Schizophrenia Flashcards
What is the strongest risk factor for developing schizophrenia?
Having a parent with the condition
Relative risk increase: 7.5
What are the risks associated with different family members having the condition and developing schizophrenia?
- Monozygotic twin: 50%
- Parent: 10-15%
- Sibling: 10%
- No relatives: 1%
What are the non-family related risk factors for schizophrenia development?
- Black caribbean ethnicity: RR 5.4
- Migration: RR 2.9
- Urban environment: RR 2.4
- Cannabis use (mostly heavy use in childhood): RR 1.4
- Childhood trauma: poor maternal bonding, poverty, exposure to natural disasters
- Maternal health issues: malnutrition, infections such as rubella and CMV
- Birth trauma: hypoxia and blood loss
What are Schneider’s first rank symptoms of schizophrenia?
- Auditory hallucinations
- Thought disorders
- Passivity phenomena
- Delusional perceptions
What are the auditory hallucinations associated with schizophrenia?
- Two or more voices discussing the patient in the third person
- Thought echo
- Voices commenting on the patient’s behaviour
What are the thought disorders associated with schizophrenia?
- Thought insertion
- Thought withdrawal
- Thought broadcasting
What is passivity phenomena?
- Bodily sensations being controlled by external influence
- Actions/ impulses/ feelings - experiences which are imposed on the individual or influenced by others
What are delusional perceptions?
A two stage process where a normal object is perceived and there’s a sudden intense delusional insight into the objects meaning
Eg. The traffic light is green and therefore I am the king
What are the other symptoms of schizophrenia (not including Schneider’s first rank symptoms)?
- Impaired insight
- Negative symptoms
- Neologisms (made-up words)
- Catatonia
What are the negative symptoms of schizophrenia?
- Incongruity/ blunting of affect
- Anhedonia
- Alogia (poverty of speech)
- Avolution (poor motivation)
- Social withdrawal
Which factors are associated with a poor schizophrenia prognosis?
- Strong family history
- Gradual onset
- Low IQ
- Prodromal phase of social withdrawal
- Lack of obvious precipitant
What is the general management for schizophrenia?
- Oral atypical antipsychotics (first line)
- CBT to all patients
- Close cardiovascular risk-factor modification
Why are there higher rates of cardiovascular disease in schizophrenic patients?
Due to the antipsychotic medication and high smoking rates (generalisation)
What is the diagnostic criteria for schizophrenia?
ICD-10, symptoms must be present most of the time during a period of at least one month
What investigations should be done in a ?schizophrenia patient to exclude organic causes of psychosis?
- Brain imaging (CT/MRI) to rule out structural abnormalities
- Blood tests to exclude infection (HIV, syphilis etc) or metabolic causes (eg. TFTs)
- Drug screening
