Schizophrenia Flashcards
What are the three groups of symptoms seen in schizophrenia?
Positive
Negative
Cognitive
Give some positive symptoms that may be seen in schizophrenia
Delusions Hallucinations Disorganised speech Disorganised behaviour Catatonic behaviour
Give some negative features that may be seen in schizophrenia
Loss of interest
Flat affect
Alogia (poverty of speech)
Avolition (decreased motivation)
Give some cognitive features that may be seen in schizophrenia
Decreased memory
Decreased learning ability
Decreased understanding
What are the three phases of schizophrenia?
Prodromal
Active
Residual
How will a patient commonly present in the prodromal phase?
Very withdrawn
What sort of symptoms may be seen in the active phase?
Positive - delusions; hallucinations; disorganised speech/behaviour and catatonic behaviour
What type of symptoms may be seen in the residual phase?
Cognitive
Give some risk factors for schizophrenia
Genetics (22q11 mutation) Birth complications Drug use (cannabis) Urban dwelling Neurodevelopmental changes (enlarged ventricles)
The diagnosis of schizophrenia requires the presence of how many first rank symptoms?
At least one
Give examples of first-rank symptoms seen in schizophrenia
Thought echo; thought insertion/withdrawal; thought broadcasting
Delusions of control/influence/passivity
Auditory hallucinations
The presence of two of which symptoms can also confer a diagnosis of schizophrenia?
Persistent hallucinations Neologisms or breaks in train of thought causing incoherent speech Catatonic behaviour Blunted affect Marked affect
How long must symptoms of schizophrenia be present to diagnose it?
One month
What class of drug is used to treat schizophrenia?
Antipsychotics
How do antipsychotics generally work?
Block D2 receptors
What are the main typical antipsychotics?
Thioridazine
Chlorpromazine
Haloperidol
What are the two main side effects of typical antipsychotics?
Extrapyramidal side effects
Hyperprolactinaemia
Give some extrapyramidal side effects caused by typical antipsychotics
Acute dystonic reaction
Parkinsonism
Akathisia
Tardive dyskinesia
What are the main features of Parkinsonism?
Tremor
Rigidity
Postural instability
Bradykinesia
Give some effects of hyperprolactinaemia due to typical antipsychotics
Galactorrhoea
Gynaecomastia
Erectile dysfunction
What are the main atypical antipsychotics?
Aripiprazole Risperidone Quetiapine Olanzipine Clozapine
What receptor is partially blocked by clozapine?
D4
Give some general effects of atypical antipsychotics
Histamine blockade
Metabolic syndrome
Alpha 1 - adrenergic blockade
Muscarinic blockade
Give some side effects due to histamine blockade
Sedation
Increased appetite
What can be caused by metabolic syndrome?
Increased weight
Diabetes
Alpha-adrenergic blockade can lead to what physiological state?
Hypotension
What are the four main effects of muscarinic blockade?
Dry mouth
Blurred vision
Constipation
Urinary retention
Clozapine must be closely monitored as it can cause what side effects?
Agranulocytosis
Myocarditis
