Schizophrenia Flashcards
Definition of schizophrenia
Schizophrenia is a long-term mental health problem which affects thinking, perception and affect
What are the six subtypes of schizophrenia?
Paranoid schizophrenia Hebephrenic schizophrenia Catatonic schizophrenia Undifferentiated schizophrenia Residual schizophrenia Simple schizophrenia
Describe paranoid schizophrenia.
This is the most common subtype of schizophrenia.
Characterised by paranoid delusions and auditory hallucinations
Describe hebephrenic schizophrenia
Usually diagnosed in adolescents and young adults. Characterised by mood changes, unpredictable behaviours, shallow affect and fragmentary hallucinations. The outlook is very poor as negative symptoms may develop rapidly
Describe catatonic schizophrenia
Characterised by psychomotor features such as posturing, rigidity and stupor
Describe undifferentiated schizophrenia
When their schizophrenia symptoms don’t fit neatly into one of the other categories
Describe residual schizophrenia.
Characterised by negative symptoms, usually when the positive symptoms have ‘burnt out’
Describe simple schizophrenia
Similar to residual schizophrenia in that it is characterised by negative symptoms
Difference is that patient’s never experience positive symptoms
Epidemiology of schizophrenia
1% of people Men = Women 15 - 35 yrs Urban areas Migrants lower socioeconomic classes (cause or effect?)
What is the difference between a positive and a negative symptom in schizophrenia?
Positive symptoms tend to represent a change in behaviour or thought, while negative symptoms usually involve a decline in normal functioning
Positive symptoms of schizophrenia
Thought echo (hearing your own thoughts out loud) Though insertion/withdrawal Thought broadcasting Auditory hallucinations Delusional perception Passivity or somatic passivity Odd behaviours Thought disorder Lack of insight
Negative symptoms of schizophrenia
Blunted affect Apathy Social isolation Poverty of speech Poor self-care
Aetiology and risk factors of schizophrenia
Exact cause unknown
- combination of psychological, environmental, biological and genetic factors
- predisposition + trigger
Family history is a strong indicator
Pregnancy
- malnutrition and viral infections
- other complications (pre-eclampsia/ emergency C-section)
Cannabis use in teenage years
- other drugs can cause psychotic symptoms (LSD, cocaine, amphetamines)
Stressful life experiences
How is schizophrenia diagnosed?
A diagnosis of schizophrenia requires a first rank symptom, or a persistent delusion for at least one month:
- Delusional perception
- Passivity
- Delusions of thought interference (thought insertion, thought withdrawal and/or thought broadcasting)
- Auditory hallucinations (thought echo, 3rd person voices and/or running commentary)
There also needs to be no other cause of psychosis such as drug intoxication or withdrawal, brain disease (including dementia/delirium/epilepsy) or extensive depressive or manic symptoms (unless it it’s clear that schizophrenic symptoms antedate the affective disturbance)
What investigations are required in order to rule out other causes of confusion/psychotic symptoms?
MSU to rule out UTI (delirium) Urine drug screen CT scan (if organic neurological cause is suspected) HIV testing Syphilis serology Lipids (before starting anti-psychotics) Physical examination Bloods – FBC, TFTs, U&Es. LFTs, CRP and a fasting glucose
