schizophrenia Flashcards
what age is it most common in and mc in M or F?
25y/o
F=M
what is schizophrenia?
disassociation from reality for 28+ days NOT due to substance misuse
what is it called if you get these symptoms for less than 28 days?
transient psychosis
which lobe is affected in schizophrenia?
temporal
what are the 2 hypothesis names?
neurodevelopment hypothesis
Neurotransmitter hypothesis
what is the neurodevelopmental hypothesis?
hypoxic ischemic injury (other birth comps = poorer brain development and increased risk)
what is the neurotransmitter hypothesis?
high mesolimbic therefore +ve symptoms and low mesocortical therefore -ve Sx
RF for schiz?
Family Hx 1^ relative
smoking cannbis in youth
traumatic birth
MHI
Trauma + abuse
what are some types of schizophrenia?
paranoic schizophrenia (persecutory) - MC
Hebephrenic (young Px)
simple
catatonic
Undifferentiated
what are the 2 types of Sx you can get?
how many of each do you need for a diagnosis?
Schnider 1^ rank
(1 of these)
2^ rank
(2 of these)
what are the Schneider 1^ rank Sx?
-delusional perception
-Thought alienation: Insertion, withdrawal, broadcast, word salad
-3rd person auditory hallucination
-Passivity
what are the 2^ rank Sx?
-Non auditory hallucinations (eg, visual, tactile)
- Catatonia (abrupt posturing)
-delusions
-low insight
what happens in term of the DVLA in schizophrenia patients?
Notify DVLA
Can’t drive until 3+ months well on Tx with psychiatry report
Psychosis Ddx?
Drug induced
schizophrenia
depression
post partum
huntingtons
syphillis
schizoaffective
Drugs causing psychosis?
steroids
benzos
cocaine
meth
LSD
ecstasy
Dx for schizophrenia?
bloods : FBC, U+E, TFT, Syphillis, B12+Folate, urine top, HBA1C
Dx needs 1+ Schneider or 2+ 2^ rank Sx for 28+ days
Medical Tx for schizophrenia?
Trial Antipsychotics for 6-8 weeks then ANOTHER
Last line = clozapine (only antipsychotic that Tx -ve Sx)
Other Tx for schizophrenia?
CBT, CMHT, Crisis team involved
Consider MHA 2 or 3 section
Social = consider social worker + care program approach (assess needs + supply as per)
Late onset schizophrenia
age?
prognosis?
Sx?
Tx?
45y+
better prognosis
persecutory delusions
Tx = low dose antipsychotics
Delusional disorder
Sx?
Tx?
isolated delusion 3+ months eg. persecutory delusions
Absent global psychosis
Consider CBT + SSRI
Schizoaffective disorder
Sx?
Tx?
Schizophrenia + 1+ mood disorder (dep/bipolar 1/2)
Tx: Antipsychotic , mood Tx
