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Psychiatry > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What is schizophrenia?

A

Mental disorder inn which the thoughts, affective response or ability to recognise reality, and ability to communicate and relate to others, are sufficiently impaired to interfere grossly with the capacity to deal with reality

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2
Q

What are the classic characteristics of schizophrenia?

A

Lack of insight, hallucinations, delusions, disorder of form of thought

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3
Q

What are the types of schizophrenia?

A

Organic conditions = delirium, dementia, stroke, brain injury
Substance use = acute intoxication, withdrawl, delerium tremens
Manic depressive psychosis = unipolar depression, bipolar disorder
Dementia praecox = schizophrenia and other paranoid illnesses
Schizoaffective disorder

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4
Q

What does schizophrenia involve?

A

Inability to distinguish between subjective experience and objective reality = qualitatively different from normal experience

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5
Q

What are some examples of psychotic experiences?

A

Hallucinations, ideas of reference, delusions, thought disorder, thought interference, passivity phenomena, loss of insight

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6
Q

What is a hallucination?

A

Perception which occurs in absence of an external stimulus

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7
Q

What are some features of a hallucination?

A

Experienced as originating in real space (not just in thoughts)
Has same qualities as normal perception
Not subject to conscious manipulation

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8
Q

What are the different types of hallucination?

A

can occur in any sensory modality = auditory, visual, olfactory, gustatory, tactile, haptic

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9
Q

What is idea of reference?

A

Innocuous or coincidental events will be ascribed significant meaning by the person

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10
Q

What are some examples of idea of reference?

A

Thinking there are messages in the newspaper about them

Believing objects have been arranged so as to convey a hidden message to them

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11
Q

What are self-referential experiences?

A

Belief that external events are related to oneself = can vary in intensity from brief though to frequent and intrusive thought to delusional intensity

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12
Q

What are some examples of self-referential experiences?

A

Feeling that others are speaking about them

Believing they are the second coming of Christ

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13
Q

What are delusions?

A

Fixed falsely held belief = held with unshakeable conviction, may be bizarre or impossible, impervious to logical arguments or evidence

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14
Q

What are the origins of delusions?

A 
Primary = arrive fully formed in the consciousness without need for explanation
Secondary = often attempts to explain anomalous experiences
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15
Q

What are some types of delusion?

A

Paranoid, sin, persecutory, poverty, grandoise, nihilistic, religious, erotomantic, misidentification, jealousy, guilt

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16
Q

How are though disorders identified?

A

Must be inferred from patterns of speech = can’t be directly observed

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17
Q

What are some examples of thought disorders?

A

Neologisms, circumstantiality, clanging and punning, loosening of association, Knight’s move thinking, verbigeration

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18
Q

What are the types of thought interference?

A

Thought insertion, withdrawl, broadcasting and blocking

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19
Q

How do we process reality?

A

Reality testing is just another constructed process driven by the brain = involved filtering the info from our senses about the world and interpreting their meaning

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20
Q

Can you tell if the filters we use for processing reality aren’t working?

A

No = everything still seems real

21
Q

What is loss of insight?

A

Patient is unable to attribute their symptoms to being an illness

22
Q

What are the differentials of psychosis?

A

Schizophrenia, substance misuse, mania, depression, delirium, dementia

23
Q

What are some features of drug induced psychosis?

A

May be very florid symptoms or more insidious and chronic = tend to be short lasting if access to substance is removed, not the same as intoxication or withdrawl effects

24
Q

What must you beware of in drug induced psychosis?

A

Comorbidity of substance use with schizophrenia or bipolar disorder

25
Q

What typifies depressive psychosis and mania with psychosis?

A

Mood congruent content of psychotic symptoms

26
Q

What are some features of depressive psychosis?

A

Delusions of guilt, worthlessness, hypochondriasis or poverty
Hallucinations of accusing, insulting or threatening voices = typically second person

27
Q

What are some features of mania with psychosis?

