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Psychiatry > Schizophrenia and Psychotic Disorders > Flashcards

Schizophrenia and Psychotic Disorders Flashcards

1
Q

What is Schizophrenia?

A

Severe mental illness characterised by fundamental distortions of thinking, perception, emotion and behaviour

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2
Q

Describe the pathphysiology of schizophrenia

A

Unknown, dopamine hypothesis

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3
Q

What gender does schizophrenia effect more?

A

M=F although males tend to present earlier

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4
Q

What is the typical age of onset of schizophrenia?

A

15-35 years

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5
Q

What are the causes of schizophrenia?

A

Genetics/FH

Adverse/traumatic life event

Obstetric complications

Maternal influenza

Malnutrition and famine

Winter birth

Cannabis use, can’t cause schizophrenia but can modify the course of established illness

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6
Q

What are the good prognostic factors for schizophrenia?

A

Absence of family members

Good premorbid function: Stable personality and relationships

Clear precipitant

Acute onset

Late onset

Mood disturbance

Prompt treatment

Maintenance of initiative and motivation

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7
Q

What are the poor prognostic factors for schizophrenia?

A

Slow, insidious onset

Childhood onset

Prominent negative symptoms

FH

Prodromal phase of social withdrawal

Low IQ

Lack of obvious precipitant

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8
Q

What are the main symptoms of schizophrenia, according to ICD-10?

A

At least one of the following, for more than a month:

Alienation of thought

Delusions of control, influence or passivity

Hallucinatory voices

Persistent delusions

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9
Q

What are the types of alienation of thought?

A

Thought echo: Hears own thoughts out loud

Insertion: Feels someone else put thoughts in their head

Withdrawal: Feels thoughts are being stolen from head

Broadcasting: Feels that other people can hear their thoughts

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10
Q

What are the secondary symptoms of schizophrenia, according to ICD-10?

A

At least two of the following, for more than a month:

Persistent hallucinations

Speech symptoms, such as neologisms, alogia, incoherent or irrelevant speech

Catatonic behaviour

Negative symptoms

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11
Q

Give examples of negative symptoms

A

Marked apathy

Anhedonia

Poverty of speech/Alogia

Blunting

Withdrawal

Incongruity of emotional responses

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12
Q

What is incongruity?

A

There is an unpredictable and contradictory emotional response to events

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13
Q

Give examples of catatonic behaviour

A

Excitement

Posturing or waxy flexibility

Negativism

Mutism

Stupor

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14
Q

What are Schnyder’s first rank symptoms?

A

Delusions of thought alienation: Withdrawal, insertion, broadcasting

Auditory third person hallucinations

Passivity Phenomena: Delusions of control

Somatic passivity: Physical sensations

Delusional perception

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15
Q

How is schizophrenia managed?

A

Anti-psychotics: 6-8 week trial of each drug

Psychological interventions

Early intervention services/social services

Perinatal care

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16
Q

What class of anti-psychotics are first line in schizophrenia management?

A

Atypical

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17
Q

Give examples of atypical anti-psychotics

A

Olanzapine

Quetiapine

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18
Q

What anti-psychotic is given to treatment resistant schizophrenia?

A

Clozapine

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19
Q

What psychological interventions are used in schizophrenia management?

A

Social skills training

CBT

Cognitive remediation

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20
Q

What issues to early intervention services address in schizophrenia management?

A

Address substance abuse

Social skills training

Employment

Housing

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21
Q

Why is perinatal care essential in schizophrenia management?

A

Anti-psychotics are teratogenic

High risk of relapse in post-partum

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22
Q

What is psychosis?

A

Represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality (lack of insight)

23
Q

What 4 factors define a hallucination?

A

Have the full force and clarity of true perception, whereas illusions you are fully aware it is not real

Located in external space

No external stimulus, whereas illusions there is external stimuli making it look like something it is not

Not willed or controlled

24
Q

What are second person hallucinations?

A

1 person is speaking to you, more likely with depression or personality disorder

25
Q

What are third person hallucinations?

A

2 people speaking to each other, commentary, more likely in psychosis

26
Q

What are pseudohallucinations?

A

Recognised by the patient as not real

27
Q

What are hypnopompic hallucinations?

A

Occur as the individual awakes

28
Q

What are hypnogogic hallucinations?

A

Occur when an individual is falling asleep

29
Q

What are reflex hallucinations?

A

Occurs when a true sensory stimulus causes a hallucination in another sensory modality

30
Q

What are Lilliputian hallucinations?

A

Visual hallucinations associated with micropsia, often occur in patients suffering from delirium

31
Q

What are Xanthopsia hallucinations?

A

Describes visual perceptions that are predominantly yellow

32
Q

What are illusions?

A

a misinterpretation of real/external stimulus

33
Q

What is a delusion?

A

Unshakeable idea or belief which is out of keeping with the person’s social and cultural background, it is held with extraordinary conviction

34
Q

What are grandiose delusions?

A

Expansive delusions where the person believes they are related to a higher figure or of extreme importance

35
Q

What are Erotomaniac delusions?

A

Delusions of love

36
Q

What are Nihilistic delusions?

A

Exaggerated form of negative thinking in which individual thinks they are dying or the world is ending

37
Q

Give differential diagnoses of schizophrenia

A

Anaemia

Sarcoidosis

Cushing’s

Stroke

Epilepsy

38
Q

How does FH affect scizophrenia epidemiology?

A

Although only 1 in 100 people get schizophrenia, about 1 in 10 people with schizophrenia have a parent with the illness

If one identical twin has schizophrenia, the other has a 50:50 chance of having it

39
Q

What drugs can cause psychosis?

A

Corticosteroids

40
Q

What is word salad?

A

Disorganised speech, sentences that do not make sense

41
Q

What is alogia?

A

Little information conveyed by speech

42
Q

What is tangentiality?

A

Wandering from a topic without returning to it

Can’t keep to a thought

43
Q

What is Circumstantiality?

A

The inability to answer a question without giving excessive, unnecessary detail

However, this differs from tangentiality in that the person does eventually return the original point

44
Q

What are neoligisms?

A

New word formations, which might include the combining of two words

45
Q

What are clang associations?

A

When ideas are related to each other only by the fact they sound similar or rhyme

46
Q

What is knight’s move thinking/derailment?

A

Severe type of loosening of associations, where there are unexpected and illogical leaps from one idea to another

47
Q

What is perseveration?

A

The repetition of ideas or words despite an attempt to change the topic.

48
Q

What is echolalia?

A

The repetition of someone else’s speech, including the question that was asked

49
Q

What is somatisation disorder?

A

Multiple physical symptoms present for at least 2 years, in which patient refuses to accept reassurance or negative test results

50
Q

What is conversion disorder?

A

Typically involves loss of motor or sensory function in which the patient doesn’t consciously feign the symptoms (factitious disorder) or seek material gain (malingering)

51
Q

What is dissociative disorder?

A

Process of ‘separating off’ certain memories from normal consciousness

52
Q

What is factitious disorder?

A

Also known as Munchausen’s syndrome, is the intentional production of physical or psychological symptoms

53
Q

What is malingering?

A

Fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain

Psychiatry (11 decks)

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