Schizophrenia

Question 1

What are schizophrenia disorders characterised by?

Answer 1

• fundamental and characteristic distortions of thinking and perception
• inappropriate or blunted affect

Question 2

What are Schneider’s 1st rank symptoms?

Answer 2

1. Delusions of thought interference (insertion, broadcasting or withdrawal)
2. Delusional perception - perception of a normal object but intensely significant meaning to the patient
3. Passivity - delusion that thoughts/feelings/impulses are influenced or controlled by external forces
4. Auditory hallucinations e.g. voices

Question 3

Diagnosis of schizophrenia

Answer 3

1. At least 1 clear 1st rank Sx, or 2 if less clear cut

OR at least 2 of:

• persistent hallucinations of any modality for weeks on end
• breaks or interjections in train of thought resulting in incoherent or irrelevant speech
• catatonic behaviour
• negative Sx e.g. blunting/incongruent affect, apathy, paucity of speech

2. AND organic brain damage excluded
3. AND Sx present for 6+ months
4. AND Sx present for much of the time for 1+ month
5. AND marked impairment in home or work functioning

Question 4

What is hebephrenic schizophrenia?

Answer 4

• affective changes are prominent

- delusions and hallucinations fleeting and fragmented

Question 5

What is paranoid schizophrenia?

Answer 5

• commonest subtype

- dominated by relatively stable, often paranoid delusions

Question 6

Positive Sx of schizophrenia

Answer 6

• delusions
• hallucinations
• thought disorder
• bizzare behaviour
• lack of insight

Question 7

Negative Sx of schizophrenia

Answer 7

• flattening of affect and volition
• amotivation, apathy
• anhedonia
• attentional impairment
• social withdrawal
• poverty of thought and speech

Question 8

What score assesses severity of schizophrenia?

Answer 8

Positive and Negative Syndrome Scale (PANSS)

Question 9

When is schizoaffective disorder diagnosed?

Answer 9

if both schizophrenic and affective Sx develop together (within days) and are roughly evenly balanced/of the same intensity (in absence of other causes)

Question 10

What are schizophreniform disorders?

Answer 10

disorders that fail to meet threshold for schizophrenia (usually due to duration of psychosis) but have some Sx and deterioration in function

Question 11

Psychological interventions for schizophrenia

Answer 11

• CBT (either general or targeted on auditory hallucinations)
• family therapy
• art therapy

Question 12

What is folie a deux?

Answer 12

‘shared psychosis’