Schizophrenia

Question 1

What is Schizophrenia the most common cause of?

Answer 1

Psychosis

Question 2

What 2 ways can Schizophrenia present?

Answer 2

Chronic
Relapsing remitting

Question 3

What is Schizophrenia

Answer 3

Severe mental illness affecting emotions, thinking and behaviour

Question 4

What are the features of schizophrenia classed under?

Answer 4

Schneider’s first rank symptoms

Question 5

What are the 4 classifications of symptoms

Answer 5

Auditory hallucinations
Thought disorder
Passivity phenomenon
Negative symptoms

Question 6

What do the auditory hallucinations include?

Answer 6

• two or more voices discussing the patient in the third person
• thought echo
• voices commenting on the patient’s behaviour

Question 7

What do though disorders include?

Answer 7

• thought insertion
• thought withdrawal
• thought broadcasting

Question 8

What is thought insertion?

Answer 8

Someone putting thoughts in their minds)

Question 9

What is thought withdrawal?

Answer 9

Thoughts being taken out of their mind

Question 10

What is thought broadcasting?

Answer 10

Others can hear their thoughts

Question 11

What is Passivity phenomenon?

Answer 11

• bodily sensations being controlled by external influence
• actions/impulses/feelings - imposed on the individual or influenced by others
• Delusional perceptions

Question 12

What are delusional perceptions?

Answer 12

Where first a normal object is perceived then secondly there is a sudden intense delusional insight into the objects meaning for the patient

Question 13

What do the negative symptoms include?

Answer 13

• Anhedonia
• Alogia
• Avolition

Question 14

What is anhedonia?

Answer 14

Inability to derive pleasure

Question 15

What is alogia?

Answer 15

Poverty of speech

Question 16

What is avolition?

Answer 16

Poor motivation

Question 17

How is Schizophrenia diagnosed?

Answer 17

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.

Question 18

What is the main factor associated with poor prognosis?

Answer 18

Strong family history

Question 19

What are the other factors which would indicate a poor prognosis?

Answer 19

• gradual onset
• low IQ
• prodromal phase of social withdrawal

Question 20

What is the first line management of Schizophrenia?

Answer 20

Oral atypical antipsychotics

Question 21

What are examples of oral atypical antipsychotics?

Answer 21

Risperidone
Olanzapine

Question 22

How many oral atypical antipsychotics would you try and for how long before using Clozapine?

Answer 22

Try 2 different oral antipsychotics
Each for 6-8 weeks

Question 23

Why is Clozapine a last resort?

Answer 23

The risk of agranular cytosis

Question 24

What would you do if someone on clozapine developed a fever?

Answer 24

Give IV broad spectrum antibiotics

Question 25

What should also be offered to all schizophrenic patients along with medication?

Answer 25

Cognitive behavioural therapy

Question 26

What type of thought pattern is associated with schizophrenia?

Answer 26

Knights move

Question 27

What does Knight’s move describe?

Answer 27

Rapid speech with no discernible links between the topics that the patient jumps between in conversation.