Schizophrenia and BiPolar Flashcards
What is schizophrenia? symptoms
- Psychosis – perceive or interpret reality in a very different way to others
- Hallucinations - visual, auditory (hearing voices is common)
- Also of smell & taste
- Delusions – unrealistic, mistaken beliefs.
- Disordered thoughts, that might reflect paranoia
- Social withdrawal.
- Losing interest and motivation in life
How do you diagnose and treat schizophrenia?
Diagnosis
Presenting clinical picture. Patient experience.
Experience of Family or outside agencies
Patient may or may not agree with diagnosis
Specialist assessment – i.e. psychiatrist
Treatment
* Individual tailored combination of talking therapy & medicine.
* Individuals may be supported by community mental health teams
* There may be voluntary or compulsory hospital admissions
* Anti-psychotics - typical (developed in the 50’s – chlorpromazine, haloperidol) or atypical developed in the 90s –risperidone, olanzapine) both work to block availability of dopamine
* May be a combination of talking therapy, lifestyle support and medication
* Medications know as ‘mood stabilisers – Lithium; anti-convulsant such as carbamazepine and valproate. ( Note all have narrow therapeutic index and
significant side effects)
* Also symptomatic medications – also anti-psychotics and anti-depressants. (Lithium used since 1949 but mechanism still being clarified)
Aim of treatment /prognosis
* Considered to be a ‘long and enduring mental illness’
* The goal of the CMHT is to provide day-to-day support and treatment while ensuring you have as much independence as possible.
* Aim of anti-psychotic medication is to calm symptoms & offer sedation (the ‘dopamine hypothesis’ of schizophrenia flowed from use of anti-psychotics rather than driving the invention of them and is considered too simplistic
What is BiPolar?
Previously know as ‘manic depression
Cyclical rhythm of ‘highs’ and ‘lows’
The ‘Up’ phase might include some symptoms
associate with psychosis. Also feeling happy, elated, over-joyed, talking very quickly, punning, feeling self important, easily distracted, not eating, not sleeping
How do you diagnose and treat BiPolar?
Diagnosis
Presenting clinical picture. Patient experience.
Experience of Family or outside agencies
Patient may or may not agree with diagnosis
Specialist assessment – i.e. psychiatrist
Tests of exclusion - thyroid
Treatment
May be a combination of talking therapy, lifestyle support and medication
Medications know as ‘mood stabilisers – Lithium; anti-convulsant such as carbamazepine and valproate.
(Note all have narrow therapeutic index and
significant side effects)
Also symptomatic medications – also anti-psychotics and anti-depressants.
(Lithium used since 1949 but mechanism still being clarified)
Considered long term problem
May be less need for hospitalisation and CMHT
support
Caution: Herbal medicines may increase clearance of anti-psychotics, or potentiate lithium
