Schizophrenia and psychotic disorders

Question 1

Neurosis

Answer 1

disease of nerves

Question 2

Psychosis

Answer 2

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

Question 3

Historical thoughts about psychosis

Answer 3

good and evil - demonic - witchcraft - TV and radio interference - FBI - aliens

Question 4

Psychotic hallucinations

Answer 4

full force and clarity of true perception
external space and no external stimulus
not willed or controlled

Question 5

5 special senses

Answer 5

auditory, visual, gustatory, tactile, olfactory

Question 6

Delusion

Answer 6

unshakeable idea or belief which is out of keeping with the persons social and cultural background –> held with extraordinary conviction

Question 7

Types of delusions

Answer 7

grandiose, paranoid, hypochondriacal, self referential

Question 8

illnesses with psychotic symptoms

Answer 8

schizophrenia - without moo disorder
delirium
severe affective disorder - depressive or manic

Question 9

What is schizophrenia?

Answer 9

A severe mental illness affecting thinking, emotion and behaviour

Question 10

Epidemiology of schizophrenia

Answer 10

most common cause of psychosis
M=F
15-35
1 in 100 people

Question 11

Positive symptoms of schizophrenia

Answer 11

hallucinations
delusions
disordered thinking

Question 12

Negative symptoms of schizophrenia

Answer 12

apathy
lack of interest
lack of emotions

Question 13

How long do the symptoms of schizophrenia need to last and in absence of what?

Answer 13

more than a month

organic or affective disorder

Question 14

schizophrenia: ICD-10

4 criteria you need 1 of

Answer 14

alienation of thought - echo, insertion, withdrawal, broadcasting
passivity - limb movement
hallucinatory
persistent delusions - completely impossible

Question 15

Schizophrenia ICD-10

4 criteria you need at least 2 of

Answer 15

persistent hallucinations
breaks or interpolations in the train of thought
catatonic behaviour eg wavy flexibility, stupor
negative symptoms eg apathy

Question 16

List some types of schizophrenia listed in ICD-10

Answer 16

Paranoid
catatonic
simple

Question 17

broad aetiology of schizophrenia

Answer 17

biopsychosocial

evolutionary theories

Question 18

Biological factors of schizophrenia

Answer 18

genetics eg neuregulin, dysbindin
neurochemistry eg dopamine
obstetric complications 
maternal influenza 
malnutrition and famine 
winter birth 
substance misuse

Question 19

Psychological theories of schizophrenia

Answer 19

Jungs - collective unconscious
conrad - development of delusion
Harland - migrants

Question 20

psychosocial factors of schizophrenia

Answer 20

occupation and social class
migration
social isolation
life events

Question 21

psychosis and families

Answer 21

schizophrenogenic mother

high EE families

Question 22

delirium

Answer 22

brain or systemic disease
affect of terror 
worse at night 
persecutory delusions 
visual experience

Question 23

affective psychoses

Answer 23

depressive - guilt, worthlessness, persecution, auditory hallucinations
manic - grandeur, special powers, overactivity, irritable

Question 24

Broad treatment of schizophrenia

Answer 24

CBT
family therapy
anti-psychotics
clozapine if treatment resistant - blood dyscriasis

Question 25

Recovery

Answer 25

Being able to live a meaningful and satisfying life, as defined by each person in the presence or absence of symptoms

Question 26

% recovery after first episode of psychosis

Answer 26

80

Question 27

Good prognostic factors

Answer 27

absence of FH
good premorbid function 
clear precipitant 
acute onset 
prompt treatment 
mood disturbance

Question 28

Poor prognostic factors

Answer 28

slow, insidious onset 
negative symptoms 
CVD, smoking, resp, cancer
suicide and violence
starts in childhood