Schizophrenia

Question 1

Onset of schizophrenia

Answer 1

Late teens to mid 30s

Question 2

Complication / prognosis of schizophrenia

Answer 2

Decreased lifespan by 15 years
Increased risk of:
- CAD, DM, HTN, emphysema (lifestyle + medication)
Suicide risk 5-10% completed 30% attempted

Question 3

DSN V criteria schizophrenia

Answer 3

> 2 of the following for most of a month
- Delusions (persecution, passivity thoughts)
- hallucinations most commonly auditory
- disorganized thinking/speech (frequent derailment or incoherent)
- grossly disorganized or catatonic behavior
- negative symptoms: diminished emotional expression or avolition, alogia, anhedonia)
- marked social / occupational/self-care dysfunction
-

Question 4

Differentials to schizophrenia

Answer 4

Brief psychotic disorder >1 or < 1 mo
Bipolar
Depression
Personality Disorder
Problem behavior (ADHD)
Substance misuse
Medical illness (hepatic encephalopathy, hypoglycemia, sepsis. Electrolyte imbalance)
Medication : anticholinergic, steroids. Narcotics
Delirium

Question 5

In all patients presenting with psychotic symptoms

Answer 5

Inquired about substance use and abuse

Question 6

In decompensating patients with schizophrenia, determine:

Answer 6

If substance abuse is contributing
Compliance to medication and s/e problems

If psychosocial support have changed