Schizophrenia and psychotic disorders

Question 1

What are the risk factors for schizophrenia?

Answer 1

family history of schizophrenia
substance misuse

migration
increasing maternal age
obstetric complications

Question 2

in what sex and age of onset schizophrenia most common?

Answer 2

M = F

15-35 years

Question 3

what are the negative symptoms of schizophrenia?

Answer 3

anhedonia
apathy
alogia (reduction in quantitative and qualitative speech)
asociality (redued motivation to engage in social interaction)
avolition (reduced motivation to perform meaningful tasks)

Question 4

what are the positive symptoms of schizophrenia?

Answer 4

hallucinations
delusions
disordered thinking

Question 5

how would you manage a patient with psychosis with extreme agitation or violence?

Answer 5

i/m antipsychotic

i/m lorazepam

Question 6

what is the treatment for treatment resistant schizophrenia?

Answer 6

clozapine

Question 7

what treatment would you give a patient who didn’t respond to clozapine?

Answer 7

dozapine + lamotrigine

Question 8

what psychological therapies can be offered for schizophrenia?

Answer 8

CBT
cognitive remediation
family therapy

Question 9

what are the good prognostic indicators for schizophrenia?

Answer 9

negative FHx
acute onset of psychosis 
good premorbid personality - stable relationships, stable personality
prompt treatment
maintenance of initiative and motivation

Question 10

what are the poor prognostic indicators for schizophrenia?

Answer 10

positive FHx
chronic, insidious, slow onset of psychosis
presentation at young age

Question 11

what are 4 main diagnostic features of schizophrenia?

Answer 11

persistant delusions

delusions of passivity, influence and control

alienation of thought i.e. thought broadcasting, thought insertion or withdrawal

hallucinatory voices

Question 12

what is the definition of a delusion?

Answer 12

an unshakable idea or belief that it outwit the persons social or cultural norm and is held with strong content

Question 13

what is the definition of a hallucination?

Answer 13

a perception in the absence of a stimulus

Question 14

what is an illusion?

Answer 14

an abnormal perception in the presence of a stimulus

Question 15

how do you differentiate schizophrenia from other psychotic disorders?

Answer 15

presence of negative symptoms

Question 16

what is a nihilistic delusion?

Answer 16

an unshakable belief that something (including ones self) isn’t real and is held with strong content

Question 17

what is the term for unable to communicate through writing?

Answer 17

agraphia

Question 18

what is the term for difficulty or inability to learn arithmetic?

Answer 18

dyscalculia

Question 19

what is a delusional perception?

Answer 19

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

Question 20

what is confabulation?

Answer 20

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

Question 21

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?

Answer 21

somatic passivity

Question 22

a patient describes that his impulsions to tidy are driven by the neighbours.
what is this termed as?

Answer 22

passivity phenomena

Question 23

what are differential diagnoses of schizophrenia?

Answer 23

major depressive disorder 
schizoaffective disorder
drug intoxication 
tumour, cerebral infection, epilepsy 
thyroid, bushings, chronic hypoglycaemia, addisons 
anaemia, carcinoid 
delirium

Question 24

what are examples of disordered thinking in schizophrenia?

Answer 24

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