Schizophrenia Flashcards
What are delusions
Belief held in spite of superior evidence to the contrary.
What conditions are deusions seen in
Schizophrenia, bipolar disorder, psychotic depression
What are nihilistic delusions
Negative delusions that are typically mood-congruent and seen in depressed patients
What are delusions of grandeur/grandiose delusions
delusions with strong positive affect where patients believe they have highly positive traits such as ‘I’m rich’ ‘I’m the prime minister’. Associated with mania.
What are delusions of control
To a sensation that an external party is controlling an individuals thoughts or actions. Seen in psychosis.
What are persecutory delusions
Set of delusional conditions in which the patient believes they are being persecuted. Seen in psychosis
Biological risk factors for Schizophrenia
Genetics - family history
Problems during pregnancy and birth
Brain structure abnormalities
Neurochemical abnormalities
Ilicit drug use
Problems during pregnancy and birth which are associated with Sz
2nd trimester viral illnesses
Pre-eclampsia, foetal hypoxia, emergency CS
CNS viral infections such as mumps and CMV
Brain structure abnormalities seen in schizophrenia
Factors during foetal and childhood development of brain
Enlarged lateral ventricles
Thinning of superior temporal gyrus
Thinner medial temporal structures such as hippocampus
Neurochemical abnormalities in Schizophrenia
Increased dopamine activity in mesolimbic area
Changes in dopamine activity in frontotemporal region
Glutamate receptor blocking
Excess seratonin
Implication of cannabis in schizophrenic patients
Type, content (9-tetrahydrocannabinol) and frequency important.
Increases risk of Sz developing.
Also makes course and prognosis worse
Social and psychological risk factors for schizophrenia
Migration
Urban upbringing
Childhood trauma and other adverse life events
Social defeat hypothesis
Four categories of schizophrenia symptoms
Positive symptoms
Negative symptoms
Thought disorder
Movement disorder
What are positive symptoms
Hallucinations and delusions. These can be:
Thought echo, insertion, withdrawal and broadcasting
Delusions of control influence, passivity, delusional perception
Hallucinatory voices giving commentary, third person dicussion
Persistent delusions of other kinds which are culturally inappropriate or completely impossible
What are negative symptoms
Flattened affect, apathy, avolition, alogia
What is thought disorder
Thinking can be jumbled, or otherwise slow or disorganised
What are catonic symptoms
Abnormalities in movement and muscle tone
Insight in someone with schizophrenia
Often lack insight, meaning they do not understand that their symptoms or problems could be caused by an illess, therefore do not ask for help or treatment
Onset on schizophrenia
Often preceded by prodromal phase, insidious onset with mainly negative and cognitive symptoms whic can take up to years before positive symptoms present
ICD-10 daignosis of schizophrenia
One positive symptom and at least 2 symptoms of negative symptoms, change in personality and behaviour, catatonic behaviour, thought disorder.
Differentials of schizophrenia
Substance induced psychotic disorder
Organic psychosis caused by infection, brain injury
Metabolic disorder such as hyperthyroidism and hyperparathyroidism
Dementia and depression psychosis
Management of schizophrenia
Care programme approach, CBT, family therapy alongside an oral antipsychotic
First line drug for sz
Risperidone
First line drug for child with Sz
Clozapine
Other drug options
Lorazepam if there is acute behaviour disturbance
