schizophrenia

Question 1

what is schizophrenia?

Answer 1

Schizophrenia is 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).

Question 2

how is schizophrenia defined by ICD 11?

Answer 2

Symptoms present for at least 1 month, causing significant impairment.

Question 3

how is schizophrenia defined by DSM 5?

Answer 3

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

Question 4

what are subtypes of schizophrenia?

Answer 4

Paranoid Schizophrenia
Catatonic Schizophrenia
Hebephrenic Schizophrenia
Residual Schizophrenia
Simple Schizophrenia

Question 5

what is paranoid schizophrenia?

Answer 5

Characterized by delusions and hallucinations, often with a persecutory theme.

Question 6

what is catatonic schizophrenia?

Answer 6

Features motor disturbances and waxy flexibility.

Question 7

what is hebephrenic schizophrenia?

Answer 7

Marked by disorganized thinking, emotions, and behavior.

Question 8

what is residual schizophrenia?

Answer 8

Residual symptoms persist after a major episode.

Question 9

what is simple schizophrenia?

Answer 9

Characterized by a gradual decline in functioning without prominent positive symptoms.

Question 10

what are RF?

Answer 10

positive family history, with the risk being proportional to the degree of genetic relationship

Childhood trauma, such as poor maternal bonding, poverty, or exposure to natural disasters
Heavy cannabis use in childhood
Maternal health issues, including malnutrition and infections like rubella and cytomegalovirus
Birth trauma, particularly hypoxia and blood loss
Urban living and immigration to more developed countries

Question 11

what are positive symptoms?

Answer 11

Question 12

what are negative symptoms?

Answer 12

Question 13

what are risk indicators?

Answer 13

Potential risks involve harm to self or others, with violence being rare. Risk indicators include command hallucinations, a history of deliberate self-harm or suicidal ideation, and fixation on specific individuals.

Question 14

what ix are done?

Answer 14

Question 15

what is 1st line tx?

Answer 15

second-generation (atypical) antipsychotics such as risperidone

Question 16

what is used in acute episodes?

Answer 16

edatives like lorazepam, promethazine, or haloperidol may be used to manage dangerous behaviour. Oral atypical antipsychotics such as risperidone/olanzepine/quetiapine (sometimes IM/depot injections may be necessary). Patients should be referred for psychiatric liaison review.

Question 17

what is maintenance therapy?

Answer 17

Maintenance therapy with antipsychotics is determined and prescribed by Psychiatrists.

Question 18

when is clozapine used?

Answer 18

Clozapine is considered when schizophrenia is resistant to other antipsychotics (in those who have not responded to 2 other trials of antipsychotics). Due to its potential lethal side effects, it requires intensive monitoring.