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Psychiatry > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What criteria is used to diagnose Schizophrenia?

A

Schneider’s First Rank of Symptoms

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2
Q

What is Schizophrenia?

A

Schizophrenia is a form of psychosis, which presents with specific symptoms, and has associated genetic neurodevelopmental vulnerability which is then triggered by environmental stressors

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3
Q

What are the Schneider’s First Rank symptoms?

A
  • Auditory hallucinations (3rd person)
  • Passivity Phenomena
  • Delusion perception
  • Delusion of thought interference
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4
Q

List the positive symptoms of Schizophrenia

A

Hallucinations
Passivity Phenomena
Delusions
Disorder of form of thought

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5
Q

List the negative symptoms of Schizophrenia

A 
Reduced Speech
Reduced Interest and pleasure
Reduced Motivation
Minimal social interaction 
Blunted Affect
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6
Q

What symptoms indicate a worse prognosis

A 
Early age of onset (childhood/adolescence)
Male
Social Isolation 
Poor work record
Early onset of negative symptoms
Non-compliance
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7
Q

What is the risk of suicide in Schizophrenic patients?

A

10-15%

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8
Q

What must be ruled out before diagnosing schizophrenia?

A

Organic causes and drug misuse

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9
Q

What drugs can worsen schizophrenia or induce it in those with the predisposition?

A

Amphetamines

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10
Q

What changes to the brain can be seen in some patients with schizophrenia?

A

Enlarged lateral ventricles (present from beginning)
Reduced fronto-temporal volume
Reduced Activation of prefrontal areas

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11
Q

List some risk factors for Schizophrenia

A 
Family history
Obstetric complications e.g. infection or c-section
Season of birth
Advancing paternal age
Stress
Poverty
High expressed emotion in family
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12
Q

What is schizoaffective disorder?

A

This is when a patient expresses symptoms of both schizophrenia and mood disorders in the same acute episode

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13
Q

What is the lifetime risk of developing schizophrenia?

A

1%

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14
Q

What % of patients with schizophrenia suffer multiple episodes and significant chronic progressive impairment?

A

> 40%

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15
Q

What chromosome is associated with schizophrenia?

A

22

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16
Q

What neurotransmitters are thought to be implicated in schizophrenia?

A

Dopamine
Serotonin receptors
Glutamate receptors

17
Q

Why do amphetamines induce schizophrenia?

A

They are dopamine agonists. Schizophrenia is assume to be related to an overactivity of dopamine pathways in the brain

18
Q

How is schizophrenia treated medically?

A

Dopamine Antagonists

Atypical first then typical

19
Q

What is akathisia?

A

Restlessness

A side effect of anti-psychotic medications

20
Q

What % of patients only ever suffer one episode?

A

10%

21
Q

Define Paranoid Schizophrenia:

A

Most common type

Hallucinations and delusions are common

22
Q

Define Hebephrenic Schizophrenia:

A 
Age of onset 15-25
Poor prognosis
fluctuating affect
Fleeting fragmented delusions / hallucinations
i.e. disorganisation symptoms
23
Q

Define Catatonic Schizophrenia:

A

Characterised by stupor, posturing, wavy flexibility and negativism.
Much rarer than it used to be

24
Q

How long must symptoms persist before a diagnosis of schizophrenia can be made?

A

At least one month

25
Q

Define residual schizophrenia:

A

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

26
Q

What are the 3 categories used to define symptoms of schizophrenia:

A

Reality distortion
Disorganisation
psychomotor poverty

27
Q

What might occur following an acute schizophrenic episode?

A

Post-schizophrenic depression

May require anti-depressant medication to control

28
Q

Are anti-psychotics effective in treating positive or negative symptoms, or both?

A

Positive symptoms

Positive symptoms are due to an excess in dopamine which is the target of antipsychotic medication

29
Q

How long should you wait before assessing response to treatment on antipsychotics?

A

At least six weeks on an effective dose

Response is gradual

30
Q

Schizophrenia = increased risk of violent behaviour. True/False

A

True

5% of violence in society is attributed to schizophrenia

Psychiatry (15 decks)

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