Schizophrenia Flashcards
What is schizophrenia
A group of mental disorders in which there is a range of problems with perception, cognition and behaviour
What is the prevalence of schizphrenia
Worldwide prevalence of 0.5 percent
Genders equally affected
What is the aetiology of schizophrenia
Unknown but thought to be a combination of genetic and environmental factors
Genetics- polygenic and non mendelian
Environment- daily cannabis usage(?)
What is the likely pathology of schizophrenia
Neurodevelopmental disconnection
ie probems with brain connections
likely to be due to dopamine excess (still a theory as only explains the positive symptoms)
What is seen on neuroimaging in schizophrenia
Alterations in prefrontal and less consistently temporal lobe function
Enlarged lateral ventricles
Disorganised cytoarchitecture in the hippo campus.
When does schizophrenia usually present
early 20s
What are the symptoms first rank of schizophrenia
Auditory, third person hallucinations
Though disorder eg withdrawal, insertion, broadcast
Delusions
Somatic passivity
What is passivity?
the belief that your thoughts/actions/feelings are controlled by an external source
describe what is meant by positive and negative symptoms
Positive- symptoms which are inherent to schizophrenia eg hallucinations, delusions, thought disorder ie psychotic symptoms
Negative- alteration to normal mood states eg lack of emiotion, poverty of thought ie. affective symptoms
How is schizophrenia sometimes divided
Type 1 - positive - acute onset delusions and hallucinations, good prognosis
Type 2 - negative - insidious onset, absence of very acute symptoms, presents with apathy, social withdrawal etc
What are the differentials in someone presenting with these symptomsq
Organic mental disorders eg temporal lobe seizures
Affective disorders eg bipolar, depression
Drug psychosis - amphetamines
Personality disorders eg schizotypal
What is a delusion
a fixed belief, not amenable to logic or argument
did not come through logical means
not cultural or subculturally related
what type of delusions occur in schizophrenia
any - usually bizarre
usually not mood congruent
What is a ‘true’ hallucination
perceptual disturbance not based on an actual object
As vivid as a real perception
exist in external space
believed to be public
what is the most common modality of hallucination in schizophrenia
third person , auditory
running commentary also common
What is thought interferance
Disturbance of the experience of though
What are examples of thought interferenct
though inserstion
withdrawl
broadcasting
what is though insertion
thoughts being put into your head - not the same as obsession which are recognised as being your own thoughts
Thought withdrawal
thoughts being taken out of your head -can be a delusional explanation for thought blocking
thought broadcasting
thoughts being broadcast to other people/shared with others
What emotional disorders occur in schizophrenia
blunted affect
incongruent affect eg laughing at a sad story
lack of motivation
anhedonia
lack of interest in social skills/relationships
What motor/behavioural disorders occur in schizophrenia
catatonia
stereotypies
wavy flexibility
mutism
What is the ICD- 10 criteria for schizophrenia
One of these symptoms:
- thought interference
- passivity phenomena
- hallucinatory voices giving running commentary, discussing patient of coming from a part of the patients body
- impossible persistent delusions
Two of these symptoms:
- formal thought disorder
- catatonic behaviour
- negative symptoms
- loss of interest, idleness, social withdrawal
For at least one month.
What is neuroleptic malignant syndrome
A rare but potentially dangerous side effect of neuroleptic medications.
Presents with hyperthermia, muscle rigisity, tachy cardia, labile BP, pallor, raised CK, raised white cells and deranged LFTs.
Treatment is to stop medications and recusitate.
What is the difference between the way that typical and atypical antipsychoitics work
Atypicals block the D2 receptors less than D1 receptors. As such they are less likely to result in extrapyramidal side effects and tardive dyskinesia.
What are the down sides to chlorpromazine (typical)
sediation
What is a common side effect of rispiradone (atypical
hyperprolactinaemia
What is the main concern with olanzapine (atypical)
weight gain and metabolic syndrome
What is used to treat intractable chronic schizophrenia
clozapine (a bibenzodiazepine)
Used in patients have failed on at least two conventional antipsychotics or as a first line therapy
What is the risks of clozapine
can cause severe agranulocytosis
