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Schizophrenia Flashcards

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1
Q

What are some positive symptoms of psychoses? (5)

A
  1. Hallucinations
  2. Delusions
  3. Disorganised speech/ thinking
  4. Grossly disorganised behaviour
  5. Catatonic behaviour (decrease reaction to surround environment)
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2
Q

What are some negative symptoms of psychoses? (3)

A
  1. Affective flattening (decrease emotional expression)
  2. Alogia (decrease speech)
  3. Avolition
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3
Q

Causes of schizophrenia?

A

Genetic (DISC-1, COMT, D3 may play a part)

Environment (Obstetric complications, early use of drugs)

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4
Q

Management of schizophrenia?

A

Pharmacological
Patient psychoeducation, family education
Problem solving, self help group
Job training, social skills training- Therapy
Assistance with daily living skills

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5
Q

What is schizotypal personality disorder?

A 
Show symptoms such as:
Ideas of reference
Odd beliefs 'magical' thinking
Unusual perceptual experiences
Suspiciousness or paranoid ideation
Odd behaviour

BUT NO HALLUCINATIONS

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6
Q

What is schizophreniform disorder?

A

A preliminary diagnosis for schizophrenia

If symptoms dont decrease within 6 months,, schiz is diagnosed

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7
Q

What is a brief psychotic disorder?

A

An extremely stressful event or trauma

Psychotic symptoms last for more than one day but less then one month

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8
Q

What is delusional disorder?

A

Non bizarre delusions: being deceived, poisoned, infected

Subtyped into categories: grandiose, jealous, persecutory

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9
Q

What is schizoaffective disorder?

A

Combination of schizophrenia and a mood disorder

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10
Q

What treatment is available for a schizoaffective disorder?

A

Medication: treat both psychotic and affective symptoms
Atypicals are better than typicals
Therapy to increase interpersonal skills/insight
Assistance with occupational issues

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11
Q

The dopamine hypothesis in schiz?

A

Positive symptoms shown by hyperactive mesolimbic projections (hyperstimulation of D2 receptors)

Negative symptoms shown by hypoactive mesocrtical projections to prefrontal cortex (hypostimulation of D1 receptors)

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12
Q

Which antipsychotics are better at treating positive symptoms?

A

typical antipsychotics

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13
Q

What are EPS?

A

Motor disturbances resulting form the basal ganglia and their connections, caused by decrease dopaminergic activity in nigrostriatal pathway
Acute: dystonia, akathiasia, parkinsonism
Chronic: tardive dyskinesia

Higher D2 antagonism, higher chance of EPS

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14
Q

Why do atypical not cause as many EPS as typical antipsychotics?

A
  1. Greater 5-HT2a: D2 antagonism ratio
  2. ‘Fast dissociation’ hypothesis
  3. Preferential action on limbic D2/D3 receptors
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15
Q

Common side effects of antipsychotics? (9)

A
  1. EPS
  2. Sedation
  3. Postural hypotension
  4. Blood dyscrasias
  5. Weight gain
  6. Glucose dysregulation dyslipidaemia
  7. Anticholinergic
  8. Hyperprolactinamia
  9. Sexual dysfunction
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16
Q

How to manage EPS?

A
  1. Reduce dose
  2. Switch to another antipsychotic- Aripiprazole, olanzepine, quetiapine, risperidone, clozapine
  3. Add anticholinergic
17
Q

How to manage akathisia?

A
  1. Reduce dose
  2. Less responsive to anticholinergic
  3. Alternatives: propanolol or BZD
  4. Change med: aripiprazole, olanzepine, quetiapine, clonzapine
18
Q

How to manage tardive dyskinesia?

A
  1. If detected early- antipsychotic can be ceased or reduced
  2. If detected late- may be unresponsive to treatment
  3. Mild symptoms- BZD (clonazepam)
  4. Botox may be helpful in some cases
  5. Change med to clonzapine, aripiprazole, quetiapine, olanzepine
19
Q

What is neuroleptic malignant syndrome?

A

Can be associated with any antipsychotic
Shows S/S of fever, rigidity, confusion, altered conscious state, leucocytosis

Treat by stopping all antipsychotics, monitor BP/pulse, rehydrate, respiratory support, cool body if >39
Bromocriptin/dantrolene may be effective for agitation

20
Q

What are major barriers to compliance?

A
  1. Regimen complexity
  2. Poor communication
  3. Unresolved concerns
21
Q

Advantages and disadvantages of using a depot?

A

Advantages:
Overcomes difficulty of adherence problems
More consistent absorption
Delivers a constant dose throughout dosage period
Infrequent dosing

Disadvantages:
Injection
Long period of elimination if adverse effects occur
Specialist knowledge is required

Psych (7 decks)

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