed on the individual or influenced by others
• Delusional perceptions
What are delusional perceptions?
Where first a normal object is perceived then secondly there is a sudden intense delusional insight into the objects meaning for the patient
What do the negative symptoms include?
• Anhedonia
• Alogia
• Avolition
What is anhedonia?
Inability to derive pleasure
What is alogia?
Poverty of speech
What is avolition?
Poor motivation
How is Schizophrenia diagnosed?
Either:
One of Schneider’s first rank symptoms
OR
2 of:
• Persistent hallucinations every day for at least one month.
• Neologisms, or though disorder, resulting in incoherence or irrelevant speech.
• Catatonic behaviour- excitement, posturing or waxy flexibility, negativism, mutism and stupor.
• “Negative” symptoms- marked apathy, paucity of speech, and blunting or incongruity of emotional responses.
What is the main factor associated with poor prognosis?
Strong family history
What are the other factors which would indicate a poor prognosis?
• gradual onset
• low IQ
• prodromal phase of social withdrawal
What is the first line management of Schizophrenia?
Oral atypical antipsychotics
What are examples of oral atypical antipsychotics?
Risperidone
Olanzapine
How many oral atypical antipsychotics would you try and for how long before using Clozapine?
Try 2 different oral antipsychotics
Each for 6-8 weeks
Why is Clozapine a last resort?
The risk of agranular cytosis
What would you do if someone on clozapine developed a fever?
Give IV broad spectrum antibiotics
What should also be offered to all schizophrenic patients along with medication?
Cognitive behavioural therapy
What type of thought pattern is associated with schizophrenia?
Knights move
What does Knight’s move describe?
Rapid speech with no discernible links between the topics that the patient jumps between in conversation.
