Schizophrenia Flashcards
What is schizophrenia classified as: a psychotic or neurotic disorder?
Schizophrenia is classified as a psychotic disorder.
What is the origin of the term “schizophrenia”?
The term “schizophrenia” originates from the Greek words “schizein” (to split) and “phren” (mind).
Under which classifications is schizophrenia listed in ICD-10 and ICD-11?
In ICD-10, schizophrenia is classified under “schizophrenia, schizotypal, and delusional disorders” (F20-F29), and in ICD-11, it is classified as “Schizophrenia or other primary psychotic disorders” (Block 6A2).
What mental modalities are disturbed in schizophrenia?
Schizophrenia is characterised by disturbances in thinking, perception, self-experience, cognition, volition, affect, behaviour, and psychomotor disturbances.
What are the core symptoms of schizophrenia?
The core symptoms include persistent delusions, persistent hallucinations, thought disorder, and experiences of influence, passivity, or control.
Who were some of the early describers of schizophrenia, and what terms did they use?
Early describers include Morel (demence precoce), Kahlbaum (dementia paranoides, katatonia), and Hecker (hebephrenia).
What are some early clinical concepts of schizophrenia?
Early clinical concepts include Greisinger’s ‘unitary psychosis’ and Kraepelin’s dementia praecox, which included four subtypes: hebephrenic, catatonic, paranoid, and simple.
What was Bleuler’s contribution to understanding schizophrenia?
Bleuler (1911) introduced the concept of “the schizophrenias,” a collection of psychoses characterised by the ‘four As’: ambivalence, loosening of associations, affective incongruity and blunting, and autism.
What are some early sociological concepts related to schizophrenia?
Some sociological concepts suggest schizophrenia is not an illness but a myth or a sane reaction to an insane world.
What is the incidence of schizophrenia per year?
The incidence of schizophrenia is 15–20 per 100,000 per year.
What is the lifetime risk of schizophrenia?
The lifetime risk of schizophrenia is approximately 0.9%.
What genetic risk factors are associated with schizophrenia?
Genetic risk factors include family history, with higher risks for parents, siblings, and children of individuals with schizophrenia.
What environmental risk factors are associated with schizophrenia?
Environmental risk factors include prenatal infection, birth complications, early cannabis use, and paternal age.
What neurotransmitters are involved in schizophrenia?
Neurotransmitters involved in schizophrenia include dopamine, glutamate, serotonin, GABA, and noradrenaline.
What neuropathological findings are associated with schizophrenia?
Neuropathological findings include a 6% decrease in brain weight, decreased synaptic markers, and non-specific ventricular enlargement.
What are some physiological abnormalities in schizophrenia?
Physiological abnormalities include abnormal smooth-pursuit eye movements, EEG changes, and decreased sensory evoked potentials (P300).
What psychological factors contribute to schizophrenia?
Psychological factors contributing to schizophrenia include personality traits and family dynamics like expressed emotion.
What are the common clinical features of schizophrenia?
Common clinical features include lack of insight, hallucinations (especially auditory), delusions, apathy, avolition, social withdrawal, and affective blunting.
What are the subtypes of schizophrenia based on symptom prominence?
Subtypes include paranoid, hebephrenic, catatonic, simple schizophrenia, undifferentiated, residual schizophrenia, and deficit syndrome.
How is schizophrenia diagnosed?
Schizophrenia is diagnosed based on psychiatric history, mental state examination, and the exclusion of other disorders. First-rank symptoms, as per Schneider, include hearing thoughts spoken aloud and delusions of control.
What are the DSM-V criteria for diagnosing schizophrenia?
DSM-V criteria require two or more symptoms, including delusions, hallucinations, or disorganised speech, present for a significant portion of time over a month.
What are some differential diagnoses for schizophrenia?
Differential diagnoses include delusional disorders, schizoaffective disorders, acute and transient psychotic disorders, and drug-induced states.
What investigations are used in the diagnosis of schizophrenia?
Investigations for schizophrenia include biological, psychological, and social assessments.
What are the main treatment approaches for schizophrenia?
Treatment approaches include typical/atypical antipsychotics, cognitive retraining, crisis management, education, vocational rehabilitation, and supportive therapy.
What are predictors of poor outcomes in schizophrenia?
Predictors of poor outcomes include male gender, early age of onset, insidious onset, substance abuse, and family history of schizophrenia.
What are the core symptoms of schizophrenia?
Core symptoms: Persistent delusions, persistent hallucinations, thought disorder, experiences of influence, passivity, or control.
What is the significance of “schizophrenia” in ICD-10 and ICD-11?
ICD-10: “Schizophrenia, schizotypal and delusional disorders” (F20-F29). ICD-11: “Schizophrenia or other primary psychotic disorders” (Block 6A2).
What are the disturbances in mental modalities seen in schizophrenia?
Disturbances in mental modalities: Thinking (delusions, disorganisation), perception (hallucinations), self-experience (control by external force), cognition (impaired attention, memory, social cognition), volition (loss of motivation), affect (blunted emotional expression), behaviour (bizarre or purposeless behaviour), psychomotor disturbances (catatonia).
What are the early clinical concepts of schizophrenia according to Kraepelin?
Kraepelin’s early clinical concepts: Schizophrenia as dementia praecox, a chronic disorder with onset in adolescence and progressive deterioration in mental function.
What are Bleuler’s fundamental symptoms of schizophrenia?
Bleuler’s fundamental symptoms: Ambivalence, loosening of associations, affective incongruity and blunting, autism (withdrawal).
What are the environmental risk factors for schizophrenia?
Environmental risk factors: Prenatal infection, birth complications, maternal malnutrition, early cannabis use, paternal age, winter birth.
What neurotransmitters are involved in the neurochemistry of schizophrenia?
Neurotransmitters: Dopamine, glutamate, serotonin, GABA, noradrenaline, CCK, neurotensin.
What are the key features of the dopamine hypothesis in schizophrenia?
Dopamine hypothesis: Postulates dopamine overactivity; supported by amphetamine-induced psychosis and the effectiveness of antipsychotics that block D2 receptors.
What are the gender differences in the incidence of schizophrenia?
Gender differences: Schizophrenia is more common in males than females, with different age-onset patterns.
What social factors are associated with schizophrenia?
Social factors: Migration, urban birth and upbringing, recent life events, ethnicity, place of residence, occupation, social isolation.
What are the subtypes of schizophrenia based on symptom prominence?
Subtypes of schizophrenia: Paranoid (persecutory delusions, auditory hallucinations), hebephrenic (thought disorder, affective symptoms), catatonic (motor symptoms), simple schizophrenia (insidious onset, social withdrawal), undifferentiated, residual schizophrenia, deficit syndrome.
What are the common investigations for diagnosing schizophrenia?
Common investigations: History and mental state examination, physical exam, investigations (biological, psychological, social).
What are the predictors of poor outcomes in schizophrenia?
Predictors of poor outcomes: Male gender, history of obstetric complications, abnormal premorbid personality, low IQ, single status, early age at onset, insidious onset, substance abuse, family history.
What are the lifetime risks for relatives of probands with schizophrenia?
Lifetime risks: Parent (4.4–5.5%), all siblings (8.5–10.2%), children (12.3–13.9%), child of 2 parents (36.6–46.3%), sibling with one parent having schizophrenia (13.8–17.2%), MZ twins (40–50%) vs DZ twins (10%).
