Schizophrenia Flashcards
What is the most common cause of psychosis
Schizophrenia
Which gender is more affected in schizophrenia
M=F
Equally
Typical age onset for schizophrenia
15-35yrs
What is psychosis
Represents an inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality
What is a hallucination
Have the full force and clarity of true perception
located in external space
No external stimulus
Not willed or controlled
What is the prevalence of schizophrenia
1%
1 in 100 pf population
Positive symptoms of schizophrenia
Hallucinations
Delusions
Disordered thinking
What are positive symptoms associated with
A better prognosis
What are the negative symptoms
Apathy
Lack of interest
Lack of emotions
What are negative symptoms associated with
A poorer prognosis
What is the underlying criteria for schizophrenia
Symptoms >1month in the absence of organisms or affective disorder
ICD-10 classification of schizophrenia (at least 1 of the following)
At least 1 of the following
a) Alienation of thought as thought echo, thought insertion or withdrawal, or thought broadcasting
b) Delusions of control, influence or passivity, clearly referred to body or limb movement actions, or sensations; delusional perception
c) Hallucinatory voices (auditory) giving a running commentary on the patient’s behaviour, or discussing him between themselves, or other types of hallucinatory voices coming from some part of the body.
d) Persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. beingable to control the weather)
ICD-10 classification (and OR at least 2 of the following)
And OR at least 2 of the following
(e) Persistent hallucinations in any modality (visual, auditory ec..), when occurring every day for at least one month.
f) Neologisms, breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech.
g) Catatonic behaviour, such as excitement, posturing or waxy flexibility, negativism, mutism and stupor.
h) “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses.
What are the biological factors implicated with schizophrenia
Winter births Maternal influenza Substance misuse Obstetric complications Malnutrition and famine
What are the social and psychological factors implicated with schizophrenia
Occupation Social class Migration Social isolation Life events as precipitants Cultural factors are NOT implicated
Good prognostic factors
Absence FH Good premorbid function Clear precipitant Acute onset Mood disturbance Prompt Rx
Poor prognostic factors
Slow insidious onset
Prominent negative symptoms
Starts in childhood
Substance misuse
What is the Rx for treatment resistant types
Clozapine
Psychological interventions
CBT
Family therapy
Arts therapy
What is the 1st line R
Atypical anti-psychotics
Name some typical anti-psychotics
Chlorpromazine Fluphenazine Haloperido Perphenzine Thioridazine
Give drug examples of Atypical anti-psychotics
Amisulpride Olanzapine Quetiapine Risperidone Aripiprazole
What is clozapine associated with
Agranulocytosis therefore specialist monitoring is required
What psychotic features might you see in a depressive episode with psychosis
Delusions of guilt, worthlessness and persecution
Derogatory auditory hallucinations
Ddx for psychosis
Schizophrenia
Delirium (acute state)
Affective disorders with psychosis (depression and mania)
What psychotic features might you see in a manic episode with psychosis
Delusions of grandeur; special powers or messianic roles
Gross overactivity, irritability and behavioural disturbance: Manic excitement
What psychotic features might you see in delirium
Prominent visual experience, hallucinations and illusions
Affect of terror
Delusions are persecutory and evanescent
Fluctuating, worse at night
What are the different types of schizophrenia
Paranoid Hebephrenic Catatonic Simple Residual
Which is the most common type of schizophrenia
Paranoid
Side effects of anti-psychotics
Weight gain DM Postural hypotension Long QT Daytime drowsiness Sexual dysfunction (e.g ED, libido) Hyperprolactinaemia
