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Pyschiatry > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What is schizophrenia

A

A chronic or relapsing and remitting form of psychosis characterized by positive symptoms (such as hallucinations, delusions, thought disorders) and negative symptoms (including alogia, anhedonia, and avolition).

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2
Q

DSM-V criteria for SCZ diagnosis

A

DSM-5 Criteria: Symptoms persist for at least 6 months, encompassing at least one month of active-phase symptoms (must include one prominent ‘ABCD’ symptom).

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3
Q

ICD-11 criteria for SCZ diagnosis

A

ICD-11 Criteria: Symptoms present for at least 1 month, causing significant impairment.

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4
Q

SCZ subtypes

A
  • Paranoid Schizophrenia: Characterized by delusions and hallucinations, often with a persecutory theme.
  • Catatonic Schizophrenia: Features motor disturbances and waxy flexibility.
  • Hebephrenic Schizophrenia: Marked by disorganized thinking, emotions, and behavior.
  • Residual Schizophrenia: Residual symptoms persist after a major episode.
  • Simple Schizophrenia: Characterized by a gradual decline in functioning without prominent positive symptoms.
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5
Q

Risk of developing SCZ in general population

A

1%

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6
Q

Typical onset of SCZ

A

Generally 15-45

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7
Q

SCZ risk factors

A
  • Genetics = biggest RF
  • Childhood trauma
  • Urban living
  • Heavy cannabis use in childhood
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8
Q

Positive symptoms of SCZ

A

ABCD:
- Auditory hallucinations
- Broadcasting of thoughts
- Control/ passivity phenomena
- Delusions

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9
Q

Negative symptoms of SCZ

A
  • Affect blunted
  • Alogia (poverty of speech)
  • Anhedonia
  • Avolition
  • Asociality
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10
Q

Schneider’s first rank symptoms of SCZ

A
  • Delusions
  • Thought disorder
  • Passivity phenomena
  • Auditory hallucinations

(ABCD)

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11
Q

The clinical picture of schizophrenia can be divided into 3 stages:

A
  • At risk mental state
  • Acute phase
  • Chronic phase
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12
Q

What is ARMS

A

Prodrome - when you start to have mild psychosis, changing in behaviours, insight maintained.
- Mx: psychosocial treatment with CBT and family intervention advised

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13
Q

Acute phase of SCZ

A

Florid psychosis - ABCD symtpoms likely

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14
Q

Chronic phase of SCZ

A

Negative symptoms/5As more common here.
May have residual positive symptoms

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15
Q

What is acute and transient psychotic disorder

A

Sudden onset of psychosis - peaks within 2 weeks but won’t last longer than 3 months. Must be the first episode of psychosis.

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16
Q

What is schizoaffective disorder

A

Schizophrenia picture with mood disorder also present e.g. depression or mania. Different to primary mood disorder with psychosis, as psychosis only develops at their extremes.

17
Q

What is delusional disorder

A

Isolated delusions lasting 3+ months, no mood changes or other symptoms of SCZ

18
Q

SCZ investigations

A
  • Full physical exam + obs
  • Routine bloods - exclude metabolic cause e.g. hyperT
  • HIV test & syphilis serology
  • UDS
  • Neuroimaging not routine unless indicated e.g. elderly person with head injury.
19
Q

First line pharmacological intervention in SCZ

A
  • Atypical antipsychotic
  • Sedatives e.g. lorazepam or haloperidol can be used for acute management of risk taking behaviour
20
Q

What is treatment resistant SCZ and how is it managed

A
  • When psychosis persists despite trialling 2 or more antipsychotics (with at least one being atypical) for at least 6 weeks each.
  • If this is the case, we give clozapine.
21
Q

SCZ psychological intervention

A
  • CBT offered to all patients with SCZ or ARMS
  • Family intervention - can improve communication between pt and family to help them understand each other
  • Art therapy
22
Q

SCZ social approaches

A
  • Psychoeducation
  • Practical needs: benefits, housing, education
  • Social skills training
  • Rehabilitation: assimilating into education, jobs, supported housing, social activities.
23
Q

Poor prognostic markers of SCZ

A
  • Male
  • Early, insidious onset
  • Longer DUP (duration of untreated psychosis - refer to EIS is ∴ crucial)
  • Low premorbid IQ
  • Poor social support
  • Cannabis/substance use
  • FHx

Pyschiatry (6 decks)

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