Schizophrenia (2) Flashcards
What is it?
What are its risk factors?
What are its main presenting symptoms?
What are its other symptoms?
➊ Type of primary psychotic disorder that can be chronic or relapsing and remitting
➋ • Family hx (major risk factor)
• Heavy cannabis use
• Traumatic childhood events
➌ • Auditory hallucinations
• Delusions
• Thought disorder - insertion, withdrawal, broadcasting
• Passivity phenomena - sensation of an external influence controlling thoughts or actions
➍ Negative symptoms - Apathy, Lack of motivation, Withdrawal, Self-neglect
How is it diagnosed?
How long do symptoms have to be present for a diagnosis to be made?
➊ At least 1 of:
• Auditory hallucinations
• Thought echo, insertion, withdrawal or broadcasting
• Delusions of control, influence or passivity
• Persistent delusions of other kinds that are culturally inappropriate and completely impossible
OR at least 2 of:
• Persistent hallucinations in any form
• Breaks in the train of thought, resulting in incohorent speech or neologisms (invented words)
• Catatonic behaviour
• Negative symptoms such as marked apathy, paucity of speech and blunting or incongruity of emotional responses
• Significant and consistent change in the overall quality of personal behaviour
➋ 1+ month
What are the investigations to do?
How is it managed?
→ Why are these preferred over haloperidol?
What is given in treatment-resistant cases?
→ What is a major side-effect with this?
➊ • Clinical diagnosis
• Bloods - FBC, LFTs, U&E, Glucose, TFTs
• Urine toxicology
• STI screen
➋ • Sedatives in the acute setting if acute behavioural disturbance e.g. Lorazepam
• Atypical antipsychotics e.g. Risperidone
→ Has a lower risk of extra-pyramidal symptoms
➌ Clozapine
→ Agranulocytosis
What are its differentials?
• Drug-induced psychosis - Usually goes within a month of drug cessation
• Schizoaffective disorder - Schizophrenic symptoms + mood disorder (depression/mania)
• Persistent delusional disorder - Most prevalent symptom is delusion
