Schizophrenia and Psychosis

Question 1

What is schizophrenia?

Answer 1

Complex and debilitating neurological disorder. involving sensory and cognitive disturbances

Question 2

Who can schizophrenia affect?

Answer 2

Can affect all cultures, genders, socio-economic groups.

Question 3

When is the typical onset of schizophrenia in males?

Answer 3

late teens to early 20’s

Question 4

What is the typical onset of schizophrenia in women?

Answer 4

late 20’s to early 30’s

Question 5

What is the prognosis for someone with schizophrenia?

Answer 5

Not preventable, no cure, this is for life. The earlier it is diagnosed and treated, the better the prognosis.

Question 6

What are some etiologies of schizophrenia?

Answer 6

Biochemistry (++ dopamine)
Cerebral Blood Flow
Molecular Biology
Genetic Predisposition
Stress
Drug-induced
Nutritional Theories

Question 7

What are some positive symptoms of schizophrenia?

Answer 7

Hallucinations
Delusions
Bizarre behaviours
Disorganized thoughts
Disorganized speech
Agitation
Catatonic behaviours

Question 8

What are some negative symptoms of schizophrenia?

Answer 8

Apathy
Lack of motivation/spontaneity
Blunted affect
Lack of emotional warmth
Impaired social skills
Impaired abstract thinking ability
Impaired concentration

Question 9

What are some cognitive symptoms of schizophrenia?

Answer 9

Impaired memory
Inattention
Inability to follow instructions
Impaired executive functioning
Poverty of thought
Avolition

Question 10

What are some depressive symptoms of schizophrenia?

Answer 10

Anxiety
Irritability
Dysphoria
Suicidality
Drug dependence
Medical conditions

Question 11

What occurs during the prodromal stage of schizophrenia?

Answer 11

Before the illness is diagnosed, they are in the prodromal stage. You start to see some alarming behaviours, (maybe some apathy or difficulties in interpersonal relationships, disruptive behavior, shifts in the sleep-wake cycle, becoming isolated, having trouble with social relationships)

Question 12

What are some symptoms of schizophrenia?

Answer 12

Negative self-perception
Hallucinations
Delusions
Circumstantiality
Tangentiality
Autistic thinking
Perseveration
Poverty of thought
Loose association

Question 13

What is schizoaffective disorder?

Answer 13

Thought AND mood disorder

Severe mood swings and psychotic symptoms

Question 14

What is delusional disorder?

Answer 14

Fixed delusions that are bizarre and not plausible.

Question 15

What happened during phase 1 of schizophrenia? And how long does it last?

Answer 15

This is generally when people are first given the diagnosis. Their first contact with health care professionals, whether it’s their family doc, they get involved with some criminal activity, end up in hospital, etc. This is where you really want to get treatment. People who get really good support and guidance during this phase of the illness have a better prognosis. You want to try to prevent people from getting to the state where they’re in active psychosis (experiencing a lot of passive symtpoms). It generally lasts 3-5 years

Question 16

What occurs during phase 2 of schizophrenia?

Answer 16

Acute phase of illness. Lots of positive symptoms. We see a lot of these people in the hospital.

Question 17

What happens during phase 3 of schizophrenia?

Answer 17

This is when you are in recovery/remission. It is very difficult to move back out of phase 2, so this is where you want to stay. Once you are in an acute psychotic episode, it is hard to regain your normal functioning fully.

Question 18

What is psychosis?

Answer 18

Symptom of mental illness
Involves abnormalities of thoughts and behaviours
Loss of contact with reality

Question 19

What are some disorders that can have the symptom of psychosis?

Answer 19

Can be present in: Bipolar Disorder, Depression, Schizophrenia, Schizoaffective Disorder, Anxiety (PTSD), Delusional Disorder, Substance Induced, Dementia and Psychosis NOS

Question 20

What is the epidemiology of psychosis?

Answer 20

Can occur in all cultures and socioeconomic groups

Affects males and females equally

3% of the population will have at least one episode of psychosis

Generally develops in late teens-mid 20

Significant impact on the health care system

Question 21

What are some risk factors for psychosis?

Answer 21

Genetic predisposition

Pregnancy with birth complications

Developmental delay

Stressful life events

Abuse/Trauma

Drug use

Immigration

Urbanicity

Question 22

What are some interventions/ways to promote recovery?

Answer 22

Strong social support systems
Stable living situations
Safe and structured environment
Sense of purpose or direction
Supportive case worker
Education about illness
Insight

Question 23

What are some treatments for psychosis and schizophrenia?

Answer 23

Early intervention
Medication
Relapse prevention
Education
Stress management
Lifestyle choices
Social skills
Life skills
Family support, therapy and education

Question 24

What are some characteristics of typical antipsychotics?

Answer 24

Typical antipsychotics eg haloperidol
Decrease dopamine
Decrease positive symtoms
Quick onset
PRNs
++ side effects (extrapyramidal effects, etc) can give an antiparkinson med as PRN to counter side effects (usually benztropine)
After long term use, can develop tardive dyskinesia. This is irreversible.

Question 25

What are some characteristics of atypical antipsychotics?

Answer 25

Atypical Antipsychotics
Decrease dopamine, increase serotonin
Work on both positive and negative symtpoms
Slower onset
Not helpful in a PRN situation
Less effective for acute psychotic symptoms
Less sidehat are someffects
Still risk for extrapyramidal side effects
Rarely causes tardive dyskinesia
Anticholinergic side effects (constipation, dry mouth, nausea, etc)

Question 26

What are some examples of atypical antipsychotics?

Answer 26

Clozapine
Olanzapine
Risperidone
Quetiapine
Aripiprazole