Schizophrenia and psychotic illness Flashcards
What is the main condition that presents with psychosis?
Schizophrenia
What is psychosis?
The inability to distinguish:
Delusions
Hallucination
Disordered thinking
From reality.
+ lack of insight.
What does psychosis in an illness mean?
The illness is at its most severe.
What is schizophrenia?
A form of psychosis that can be relapsing or remitting.
What are the risk factors for schizophrenia?
What are the risk factors for schizophrenia?
Family history Traumatic event in childhood Chronic cannabis use immigrant population DiGeorge syndrome Malnutrition Winter birth Substance misuse
What are the positive symptoms of schizophrenia?
Delusion - outside control or reference Hallucination Disorganised speech Catatonic behaviour Disorganised behaviour
What are the negative symptoms of schizophrenia?
Lack of apathy Lack of emotion Avolition (lack of motivation) Alogia (poverty of speech) Anhedonia
What are the types of thought disorder?
Insertion - thoughts coming into your head that aren’t yours
Withdrawal - thoughts being removed from you head
Broadcasting - thinking others can hear your thoughts
Is schizophrenia more common in men or women?
Both the same. Males present earlier.
Males - 28yrs
Females- 32yrs.
What are the cognitive symptoms of schizophrenia?
Inability to:
Understand
remember
learn
^VERY subtle.
How do most antipsychotic medications work?
By blocking dopamine.
What are the types of auditory hallucinations?
Echo
Command
Running commentary
What is the 25% rule?
25% of people never have another episode
25% are treatment resistant
25% have some improvement with medication
25% have a big improvement on medication
What are the main types of delusion?
Grandiose
Paranoid/persecutory
Hypochondrial
Self referential
What is the ICD10 criteria?
At least 1 of:
- Alienation of thought (echo, insertion, withdrawal or broadcasting).
- Delusion of control or influence (someone else is controlling them)
- Auditory Hallucination
- Persistent delusion of other kinds
OR 2 of:
- Hallucination of any sense
- Breaks in train of thought (incoherent or irrelevant speech)
- catatonic behaviour
- Negative symptoms (apathy, speech, emotion).
What are catatonic behaviours?
Excitement
Posturing or waxy flexibility
Negativism
Stupor.
How long must symptoms be present for to diagnose schizophrenia?
At least 1 month
What is the most common subtype of schizophrenia?
Paranoid schizophrenia.
What is the most common subtype of schizophrenia?
Paranoid schizophrenia.
What is a common neurological abnormality seen in schizophrenia?
Abnormal eye movement.
What is schizoaffective disorder?
A mix of affective and schizophrenic like features.
How long should antipsychotics be continued for after 1st episode?
At least 2 years.
When are females at risk of relapse?
In the post partum period.
Which medication is given if the patient is treatment resistant?
Clozapine
What indicates a better prognosis?
Higher IQ Sudden onset Clear precipitating factor Strong support network Absent family history Good premorbid state Prompt treatment POSITIVE FEATURES ARE PREDOMINANT
What indicates a poorer prognosis?
Negative features predominant
Slow onset
No identifiable precipitating cause
Younger onset
How high is the risk of suicide in schizophrenic patients?
9x higher than general population.
