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Year Three - Psychiatry > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What is schizophrenia?

A

It as a chronic condition which affects individual’s thinking, perception and affect

It tends to result in psychosis, which is characterised by an inability to distinguish delusions, hallucinations and disordered thinking from reality

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2
Q

What is schizoaffective disorder?

A

It is a condition in which individuals suffer from a combination of mild affective and schizophrenia features

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3
Q

What are the three neurochemical changes in schizophrenia?

A

There are increased dopamine levels in the mesocorticolimbic system, which are thought to produce the positive features of schizophrenia

There are decreased dopamine levels in the mesocortical tracts, which are thought to produce the negative features of schizophrenia

Due to the positive feedback systems interacting with dopamine, there are also associated decreased glutamate levels and increased serotonin levels

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4
Q

What are the six classifications of schizophrenia?

A

Paranoid Schizophrenia

Hebephrenic Schizophrenia

Simple Schizophrenia

Catatonic Schizophrenia

Undifferentiated Schizophrenia

Residual Schizophrenia

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5
Q

What is the most common classification of schizophrenia?

A

Paranoid Schizophrenia

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6
Q

What is paranoid schizoprehnia?

A

It is characterised by paranoid delusions and auditory hallucinations

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7
Q

What is hepephrenic schizophrenia?

A

It is characterised by mood changes, unpredictable behaviour, shallow affect and fragmentary hallucinations

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8
Q

Which patient group tend to be affected by hepephrenic schizophrenia?

A

Young Adults

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9
Q

What is simple schizophrenia?

A

It is characterised by negative clinical features, with no experience of positive clinical features

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10
Q

What is catatonic schizophrenia?

A

It is characterised by psychomotor clinical features, such as posturing, rigidity and stupor

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11
Q

What is undifferentiated schizophrenia?

A

It is characterised by clinical features that do not fit into one of the other categories of schizophrenia

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12
Q

What is residual schizophrenia?

A

It is characterised by negative clinical features, which occur when the positive clinical features have ‘burnt out’

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13
Q

What are the eight risk factors associated with schizophrenia?

A

Male Gender, 18 – 25 Years Old

Female Gender, 25 – 35 Years Old

Black Caribbean Ethnicity

Family History

Pregnancy Complications

Traumatic Life Events

Substance Misuse

Lower Socioeconomic Status

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14
Q

What is the strongest risk factor of schizophrenia?

A

Family History

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15
Q

What are the three genes associated with schizophrenia?

A

Neuregulin (chromosome 8p)

Dysbindin (chromosome 6p)

Di George Syndrome (chromosome 22q)

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16
Q

What are the four pregnancy complications associated with schizophrenia?

A

Malnutrition

Viral Infection

Pre-Eclampsia

Emergency C-Sections

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17
Q

What three traumatic life events are associated with schizophrenia?

A

Migration

Sexual Abuse

Physical Abuse

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18
Q

What are the four substance misuses are associated with schizophrenia?

A

Cannabis

Cocaine

Amphetamines

LSD

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19
Q

What main substance misuse is associated with schizophrenia?

A

Cannabis

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20
Q

What is another term for positive schizophrenia clinical features?

A

First rank features

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21
Q

What are the seven positive clinical features of schizophrenia?

A

3rd Person Auditory Hallucinations

Thought Echo

Thought Insertion

Thought Withdrawal

Thought Broadcasting

Delusional Perception

Passivity Phenomena

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22
Q

What are hallucinations?

A

They are when individuals hear, see, smell, taste or feel things that appear to be real but only exist in their mind

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23
Q

What are three characteristic features of auditory hallucinations in schizophrenia?

A

There are two or more voices discussing the patient in third person

There are voices commenting on the patient’s behaviour

There is thought echo

24
Q

What is thought echo?

A

It is a form of auditory hallucination, in which the patient hears their thoughts spoken aloud

25
Q

What is thought insertion?

A

It involves someone experiencing one’s own thoughts as someone else’s

26
Q

What is thought withdrawal?

