Schizophrenia Flashcards
What criteria is used to diagnose Schizophrenia?
Schneider’s First Rank of Symptoms
What is Schizophrenia?
Schizophrenia is a form of psychosis, which presents with specific symptoms, and has associated genetic neurodevelopmental vulnerability which is then triggered by environmental stressors
What are the Schneider’s First Rank symptoms?
- Auditory hallucinations (3rd person)
- Passivity Phenomena
- Delusion perception
- Delusion of thought interference
List the positive symptoms of Schizophrenia
Hallucinations
Passivity Phenomena
Delusions
Disorder of form of thought
List the negative symptoms of Schizophrenia
Reduced Speech Reduced Interest and pleasure Reduced Motivation Minimal social interaction Blunted Affect
What symptoms indicate a worse prognosis
Early age of onset (childhood/adolescence) Male Social Isolation Poor work record Early onset of negative symptoms Non-compliance
What is the risk of suicide in Schizophrenic patients?
10-15%
What must be ruled out before diagnosing schizophrenia?
Organic causes and drug misuse
What drugs can worsen schizophrenia or induce it in those with the predisposition?
Amphetamines
What changes to the brain can be seen in some patients with schizophrenia?
Enlarged lateral ventricles (present from beginning)
Reduced fronto-temporal volume
Reduced Activation of prefrontal areas
List some risk factors for Schizophrenia
Family history Obstetric complications e.g. infection or c-section Season of birth Advancing paternal age Stress Poverty High expressed emotion in family
What is schizoaffective disorder?
This is when a patient expresses symptoms of both schizophrenia and mood disorders in the same acute episode
What is the lifetime risk of developing schizophrenia?
1%
What % of patients with schizophrenia suffer multiple episodes and significant chronic progressive impairment?
> 40%
What chromosome is associated with schizophrenia?
22
What neurotransmitters are thought to be implicated in schizophrenia?
Dopamine
Serotonin receptors
Glutamate receptors
Why do amphetamines induce schizophrenia?
They are dopamine agonists. Schizophrenia is assume to be related to an overactivity of dopamine pathways in the brain
How is schizophrenia treated medically?
Dopamine Antagonists
Atypical first then typical
What is akathisia?
Restlessness
A side effect of anti-psychotic medications
What % of patients only ever suffer one episode?
10%
Define Paranoid Schizophrenia:
Most common type
Hallucinations and delusions are common
Define Hebephrenic Schizophrenia:
Age of onset 15-25 Poor prognosis fluctuating affect Fleeting fragmented delusions / hallucinations i.e. disorganisation symptoms
Define Catatonic Schizophrenia:
Characterised by stupor, posturing, wavy flexibility and negativism.
Much rarer than it used to be
How long must symptoms persist before a diagnosis of schizophrenia can be made?
At least one month
Define residual schizophrenia:
This is a transient phase between acute and chronic schizophrenia in which a patient with positive symptoms within the last year have begun to develop negative symptoms
What are the 3 categories used to define symptoms of schizophrenia:
Reality distortion
Disorganisation
psychomotor poverty
What might occur following an acute schizophrenic episode?
Post-schizophrenic depression
May require anti-depressant medication to control
Are anti-psychotics effective in treating positive or negative symptoms, or both?
Positive symptoms
Positive symptoms are due to an excess in dopamine which is the target of antipsychotic medication
How long should you wait before assessing response to treatment on antipsychotics?
At least six weeks on an effective dose
Response is gradual
Schizophrenia = increased risk of violent behaviour. True/False
True
5% of violence in society is attributed to schizophrenia
