Schizophrenia and Psychotic Disorders Flashcards
Two presenting symptoms of a psychotic disorder
Hallucinations
Delusions
Define Hallucination
Full force and clarity of a true perception located within external space without external stimulus
‘Perception without stimulus’
Define delusion
False, fixed, unshakeable belief
Out of keeping with social, cultural background
Extraordinary conviction
Give two examples of delusion
Grandiose
Hypochondriasis
Name three illness with psychotic symptoms
Schizophrenia
Delirium
Severe Affective Disorder
Schizophrenia is common to which age group
15-35 year olds
Positive symptoms for schizophrenia
Hallucination
Delusion
Disordered Thinking
Negative symptoms of schizophrenia
Apathy
Lack of interest
Lack of emotion
ICD 10 classification of schizophrenia
Symptoms for more than 1 month
Absence of affective/organic disorder
One from additional symptoms a-d
2 from symptoms e-h
Additional symptoms a-d in ICD10 classification of schizophrenia
a) Alteration of thought
b) Delusions of control
c) Hallucinatory voices
d) Persistent delusions that are culturally inappropriate
Additional symptoms e-h in ICD10 Classification of schizophrenia
e) Persistent hallucinations every day for 1 month
f) Neologisms/breaks/interpolations in train of thought
g) Catatonic behaviour
h) Negative symptoms - paucity of speech, blunting, incongruity of emotional responses
4 presentations of alteration of thought
Echo
Insertion
Withdrawal
Broadcasting
Explain what is meant by delusions of control
Influence/passivity
Body or limb movement actions/sensations
Delusional perceptions
How may neologism/breaks in thought present?
Incoherence
Irrelevant speech
6 examples of catatonic behaviour
Excitement Posturing Waxy flexibility Negativism Mutism Stupor
4 aspects of aetiology of psychosis
Biological
Psychological
Social
Evolutionary
Which biological factors can increase the risk of schizophrenia
Obstetric complications Maternal influenza Malnutrition Winter birth Substance misuse- cannabis
Which social factors may increase the risk of schizophrenia?
Migration Social isolation Major life events Occupation Social class
How can High Expressed Emotion be targeted?
Family therapy
Differentials for schizophrenia
Delirium/Acute Organic Brain Syndrome
Affective disorders
Schizoaffective disorder
Which Sign Guidance is used for management of schizophrenia?
SIGN 131
How is schizophrenia managed?
Antipsychotics
2 weeks if first episode
Recurrence- 4 weeks with follow-up
Maintenance antipsychotic - amisulpride, olanzapine, risperidone - minimum 2 years
CBT
What can be used in treatment-resistant schizophrenia?
Clozapine
Adverse effects of antipsychotics
Weight gain
Sedation
Tardive dyskinesia
What percentage of patients with schizophrenia will recover from first episode?
80%
4 factors that indicate a good prognosis
Absence of family history
Good premorbid function
Clear precipitation
Acute onset
Poor indicators and risk factors in schizophrenia
Slow onset
Negative symptoms
CVD, Resp disease and Cancer
Suicide risk and death from violent incidents
Substance misuse
Starts in childhood