A

It involves someone experiencing one’s thoughts being removed from their mind by other people or forces outside oneself

27
Q

What is thought broadcasting?

A

It is a condition that causes a person to believe that their thoughts can be heard or known by people around them

28
Q

What are delusional perceptions?

A

It is when individuals abnormally percieve an object and then there is sudden, intense delusional insight into the objects meaning for the patient

For example - ‘The traffic light is green therefore I am the King’

29
Q

What is passivity phenomena?

A

It is defined as the belief that an individual’s bodily sensations are being controlled by an external force

30
Q

What are the six negative clinical features of schizophrenia?

A

Blunted Affect

Apathy

Anhedonia

Alogia

Avolition

Social Isolation

31
Q

What is apathy?

A

It is defined as reduced emotional reaction

32
Q

What is anhedonia?

A

It is defined as a lack of interest/enjoyment in activities

33
Q

What is alogia?

A

It is defined as poverty of speech

34
Q

What is avolition?

A

It is defined as a lack of motivation

35
Q

What is a somatic clincial feature of schizophrenia?

A

Insomnia

36
Q

What are the three investigations used to diagnose schizophrenia?

A

Blood Tests

Urine Culture

CT Scans

37
Q

How are blood tests used to diagnose schizophrenia?

A

They are used to exclude organic causes of the patient’s presentation

38
Q

What are the seven blood tests used to investigate schizophrenia?

A

Full Blood Count

Urea & Electrolytes

Liver Function Tests

Thyroid Function Tests

CRP Levels

Lipid Profile

Fasting Glucose

39
Q

How is a urine culture used to diagnose schizophrenia?

A

It is used to exclude urinary tract infection, causing delirium, as the cause of the patient’s presentation

40
Q

How are CT scans used to diagnose schizophrenia?

A

They are used to exclude an organic neurological cause, if the patient’s presentation is suggestive of this

41
Q

What are the two diagnostic criteria for schizophrenia?

A

There should be the presence of a first rank feature for a period of at least one month

The clinical features are not attributable to other organic, or substance causes – dementia, delirium, epilepsy, drug intoxication

42
Q

What are the three psychological management options for schizophrenia?

A

Psychoeducation

Cognitive Behaviour Therapy (CBT)

Family Intervention Therapy

43
Q

What is psychoeducation?

A

It involves providing patients with information about schizophrenia and ways in which they can control and minimise it

44
Q

What is CBT?

A

It is a talking therapy used to manage the way in which patients think, feel and behave

45
Q

When is CBT used to manage schizophrenia?

A

It is recommended in all cases of schizophrenia

46
Q

What is family intervention therapy?

A

It is a talking therapy used to improve the family’s knowledge of schizophrenia and its management

47
Q

What are the two pharmacological management options used in schizophrenia?

A

Atypical Antipsychotics

Typical Antipsychotics

48
Q

When are atypical antipsychotics used to manage schizophrenia?

A

They are the first line pharmacological management option

49
Q

Name six atypical antipsychotics used to manage schizophrenia

A

Olanzapine

Risperidone

Clozapine

Amisulpride

Quetiapine

Aripiprazole

50
Q

What is the mechanism of action of atypical antipsychotics?

A

They selectively inhibit dopamine and serotonin receptors

51
Q

When are typical antipsychotics used to manage schizophrenia?

A

They are the second line pharmacological management option

52
Q

Name three typical antipsychotics used to manage schizophrenia

A

Haloperidol

Chlorpromazine

Flupentixol

53
Q

What is the mechanism of action of typical antipsychotics?

A

They generally inhibit dopamine receptors

54
Q

What advice should schizophrenia patients recieve about driving?

A

They should notify the DVLA

They should not drive untile stable and well for a period of three months

They should obtain a psychiatry report which confirms driving eligibility following this period

55
Q

What are the five poor prognostic factors of schizophrenia?

A

Strong Family History

Gradual Onset

Low IQ

Prodromal Phase of Social Withdrawal

Lack of Obvious Precipitant

Year Three - Psychiatry (23 decks)

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