Schizophrenia Flashcards
Is schizophrenia more common in men or women?
Men
What is the lifetime risk of developing schizophrenia?
0.5-1%
What is the average age of onset
Around 20-30 tends to be younger in men
What the definition of schizophrenia?
Mental disorder characterised by distortion of thinking and perception associated with blunted affect
What is paranoid schizophrenia?
Often with persecutarory delusions
What is hebaphrenic schizophrenia?
Has more negative symptoms with changeable delusions and fleeting hallucinations
What does avolition mean?
Lack of motivation/ interest in life
What are schniders first rank principles?
Delusional perception
3rd person auditory hallucinations
Thought echo insertion withdrawal
Passivity (somatic and made)
Why percentage of people with schniders first rank symptoms?
20%
Too much dopamine is what part of te brain gives positive symptoms?
Mesolimbic system
Antipsychotics affect dopaminergic transmission in 3 main areas, what are they and what affects to antipsychotics cause?
Mesolimbic / mesocortical- antipsychotic
Substantia nigra - epse
Tubero-infundibular - prolactin secretion
What are the triad of symptoms in psychosis
Thought disorder
Delusion
Hallucination
What are schniders first rank principles?
3rd person auditory hallucinations
Thought echo, insertion, withdrawal, broadcast
Passivity (somatic and made)
Delusional perception
What is the concordance rate of schizophrenia in MZ twins?
50%
What is the difference between schizophrenia and delusional disorder?
Delusional disorder only has a delusion no hallucinations of blunted affect of other signs of schizophrenia, or delusion of control
Is interlectual capacity maintained in schizophrenia?
Yes
Why do antipsychotic drugs cause galactorrhoea?
They block dopamine receptors
Dopamine normally inhibits prolactin secretion
What are the symptoms of hyperprolactinaemia?
Amenhorrea Galactorrhoea Infertility Loss of libido Breast enlargement Reduced bone density
Which drugs are bad for hyperprolactinaemia?
Why?
Typical antipsychotics
Rispiridone /amisulpride
They have a greater affinity to D2 receptors
What are the three mains categories of EPSEs?
Parkinson’s like symptoms
Dystonia
Akathesia
what can you use to treat EPSEs?
Anticholinergics for dystonia and Parkinson’s type symptoms
For akathesia reduce or stop medications
Antipsychotics can cause withdrawal symptoms, what are they?
Nausea vomiting diarrhoea
Dizzy
Tremor
What is the only antipsychotic to reduce prolactin?
Aripiprazole
Which antipsychotic causes hyper salivation?
Clozapine
Which antipsychotics are less likely to cause weight gain?
Aripiprazole
Amisulpride
Haloperidol
Trifluphenazine
Which antipsychotic has least effect on the QT interval?
Aripiprazole
Which generation of antipsychotics are best at treating negative symptoms?
Second generation
Which antipsychotics have the lowest risk of sexual dysfunction?
Aripiprazole
Quetiapine
What are the triad of symptoms in psychosis?
Thought disorder
Hallucination
Delusions
How long to schizophrenic symptoms need to be present for a diagnosis ?
1 month
How long are antipsychotics continued for after recovery?
1-2 years
What psychological therapies are indicated in schizophrenia?
CBT
Family therapy
Arts therapy
What psychosocial interventions may be used in schizophrenia?
Supported employment
Reduced expressed aemotions
Recognise release signature
What is the prognosis for schizophrenia?
20% full recovery
35% long periods of remission
35% persistent mild symptoms
10% completely unresponsive
What premier if factors predict a poor prognosis in schizophrenia?
Poor work Hx
Poor achievement at school
Social problems
Which has a worse prognosis in schizophrenia slow onset or quick onset?
Slow onset and delay in treatment
How long does the psychosis need to behind before depression in schizoaffective disorder?
2 weeks
