schizophrenia

Question 1

what is schizophrenia

Answer 1

Schizophrenia is a long-term mental health problem which affects thinking, perception and affect.

Question 2

how does schizophrenia effect patients

Answer 2

trouble thinking clearly, making good decisions, behaving appropriately, knowing reality from imagination

Question 3

when is the onset of schizophrenia

Answer 3

males 28

females 32

Question 4

what are positive symptoms of schizophrenia

Answer 4

hallucinations
delusions
disordered thinking/speech
abnormal motor behaviour

Question 5

what is the most common type of hallucination in schizophrenia

Answer 5

auditory

Question 6

what are negative symptoms of schizophrenia

Answer 6

apathy
lack of interest 
lack of emotional response 
less eye contact 
less limb movement

Question 7

what is the ICD 10 classification

Answer 7

at least one of the first set of criteria or two of the second set for at least a month with no other explaination

Question 8

what is the first set of criteria for ICD 10 classification (set you only need one from)

Answer 8

alienation of thought - echo, insertion, withdrawal, broadcasting
delusions of control
hallucinatory voices
persistent delusions

Question 9

what is the second set of criteria (need 2 of)

Answer 9

persistent hallucinations
neologisms, incoherent/disorganised speech
catatonic behaviour - posturing, negativism, mutism, stupor
negative symptoms - apathy, paucity of speech, blunting of emotional response

Question 10

what is the aetiology of schizophrenia

Answer 10

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)

Question 11

how do typical anti-psychotics work

Answer 11

cause generalised dopamine receptor block

Question 12

examples of typical anti-psychotics

Answer 12

haloperidol
chlorpromazine
flupentixol decanoate

Question 13

how do atypical anti-psychotics work

Answer 13

more selective at blocking dopamine receptors

block serotonin 5HT2 receptors

Question 14

what are some side effects of anti-psychotics

Answer 14

extra-pyramidal side effects - parkinsonian symptoms, dystonia, akathisia
hyperprolactinaemia

Question 15

examples of atypical anti-psychotics

Answer 15

clozapine 
olanzapine 
risperidone 
quetiapine 
amisulpride

Question 16

what is the first step for medication

Answer 16

atypical anti-psychotic

Question 17

second step if first step is ineffective

Answer 17

try a different atypical anti-psychotic
or
typical antipsychotic

Question 18

third step if second doesn’t work

Answer 18

try clozapine

Question 19

fourth step if third doesn’t work

Answer 19

clozopine with another atypical antipsychotic added on

Question 20

fifth step

Answer 20

try a different anti-psychotic not used before

Question 21

last resort

Answer 21

combination therapy

Question 22

what should be offered to all patients

Answer 22

CBT

family therapy

Question 23

what are good prognostic factors

Answer 23

no FH
good pre-morbic function 
clear precipitant
acute onset 
mood disturbance 
prompt treatment

Question 24

what are poor prognostic factors

Answer 24

slow onset 
mostly negative symptoms 
CVS/resp disease/cancer 
childhood onset 
substance misuse

Question 25

what is schizoaffective disorder

Answer 25

affective disorder features + schizophrenia features of psychosis