Schizophrenia

Question 1

define psychosis?

Answer 1

an inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

Question 2

describe 2 historical trends of psychotic symptoms?

Answer 2

demonic possession (good vs. evil), scrutiny via TV/ radio

Question 3

how does psychosis usually present?

Answer 3

hallucinations

Question 4

describe the hallucinations involved in psychosis?

Answer 4

they have the full force and clarity of true perception with no external stimulus

Question 5

name 5 special senses which hallucinations can affect in psychosis?

Answer 5

auditory, visual, tactile, olfactory, gustatory

Question 6

define a delusion?

Answer 6

an unshakeable idea or belief which is out of keeping with the person’s social and cultural background; it is held with extraordinary conviction

Question 7

name 4 examples of delusions?

Answer 7

grandiose, paranoid, hypochondriacal, self referential

Question 8

name 3 disorders which are characterised by psychosis?

Answer 8

schizophrenia, delirium, severe affective disorder (depression/BAD)

Question 9

what is the most common cause of psychosis?

Answer 9

schizophrenia

Question 10

describe 3 +ve symptoms of schizophrenia?

Answer 10

Hallucinations, Delusions, Disordered thinking

Question 11

describe 3 -ve symptoms of schizophrenia?

Answer 11

Apathy, Lack of interest, Lack of emotions

Question 12

how is schizophrenia diagnosed using ICD-10?

Answer 12

At least one of the following for more than a month in the absence of organic or affective disorder:
alienation of thought, delusions of control (influence/ passivity), hallucinatory voices, persistent delusions

OR @ LEAST 2 of the following:
persistent hallucinations, breaks/ interpolations in the train of thought, catatonic behaviour, -ve symptoms

Question 13

describe familial risks of developing schizophrenia if -

parent/ MZ twin/ both parents are affected?

Answer 13

one parent = 10%, MZ twins = 50%, both parents = 40%

Question 14

name 3 conditions which increase risk of schizophrenia?

Answer 14

neuregulin (chromosome 8p), dysbindin (chromosome 6p), Di George syndrome

Question 15

name 3 biological factors implicated in schizophrenia?

Answer 15

obstetric complications, maternal influenza, winter birth

Question 16

name 3 social and psychological factors implicated in schizophrenia?

Answer 16

migration, life events, social isolation

Question 17

name 4 differentials for schizophrenia?

Answer 17

delirium, depression, anti-social personality disorder, thyroid disease

Question 18

name 3 good prognostic factors in schizophrenia?

Answer 18

Acute onset, Mood disturbance, absence of family history

Question 19

name 3 poor prognostic factors in schizophrenia?

Answer 19

slow, insidious onset, started in childhood, suicide risk

Question 20

describe initial treatment in 1st episode psychosis?

Answer 20

antipsychotics - for at least 2 weeks

Question 21

describe treatment for acute exacerbation/ recurrence of psychosis/ preventing relapse?

Answer 21

amisulphuride, olanzapine or risperidone

Question 22

describe treatment for those with treatment-resistant schizophrenia?

Answer 22

clozapine