schizophrenia

Question 1

Peak onset for males and females?

Answer 1

Males = 20-28
Females = 26-32

Question 2

Schemer’s first rank symptoms?

Answer 2

Delusional perception
3rd person hallucinations - commentary and commands
Thought: echo, withdrawal, insertion, broadcast
Passivity
Somatic
Made - acts, impulses, affects imposed on patient

Nb. absent in 20% of schizophrenia cases

Question 3

Outline paranoid schizophrenia

Answer 3

Relatively stable

Paranoid delusions with auditory hallucinations and perceptual disturbances

Question 4

Hebephrenic

Answer 4

Affective changes are prominent
Delusions and hallucinations are fleeting and fragmented
Behaviour is irresponsible/inappropriate/unpredictable
Mannerisms common
Mood = shallow, thoughts disorganised
Speech is incoherent
Social isolation with rapid onset of -ve symptoms

Question 5

What pathway in the brain causes +ve symptoms?

Answer 5

Mesolimbic - increased DA activity

Question 6

What pathway in the brain causes -ve symptoms?

Answer 6

mesocorticol - decreased DA activity

Question 7

Other transmitters involved in schizophrenia?

Answer 7

5HT
Glutamate
ACh - possible cause of cognitive impairment
GABA

Question 8

What are the negative symptoms in schizophrenia?

Answer 8

Avolition - lack of motivation
Anyhdonia - loss of enjoyment
Alogia - poverty speech
Asociality - lack of desire for relationships
Affect blunt

Question 9

What is schizophrenic disorder?

Answer 9

When affective symptoms present at the same time as schizophrenic symptoms

Question 10

If a patient presents with their first psychotic episode in a GP, where should they be referred to?

Answer 10

Urgent referral to local community-based secondary mental health service (early intervention service, crisis resolution and home treatment team, or community mental health team)