Schizophrenia

Question 1

What is Schizophrenia

Answer 1

severe psychiatric disorder characterised by chronic or recurrent psychosis

Question 2

what is diagnosis based on

Answer 2

a cluster of symptoms

Question 3

what are Schneider’s first rank symptoms

Answer 3

symptoms that are suggestive of Schizophrenia in the absence of drug use or organic disease

Question 4

are 1st rank symptoms pathognomonic of schizophrenia

Answer 4

no

Question 5

list the 1st rank symptoms

Answer 5

Delusion: delusional percept
Auditory hallucinations: audible thoughts, voices arguing/discussing, voices commenting on patient’s actions
Thought disorder: thought insertion, withdrawal, broadcasting
Passivity experiences: volition, affect, impulse, somatic passivity

Question 6

What is the ICD10 criteria for the timing of symptoms

Answer 6

symptoms should be present for most of the time during an episode of psychotic illness lasting for at least 1 month

Question 7

ICD10 criteria: should include at least 1 of the following

Answer 7

Thought disorders
Delusions of control, influence or passivity
Auditory hallucinations
Delusions of other kinds that are culturally inappropriate

Question 8

ICD10 criteria: or should include at least 2 of the following

Answer 8

Persistent hallucinations of any modality occurring everyday for at least 1 month
Neologisms or breaks in thought resulting in incoherent speech
Catatonic behaviour
Negative symptoms

Question 9

What are the subtypes of schizophrenia and which is the most common

Answer 9

Paranoid - most common
Hebephrenic
Catatonic

Question 10

what are positive symptoms

Answer 10

hallucinations
delusions
formal thought disorders
passivity phenomena

Question 11

what are negative symptoms

Answer 11

blunted affect

reduced: speech, motivation, interest, social interaction

Question 12

in terms of prognosis what is the rule of thirds

Answer 12

1/3rd:
will get better
relapsing remitting
never fully recover

Question 13

what should you assess for in terms of risk assessment

Answer 13

suicide
homicide
- command hallucinations
- delusions

Question 14

when is the onset of schizophrenia

Answer 14

15-25 men

25-35 women

Question 15

risk factors for schizophrenia

Answer 15

M>F
age 
genetics
birth complications
lower socioeconomic class
cannabis use
urban living 
neurodevelopmental and neurochemical changes

Question 16

list bad prognostic factors

Answer 16

poor premorbid adjustment 
insidious onset
early onset 
long time untreated
cognitive impairment 
enlarged ventricles

Question 17

list good prognostic factors

Answer 17

older age of onset
FH
female
marked mood disturbance

Question 18

which are harder to treat, positive or negative symptoms

Answer 18

negative symptoms

they are more incapacitating

Question 19

what does the brain look like in Schizophrenia

Answer 19

reduced frontal lobe grey matter and volume

enlarged lateral ventricle volume

Question 20

subcortical dopamine hyper/hypo activity leads to psychosis

Answer 20

hyperactivity

Question 21

mesocortical hyper/hypo activity leads to negative and cognitive symptoms

Answer 21

hypoactivity

Question 22

which atypical antipsychotic is usually first line

Answer 22

risperidone