Schizophrenia

Question 1

Definition

Answer 1

Complex neuro-developmental disorder which is mediated or exacerbated by environmental factors.

Question 2

There is reduction/excess of dopamine?

Answer 2

Excess dopamine

Question 3

Onset

Answer 3

Young adults

- peak incidence 15-25 for males and 25-35 for females

Question 4

Risk factors - genetics

Answer 4

The more genes you share with someone with schizophrenia, the more likely you are to develop it

3rd degree relative affected - 2% risk 
2nd degree relative affected - 5% risk 
1st degree relative affected - 12% risk
monozygotic twin affected - 50% risk 
Both parents affected - 50% risk

Question 5

Risk factors - birth complications

Answer 5

Maternal viral infection 
Obstetric problems 
Prematurity
Prolonged labour 
Childhood viral infections

Question 6

Risk factors - substance misuse. Which drug is commonly associated with schizophrenia?

Answer 6

Cannabis

Question 7

Neurobiology - brain ventricles are shrunken. True or false?

Answer 7

False

- brain ventricles are enlarged

Question 8

Which area of the brain is commonly affected?

Answer 8

Fronto-temporal areas

Question 9

Increased/decreased frontal lobe grey mater?

Answer 9

decreased

Question 10

Grey matter abnormalities are present early/late in schizophrenia?

Answer 10

Early

Question 11

Schizophrenia is related to under-activity of dopamine pathways in the brain. True or false?

Answer 11

False

- over-activity of dopamine pathways

Question 12

Clinical presentation

Answer 12

Similar to psychosis section.

• delusions
• hallucinations
• thought interference
• passivity
• loss of insight

Question 13

First rank symptoms are pathognomic. true or false?

Answer 13

False

- the symptoms can occur in other disorders e.g. mania

Question 14

Hallucinations

Answer 14

3rd person auditory hallucinations

- running commentary on patients behaviour

Question 15

Delusions

Answer 15

Persistent
Culturally inappropriate and completely impossible
- e.g. being in communication with aliens from another world

Question 16

Positive symptoms - definition

Answer 16

A “gain”

Something that is completely new that the patient hasn’t experienced before

Question 17

Positive symptoms - examples

Answer 17

Psychotic symptoms such as:

• delusions
• hallucinations
• assibity
• disorder of form of thought

Question 18

Negative symptoms - definition

Answer 18

Patient has always had this feature but not has it to a lesser extent

Question 19

Negative symptoms - examples

Answer 19

Reduced amount of speech
Reduced motivation
Reduced social interaction

Question 20

It is not possible to diagnose schizophrenia by radiological means. True or false?

Answer 20

True

Question 21

Management

Answer 21

Dopamine receptor antagonists

Anti-psychotics

Question 22

Which drug is good for treating -ve symptoms?

Answer 22

Clozapine

Question 23

Prognosis

Answer 23

Suicide

- may occur following recovery of insight