Schizophrenia and psychotic disorders Flashcards
What are the risk factors for schizophrenia?
family history of schizophrenia
substance misuse
migration
increasing maternal age
obstetric complications
in what sex and age of onset schizophrenia most common?
M = F
15-35 years
what are the negative symptoms of schizophrenia?
anhedonia
apathy
alogia (reduction in quantitative and qualitative speech)
asociality (redued motivation to engage in social interaction)
avolition (reduced motivation to perform meaningful tasks)
what are the positive symptoms of schizophrenia?
hallucinations
delusions
disordered thinking
how would you manage a patient with psychosis with extreme agitation or violence?
i/m antipsychotic
i/m lorazepam
what is the treatment for treatment resistant schizophrenia?
clozapine
what treatment would you give a patient who didn’t respond to clozapine?
dozapine + lamotrigine
what psychological therapies can be offered for schizophrenia?
CBT
cognitive remediation
family therapy
what are the good prognostic indicators for schizophrenia?
negative FHx acute onset of psychosis good premorbid personality - stable relationships, stable personality prompt treatment maintenance of initiative and motivation
what are the poor prognostic indicators for schizophrenia?
positive FHx
chronic, insidious, slow onset of psychosis
presentation at young age
what are 4 main diagnostic features of schizophrenia?
persistant delusions
delusions of passivity, influence and control
alienation of thought i.e. thought broadcasting, thought insertion or withdrawal
hallucinatory voices
what is the definition of a delusion?
an unshakable idea or belief that it outwit the persons social or cultural norm and is held with strong content
what is the definition of a hallucination?
a perception in the absence of a stimulus
what is an illusion?
an abnormal perception in the presence of a stimulus
how do you differentiate schizophrenia from other psychotic disorders?
presence of negative symptoms
what is a nihilistic delusion?
an unshakable belief that something (including ones self) isn’t real and is held with strong content
what is the term for unable to communicate through writing?
agraphia
what is the term for difficulty or inability to learn arithmetic?
dyscalculia
what is a delusional perception?
a true perception to which a person attributes a false meaning
i.e. seeing the lights turn red mean you are going to be the next queen
what is confabulation?
a memory error in which made up stories fill in gaps in memory
results in fabricated, distorted or misinterpreted memories of ones self or the world
a patient describes that when he was in the shop it was the shopkeeper that was making his leg feel like pins and needles.
what is this termed as?
somatic passivity
a patient describes that his impulsions to tidy are driven by the neighbours.
what is this termed as?
passivity phenomena
what are differential diagnoses of schizophrenia?
major depressive disorder schizoaffective disorder drug intoxication tumour, cerebral infection, epilepsy thyroid, bushings, chronic hypoglycaemia, addisons anaemia, carcinoid delirium
what are examples of disordered thinking in schizophrenia?
thought blocking
illogicality
perservation of speech - repetition of a word or phrase
tangentiality - tendency to speak about topics that are unrelated to the topic of conversation
schizophasia - confused mixture of unrelating words or phrases
