Schizophrenia Flashcards
In the ICD-10 criteria for schizophrenia, 1st rank symptoms
- thought disorders
- delusions of control, passivity
- auditory hallucinations
- other inappropriate/ impossible persistent delusions
In the ICD-10 criteria for schizophrenia, other symptoms after 1st rank
- Persistent hallucinations + delusions
- Breaks in train of thought (causing incoherence)
- Catatonic behaviour (excitement, stupor)
- Negative symptoms (eg marked apathy)
6 types of thought disorders
- thought block
- thought withdrawal
- thought insertion
- thought broadcasting
- thought echo/ audible thought
- breaks in train of thought
3 categories of symptoms in schizophrenia
- Reality distortion: delusions and hallucinations
- Disorganisation: thought disorder
- Psychomotor poverty: similar to negative symptoms
Negative symptoms in schizophrenia
• Blunted emotions, anhedonia • Poverty of thought: Not thinking much about anything • Social withdrawal • Apathy, loss of energy • Impaired attention •
Define delusions
Fixed false beliefs, cannot be corrected by logic.
Not consistent with culture and education of patient.
Difference between hallucinations and illusions
Hallucination = false perception without external stimulus
Illusion = misperception of real external stimulus
Difference between real vs pseudo auditory hallucinations
Real: hearing 3rd person voice talking about you
Pseudo: hearing your own voice in your head
In what type of disorders are pseudo-hallucinations common
Personality disorders
Delusions that exist in psychosis vs depression
PSYCHOSIS DELUSIONS
- grandoise
- delusional perception
- delusional reference
- passivity
DEPRESSION DELUSIONS
- nihilistic
- guilt
4 main subtypes of schizophrenia
- Paranoid
- Disorganised/ hebephrenic
- Catatonic
- Residual
What are nihilistic delusions
Believing that parts of body are rotting or dead
What are Fregoli delusions
Thinking that different people are a single person in disguise
What motor disorders may occur as a side effect of antipsychotics
- Dystonia
- Parkinsonism
- Akathisia
- Tardive dyskinesia
Difference between delusional disorder and schizophrenia
Schizophrenia features formal thought disorder (alongside delusions, hallucinations)
Delusional disorder only has delusions.
When is the peak onset of schizophrenia
Early adulthood
Risk factors for schizophrenia
- genetics
- preterm birth, hypoxic birth
- drug abuse eg amphetamines
- significant life events
Serious medical side effects of antipsychotics
- T2DM
- Cardiovascular disease
What is the dopamine theory of schizophrenia
Schizo is due to excess of dopamine (either too much dopamine or too many receptors) in basal ganglia (striatum)
MoA of antipsychotic drugs
D2 receptor antagonists
How long do antipsychotics take to work
2-3 weeks
Side effects of antipsychotics
- Extrapyramidal (Parkinsonism, tardive dyskinesia, akanthesia)
- Anticholinergic (dry eyes, urinary retention)
- Anti adrenergic (tachycardia, postural hypotension, sexual dysfunction)
- Antihistamine (sedation, weight gain)
- QT prolongation
- Neuroleptic malignant syndrome
Symptoms of neuroleptic malignant syndrome
What causes it
Due to blockage of dopamine receptors
Symptoms
- Muscle rigidity
- High fever
- Fluctuating consciousness
Complications of neuroleptic malignant syndrome
Rhabdomyolysis
Hyperkalemia, kidney failure
Seizures
Risk factors for poor prognosis in schizophrenia
- family history
- onset
- education
- premorbid personality
- age
- strong family history
- gradual onset, no obvious precipitation
- low education
- premorbid history of social withdrawal
- younger age of onset
