Schizophrenia

Question 1

What are the 4 main features of Schneider’s first rank symptoms

Answer 1

1. Auditory hallucinations,
2. Thought disorders,
3. Passivity phenomena
4. delusional perceptions:

Question 2

Name 3 x types of auditory hallucinations

Answer 2

1. two or more voices discussing the patient in the third person
2. thought echo
3. voices commenting on the patient’s behaviour

Question 3

Thought disorders

Answer 3

Thought insertion
thought withdrawal
thought broadcasting

Question 4

Passivity phenomenon

Answer 4

bodily sensations being controlled by external influence

actions/impulses/feelings - experiences which are imposed on the individual or influenced by others

Question 5

Delusional perceptions

Answer 5

Delusional perceptions
a two stage process) where first a normal object is perceived then secondly there is a sudden intense delusional insight into the objects meaning for the patient e.g. ‘The traffic light is green therefore I am the King’.

Question 6

First line Mx for Schizophrenia

Answer 6

1. oral atypical antipsychotics are first-line

2. cognitive behavioural therapy should be offered to all patients

Question 7

Which antipsychotic medication is best at treating the negative symptoms of schizophrenia?

Answer 7

Clozapine

Question 8

What are some of the positive symptoms of schizophrenia?

Answer 8

Hallucinations
Delusions
Ideas of reference

Question 9

What does the terms “ideas of reference” mean with regard to schizophrenia?

Answer 9

t is “the notion that everything one perceives in the world relates to one’s own destiny.”

Question 10

What is the difference between a hallucination and an illusion?

Answer 10

Hallucinations are perceptions occurring in the absence of any external stimulus. (eg hearing a voice)

Illusions are misperceptions of real external stimuli. (eg perceiving a hanging coat as a person)

Question 11

What is the difference between a hallucination and a pseudohallucination? Are both associated with schizophrenia?

Answer 11

Pseudohallucinations are perceived within the mind and the patient recognises that they are not real external stimuli. (eg a voice inside my head). They tend not to be associated with true psychotic experiences, despite sometimes being very traumatic.

Hallucinations are perceived as real external stimuli and therefore insight tends to be reduced. (eg an invisible person talking to me). They are one of the classic symptoms of psychosis.

Question 12

Are visual hallucinations typically associated with schizophrenia?

Answer 12

No, they tend to be more associated with organic disturbances of the brain. This includes delirium, occipital lobe tumours, epilepsy and dementia. Certain substances can also induce visual hallucinations - LSD, petrol/glue sniffing, alcoholic hallucinosis.