schizophrenia Flashcards
what is schizophrenia
Schizophrenia is a long-term mental health problem which affects thinking, perception and affect.
how does schizophrenia effect patients
trouble thinking clearly, making good decisions, behaving appropriately, knowing reality from imagination
when is the onset of schizophrenia
males 28
females 32
what are positive symptoms of schizophrenia
hallucinations
delusions
disordered thinking/speech
abnormal motor behaviour
what is the most common type of hallucination in schizophrenia
auditory
what are negative symptoms of schizophrenia
apathy lack of interest lack of emotional response less eye contact less limb movement
what is the ICD 10 classification
at least one of the first set of criteria or two of the second set for at least a month with no other explaination
what is the first set of criteria for ICD 10 classification (set you only need one from)
alienation of thought - echo, insertion, withdrawal, broadcasting
delusions of control
hallucinatory voices
persistent delusions
what is the second set of criteria (need 2 of)
persistent hallucinations
neologisms, incoherent/disorganised speech
catatonic behaviour - posturing, negativism, mutism, stupor
negative symptoms - apathy, paucity of speech, blunting of emotional response
what is the aetiology of schizophrenia
mostly unknown - combo of psychological, environmental, biological and genetic factors
use of cannabis in adolescence ventriculomegaly migration substance misuse cytoarchitectural abnormalities maternal influenza winter birth increased levels of dopamine in the brain (dopamine hypothesis)
how do typical anti-psychotics work
cause generalised dopamine receptor block
examples of typical anti-psychotics
haloperidol
chlorpromazine
flupentixol decanoate
how do atypical anti-psychotics work
more selective at blocking dopamine receptors
block serotonin 5HT2 receptors
what are some side effects of anti-psychotics
extra-pyramidal side effects - parkinsonian symptoms, dystonia, akathisia
hyperprolactinaemia
examples of atypical anti-psychotics
clozapine olanzapine risperidone quetiapine amisulpride
what is the first step for medication
atypical anti-psychotic
second step if first step is ineffective
try a different atypical anti-psychotic
or
typical antipsychotic
third step if second doesn’t work
try clozapine
fourth step if third doesn’t work
clozopine with another atypical antipsychotic added on
fifth step
try a different anti-psychotic not used before
last resort
combination therapy
what should be offered to all patients
CBT
family therapy
what are good prognostic factors
no FH good pre-morbic function clear precipitant acute onset mood disturbance prompt treatment
what are poor prognostic factors
slow onset mostly negative symptoms CVS/resp disease/cancer childhood onset substance misuse
what is schizoaffective disorder
affective disorder features + schizophrenia features of psychosis
