Schizophrenia Flashcards
What symptoms are detailed in the ICD-10 to diagnose schizophrenia?
Schneider’s First Rank Symptoms:
- Delusions
- Hallucinations
- Thought interference
- Passivity
How long should symptoms of Schizophrenia last for in order to be diagnosed using the ICD-10?
- present for most of the time during episode of psychotic illness
- episode must last for at least one month
What are the main types of Schizophrenia?
Paranoid - most common form, 1st rank symptoms
Hebephrenic - immaturity, inappropriate, frivolous
Catatonic - movement disorder predominates
Give examples of other “paranoid” psychoses
- Persistent Delusional Disorder - fixed delusion on 1 feature
- Schizotypal disorder - social withdrawal, eccentric patient
- Acute and Transient Psychotic Disorder - schizophrenia symptoms lasting <1 month
- Schizoaffective Disorder - 1st rank symptoms of schizophrenia + episodes of depression/mania
What indicates a negative schizophrenia syndrome?
- Reduced amount of speech
- Reduced motivation / drive
- Reduced interest / pleasure
- Reduced social interaction
- Blunting of affect
At what age does the peak incidence of schizophrenia occur in both males and females?
Males - 15-25 years
Females - 25-35 years
What is thought to cause schizophrenia?
- genetic neurodevelopmental vulnerability
- later triggered by environmental stressors
Schizophrenia has a higher incidence in lower socioeconomic classes. TRUE/FALSE?
TRUE **we are unaware if patients are likely to drift into the lowest social class due to life after diagnosis**
What are the risk factors for developing schizophrenia?
- Genetics - e.g. twins or parents
- Ethnicity - e.g. African-Caribbean in UK
- Birth Complications
- Winter/Spring birth - (linked to virus exposure?)
- drug use
- urban dwelling
What premorbid symptoms are noticed in patients who go on to develop schizophrenia?
• subtle developmental delays in childhood e.g. social, cognitive, motor
What are the bad prognostic indicators in schizophrenia?
- Insidious onset
- Early onset - childhood / adolescence
- Long duration of untreated psychosis
- Cognitive impairment
- Enlarged ventricles
What indicates a good prognosis in schizophrenia?
- Older age of onset
- Female gender
- Marked mood disturbance especially elation
- Family history of mood disorder
When is suicide most likely to occur as an outcome of schizophrenia?
High risk time in first week of discharge from hospital
Which of the ICD-10 first rank symptoms is most specific to schizophrenia as opposed to psychosis?
Thought interference
- insertion, withdrawal, blocking, echo etc
What is the first line treatment for schizophrenia?
Atypical antipsychotic
=> Risperidone, Olanzapine etc
Beware of olanzapine in diabetic patients, as it can cause metabolic syndrome as a side effect