A

Delusions of grandeur, special ability, persecution or religiosity
Hallucinations = tend to be second person and auditory
Flight of ideas

28
Q

What is delirium?

A

Acute transient disturbance = clouding of consciousness ranging from subtle drowsiness to unresponsive disorientation, worse at night, may have lucid intervals

29
Q

What are some causes of delirium?

A

Alcohol withdrawl, septicaemia, organ failure, hypoglycaemia, encephalitis, space occupying lesions

30
Q

What are some features of delirium?

A

Impaired concentration and memory = esp. new info
Visual hallucinations +/- auditory hallucinations
Persecutory delusions, irritability and insomnia
Psychomotor disturbance = agitation or retardation

31
Q

What are the core symptoms of schizophrenia?

A

Delusions, auditory hallucinations, thought interference, passivity phenomena

32
Q

What is the first set of ICD-10 criteria for schizophrenia?

A

At least 1 of = Thought echo, insertion, withdrawl or boradcasting
Delusions of control/influence clearly referred to body movements or thoughts
Hallucinatory voices
Persistent delusions of other kinds that are culturally inappropriate

33
Q

What is the second set of ICD-10 criteria for schizophrenia?

A

At least 2 of = Catatonic behaviour
Persistent hallucinations occurring every day for at least one month when accompanied by delusions
Neologisms, breaks or interpolations in train of thought resulting in incoherent speech
Negative symptom

34
Q

What are some negative symptoms that occur in schizophrenia?

A

Marked apathy, paucity of speech, blunting or incongruity of emotional responses

35
Q

What are the subtypes of schizophrenia?

A

Paranoid = most common, 80% of all cases, 1st rank symptoms predominate
Hebephrenic
Catatonic = movement disorder predominates

36
Q

What are some examples of other paranoid psychoses?

A

Persistent delusional disorder, schizotypal disorder, acute and transient psychotic disorder, schizoaffective disorder

37
Q

What are some features of persistent delusional disorder?

A

Systematised = fixed delusions are the major or only feature

38
Q

What are some features of schizotypal disorder?

A

Eccentricity and aloofness, social withdrawl, paranoid quasi-delusional ideas, magical thinking, transient auditory hallucinations

39
Q

What are some features of acute and transient psychotic disorder?

A

Schizophrenia-like symptoms lasting less than a month

40
Q

What are some features of schizoaffective disorder?

A

First rank symptoms with depression or mania

41
Q

What are some examples of positive syndromes?

A

Hallucinations, delusions, passivity phenomena, disorder of form of thought

42
Q

What are some examples of negative syndromes?

A

Reduced amount of speech, reduced motivation or drive, reduced interest or pleasure, reduced social interaction, blunting of affect

43
Q

What is schizophrenia considered to be?

A

A genetically determined neurodevelopmental vulnerability later triggered by environmental stressors

44
Q

When is the peak incidence of schizophrenia?

A 
Males = age 15-25
Females = age 25-35
45
Q

What is schizophrenia associated with?

A

Perinatal complications = prematurity, prolonged labour, foetal distress, hypoxia

46
Q

What are the risk factors for schizophrenia?

A

Drug use, urban dwelling, social deprivation, enlarged ventricles and thinner cortices, altered dopamine signalling

47
Q

What is the link between suicide and schizophrenia?

A

10-15% completed suicide rate in schizophrenics = may occur following recovery of insight, high risk in first week following discharge from hospital

48
Q

What are some indicators of poor prognosis for schizophrenia?

A 
Poor premorbid adjustment 
Insidious onset and childhood/adolescent onset
Long duration of untreated psychosis
Cognitive impairment
Enlarged ventricles
49
Q

What are some indicators of good prognosis for schizophrenia?

A

Shorter time of untreated psychosis
Older age of onset and positive family history
Marked mood disturbance
Female gender

Psychiatry (36 decks)

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