Schizophrenia Flashcards
What is schizophrenia?
a group of brain disorders characterised by distortions of though, emotion, behaviour and perception
What is the common pathognomonic symptom in Schizophrenia?
There isnt one!
What is the criteria for schizophrenia diagnosis?
one of: thought interference passivity phenomena hallucinatory voices giving a running commentary or discussing the patient impossible persistent delusions
or two of: formal thought disorder catatonic behaviour negative symptoms loss of interest, idleness, social withdrawal
How long should a patients symptoms be present before i diagnosis is made?
1 month
What are schneiders first rank symptoms of schizophrenia?
thoughts spoken aloud
third person voices
running commentary
passivity phenomena - acts, impulses, volition, feelings
delusional perceptions
thought broadcasting, thought withdrawal, thought insertion
What are examples of auditory hallucinations?
hearing own thoughts aloud
voices talking about them in third person
voices giving them a running commentary
What is passivity?
a feeling then explained by delusions - e.g. acts, impulses and feelings are being imposed by an outside agency.
What is a delusion?
A fixed belief, not amenable to logical thought or argument.
not founded by logic and not related to cultural beliefs of the person.
What is a true hallucination?
perceptual experience not based on an actual object
as vivid as a real perception
exists in external space and is believed to be public
often explained that others cannot see/hear them by another delusion e.g. forcefields
What kind of hallucination is most common in schizophrenia?
Auditory
What other types of hallucinations can occur in SZD?
visual olfactory gustatory tactile kinaesthetic
What is thought disorder?
disruption of the thinking process
What is disruption of associations?
a lack of association between thoughts so what they are saying doesn’t make sense - move from one topic to the next
What is thought blocking?
When the chain of thought unexpectedly breaks off (- not caused by other distractions)
What is crowding of thought?
thoughts feel passively concentrated and compressed with a quality of “outside control”
What is thought insertion?
thoughts being put into the mind by an external agency
what is Thought withdrawal?
thoughts being taken out of the mind by an external agency- can be delusional explanation for thought blocking
What is thought broadcasting?
thoughts being broadcast to other people/shared
What things are involved in emotional disorder?
blunting of affect - limited emotional range
Incongruent affect - affect incongruent with circumstances
Apathy - lack of feelings/care
anhedonia
social withdrawal
What is apathy?
Lack of feelings/care
What is catatonia?
State of increased tone in muscles at rest which is abolished by voluntary activities
What is stupor?
state of increased tone in muscles at rest
What are stereotypies?
non-goal directed movements (can involve unusual postures which can be held for a long time), or mannerisms
What conveys good prognosis in SZD?
older age at onset
female gender
marked mood disturbance
family history of mood disorder
What conveys poor prognosis in SZD?
longer duration of untreated psychosis poor pre-morbid adjustment insidious onset early onset cognitive impairment enlarged ventricles
What is important to remember about SZD and physical health?
people with schizophrenia are more prone to other physical illness
Can physical illness precipitate psychiatric symptoms?
YES
What are “positive” symptoms?
delusions
hallucinations
thought disorder
What are “negative” symptoms?
apathy
lack of volition
social withdrawal
cognitive impairment
What is the difference between + and - symptoms?
positive symptoms tend to respond better to treatment
Some evidence that negative symptoms have more impact on functionality
