SCHIZOPHRENIA

Question 1

Give some first rank symptoms

Answer 1

• delusion
• delusional percept
• auditory hallucinations
• audible thoughts
• voices arguing or discussing
• voices commenting on the patient’s actions
• though disorder: passivity of thought, thought withdrawal/insertion/broadcasting
• passivity experiences/of affect/of impulse/ of volition
• somatic passivity

Question 2

What is passivity phenomenon?

Answer 2

Not having a sense of control of your own movements or belief that other people are changing your emotions
- somatic = “rays controlling you”

Question 3

What are the subtypes of schizophrenia?

Answer 3

Paranoid, hebephrenic and catatonic

Question 4

In which type of schizophrenia is there child-like behaviour?

Answer 4

Hebephrenic

Question 5

Which type of schizophrenia primarily affects motor?

Answer 5

Catatonic (increased tone at rest)

Question 6

What are ideas of reference?

Answer 6

Seeing meaning in things that have no meaning eg. words spelled out in newspapers

Question 7

How long does a psychotic episode need to last to class it as schizophrenia?

Answer 7

A month

Question 8

What is first-line treatment of schizophrenia?

Answer 8

Second generation (atypical) anti-psychotics if side-effect profile is tolerated  + CBT
eg risperidone --> aripiprazole

Question 9

Which drug is reserved for treatment-resistant schizophrenia?

Answer 9

clozapine

Question 10

What are the serious side effects of clozapine?

Answer 10

agranulocytosis, neutropenia, neutropenic sepsis, death

Question 11

Features in the brain

Answer 11

• ventricular enlargement
• reduced frontal lobe grey matter and volume
• reduced grey matter in the temporal cortex and medial temporal lobe.

Question 12

What is flight of ideas?

Answer 12

when words are inappropriately associated due to meaning or rhyme

Question 13

What is Knight’s move thinking?

Answer 13

when someone jumps between topics without there being a connection

Question 14

What is circumstantiality?

Answer 14

an inability to answer a question without giving excess detail

Question 15

What is a neologism?

Answer 15

a word or phrase that only means something to the patient

Question 16

What is a delusion?

Answer 16

A fixed, false belief

Question 17

What is derealisation?

Answer 17

When someone thinks the world isn’t real

Question 18

Give some positive symptoms of schizophrenia

Answer 18

delusions, hallucinations, though disorders

Question 19

Give some negative symptoms of schizophrenia

Answer 19

apathy, decreased volition, social withdrawal, cognitive impairment

Question 20

Is it easier to treat positive or negative symptoms of schizophrenia?

Answer 20

positive

Question 21

How can you treat catatonia?

Answer 21

ECT and benzodiazepines

Question 22

Good prognostic factors for schizophrenia

Answer 22

female
older onset
mood disturbance (personal or familial)

Question 23

Poor prognostic factors for schizophrenia

Answer 23

going a long time without treatment
insidious, early onset
cognitive impairment
enlarged brain ventricles

Question 24

What is a self-referential experience?

Answer 24

a belief that the environment is reacting to you

Question 25

Risk factors for psychotic disorders

Answer 25

family history
black
migration
urban environment
cannabis 
lower socio-economic background