Schizophrenia and other primary psychotic disorders

Question 1

Outline the diagnositic criteria for Schizophrenia

Answer 1

2+ symptoms present for most of the the time over one month.

At least one of:
* Persistent delusions
* Persistent hallucinations
* Disorganised thinking
* Experiences of influence, passivity, control

Additional:
* Negative symptoms
* Grossly disorganised behaviour
* Psychomotor disturbance

Not due to another medical condition, substances, medications, or withdrawal.

Question 2

Describe the prodromal phase of schizophrenia

Answer 2

Weeks/months of:
* Anhedonia
* Affect flattened
* Alogia (poverty of speech)
* Avolition
* Apathy
* Attention reduced

Question 3

Outline the prognosis of schizophrenia

Answer 3

Some experience:
* Complete remission (smaller proportion - 1 in 5)
* Relapsing remitting (commonest - 3 in 5)
* Gradual worsening (15% after two years - 1 in 5)

4 out of 5 people show some improvement with treatment within a year.

1 out of 5 have no further episodes within the next 5 years.

Question 4

How do symptoms of schizophrenia change with time?

Answer 4

• Positive symptoms tend to diminish naturally over time.
• Negative symptoms often persist.
• Cognitive symptoms tend to persist.

Question 5

How does acute and transient psychotic disorder differ from schizophrenia?

Answer 5

• Rapid progression of symptoms without prodrome
• Symptoms tend to fluctuate rapidly in intensity and type, even daily
• Absence of negative symptoms
• Duration does not exceed 3 months, often lasts few days - one month

Question 6

Describe how schizotypal disorder differs from other primary psychotic disorders

Answer 6

Pattern of unusual speech, perceptions, beliefs and behaviours
* Psychotic-like symptoms
* Tends to be stable over time (unlike evolving symptoms of prodromal or residual schizophrenia)
* Insufficient intensity or duration to meet criteria of other primary psychotic disorders.