schizophrenia Flashcards
distortions of (4)?
thoughts, perceptions, behaviour, emotion
3 kinds of thought disorder
thought insertion, thought withdrawl, thought broadcasting
what is thought blocking?
disruption in chain of thought
what are neologisms?
made up terms for objects (paper skate - pen)
what is apathy?
lack of feelings/care about things
some emotional symptoms?
anhedonia (sums on board), blunting affect (robot) - lack of emotional sensitivity, incongruent affect (laughing at sad story), lack of motivation (big things), lack of interest in relationships/being sociable, lack of social skills. LIMITED RANGE OF EMOTION)
how do thoughts feel?
passively concentrated and compressed
what are positive symptoms? who are they not seen in?
healthy people. delusions, hallucinations, thought disorder
how long do you need to have symptoms to be dx?
1 moth(month)
typical auditory hallucinations?
3rd person hallucination, running commentary, thoughts being spoken aloud
what is a delusional perception?
a normal perception that someone thinks has a special meaning to them i.e. phone ringing three ties means something or seeing a cloud means someone is telling them to save the world
which symptoms respond better to treatment?
POSITIVE SYMTPMS
negative symptoms?
apathy - lack of interest/enthusiasm/concern
lack of violation (decision making process
social withdrawl
cognitive impairment)
typical age of onset in men and women?
15-25 in males, 25-35 in females. associated with lower socioeconomic class
hallmarks of psychosis?
hallucinations, delusions and disorder of the form of thought
what is psychosis ?
inability to distinguish between subjective experience and reality
Characterised by lack of insight
second person auditory hallucination?
voices directly address patient
third person auditory hallucination ?
discuss patient or give running commentary on them
what type of hallucination is bugs crawling under skin?
somatory
Behaviour is experienced as being controlled by an external agency rather than by the individual
passivity phenomenon (governement)
what are self referential experiences?
think that things have a relevence to them - tv transmitting messages to them
who is schizophrenia more common in
males of lower social class
what kind of obstetric complications can cause it?
• 2nd trimester viral infectin, pre eclampsia, hypoxia), childhood CNS infections, early cannabis use, urban upbringing.
psychological causes ?
stress, adverse life events, use of psychoactive drugs
neurochemical changes in schizophrenia?
Changes in dopamine signalling within the brain, with this being confirmed by the fact that anti psychotics target dopamine receptors (not a simple increase or decrease but probably a combination of both in different parts of brain )
histologically, there is a lack of ?
gliosis
structural changes in brain?
ventricular enlargement and alteration of CSF flow
decreased amount of healthy white matter
decrease in great matter volume
negative symptoms ?
apathy, social withdrawal, self neglect, poverty of thought, reduced social performance blunted and incongruent affect
positive symptoms ?
delusions, hallucinations, thought disorder.
o Mutism, stupor, posturing, negativism, command automatism.
♣ Posturing: maintenance of odd postures.
♣ Negativism: resistance to command or attempts to be moved.
Command automatism: will do whatever you ask them to
what type of schizophrenia?
Catatonic
disorganised schizophrenia?
thought disorder, odd behaviour, odd delusions
what is the most common type of schizophrenia?
paranoid
first rank symptoms are bad indicator. what are they
passivity, delusional perception, thought insertion etc
Diagnosis?
Clinical
one psychotic symptom and negative symptoms and thought disorder which have been present for one month
what is first line treatment of schizophrenia?
oral atypical antipsychotics
what should be offered to all patients?
CBT
why monitor cardiovascular risk factors in schizophrenia?
high rates of CVD linked to anti psychotic medication and high smoking rates
