Schizophrenia and Psychotic Disorders

Question 1

Two presenting symptoms of a psychotic disorder

Answer 1

Hallucinations

Delusions

Question 2

Define Hallucination

Answer 2

Full force and clarity of a true perception located within external space without external stimulus

‘Perception without stimulus’

Question 3

Define delusion

Answer 3

False, fixed, unshakeable belief
Out of keeping with social, cultural background
Extraordinary conviction

Question 4

Give two examples of delusion

Answer 4

Grandiose

Hypochondriasis

Question 5

Name three illness with psychotic symptoms

Answer 5

Schizophrenia
Delirium
Severe Affective Disorder

Question 6

Schizophrenia is common to which age group

Answer 6

15-35 year olds

Question 7

Positive symptoms for schizophrenia

Answer 7

Hallucination
Delusion
Disordered Thinking

Question 8

Negative symptoms of schizophrenia

Answer 8

Apathy
Lack of interest
Lack of emotion

Question 9

ICD 10 classification of schizophrenia

Answer 9

Symptoms for more than 1 month
Absence of affective/organic disorder
One from additional symptoms a-d
2 from symptoms e-h

Question 10

Additional symptoms a-d in ICD10 classification of schizophrenia

Answer 10

a) Alteration of thought
b) Delusions of control
c) Hallucinatory voices
d) Persistent delusions that are culturally inappropriate

Question 11

Additional symptoms e-h in ICD10 Classification of schizophrenia

Answer 11

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

Question 12

4 presentations of alteration of thought

Answer 12

Echo
Insertion
Withdrawal
Broadcasting

Question 13

Explain what is meant by delusions of control

Answer 13

Influence/passivity
Body or limb movement actions/sensations
Delusional perceptions

Question 14

How may neologism/breaks in thought present?

Answer 14

Incoherence

Irrelevant speech

Question 15

6 examples of catatonic behaviour

Answer 15

Excitement
Posturing
Waxy flexibility
Negativism
Mutism
Stupor

Question 16

4 aspects of aetiology of psychosis

Answer 16

Biological
Psychological
Social
Evolutionary

Question 17

Which biological factors can increase the risk of schizophrenia

Answer 17

Obstetric complications
Maternal influenza
Malnutrition
Winter birth
Substance misuse- cannabis

Question 18

Which social factors may increase the risk of schizophrenia?

Answer 18

Migration
Social isolation
Major life events
Occupation
Social class

Question 19

How can High Expressed Emotion be targeted?

Answer 19

Family therapy

Question 20

Differentials for schizophrenia

Answer 20

Delirium/Acute Organic Brain Syndrome
Affective disorders
Schizoaffective disorder

Question 21

Which Sign Guidance is used for management of schizophrenia?

Answer 21

SIGN 131

Question 22

How is schizophrenia managed?

Answer 22

Antipsychotics

2 weeks if first episode
Recurrence- 4 weeks with follow-up

Maintenance antipsychotic - amisulpride, olanzapine, risperidone - minimum 2 years

CBT

Question 23

What can be used in treatment-resistant schizophrenia?

Answer 23

Clozapine

Question 24

Adverse effects of antipsychotics

Answer 24

Weight gain
Sedation
Tardive dyskinesia

Question 25

What percentage of patients with schizophrenia will recover from first episode?

Answer 25

80%

Question 26

4 factors that indicate a good prognosis

Answer 26

Absence of family history
Good premorbid function
Clear precipitation
Acute onset

Question 27

Poor indicators and risk factors in schizophrenia

Answer 27

Slow onset
Negative symptoms

CVD, Resp disease and Cancer
Suicide risk and death from violent incidents
Substance misuse

Starts in childhood