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Psychiatry > Schizophrenia And Psychotic Related Diaorders > Flashcards

Schizophrenia And Psychotic Related Diaorders Flashcards

1
Q

Define Psychosis

A

The inability to diatinguish fantasy from reality
Impaired reality testing with the creation of a new reality

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2
Q

Common manifestation in Schisophrenia and other psychotic related disorder dx class

A

Psychosis

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3
Q

Does cannabis (weed) increase risk of developing psychotic disorders?

A

Yes

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4
Q

Name disorders under Schizophrenia and other psychotic related disorders dx class in DSM 5

A

Schizophrenia
Delusional disorder
Brief psychotic disorder
Schizophreniform disorder
Schizoaffective disorder
Schizotypal personality disorder

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5
Q

Name other disorders under Schizophrenia and other psychotic related disorders dx class in DSM 5

A

Substance abd medication related psychotic disorder
Pssychotic disorders due to other medical condition
Catatonic diorder due to medical cause
Unspecified catatonia
Other specified schizophrenia spectrum and other psychotic disorder
Unspecified schizophrenia spectrum and other psychotic disorder

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6
Q

What is schizophrenia?

A

Mental disorder characterized by disintegration of thought processes and of emotional responsiveness
Brain disorder that affects how people think, feel and perceive

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7
Q

“Schizo”

A

Fragment or split”

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8
Q

“Phrenia”

A

Mind

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9
Q

Schizophrenia prevalence ratio in males to females

A

1:1 (0.3-0.7)

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10
Q

Schizophrenia mean age of onset in females

A

21-30 yrs

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11
Q

Schizophrenia mean age of onset in males

A

18-25 yrs

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12
Q

What are the 3 phases of Schizophrenia

A
  1. Prodormal
  2. Acute
  3. Residual
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13
Q

Describe prodormal phase of Schizophrenia

A

Lasts weeks,months or even years
Sx - loss of interest in usual persuit
- pull away from family
- easily confused
- trouble concentrating
- lethargy
- apathetic
- prefer spending time alone

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14
Q

Describe the Acute phase of Schizophrenia

A

Sx - acute psychotic episode
- negative and positive sx of Schizophrenia
- positive sx > than negative sx

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15
Q

Describe the residual phase of Schizophrenia

A

Sx similar to those in prodormal phase
- reduced positive sx
- negative sx persist
- Improved cognitive functioning
-patient is aware of their strange beliefs

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16
Q

Etiology of Schizophrenia

A

Genetic
Neurochemistry
Neuroanatomy
Neuroendocrinology
Neuropsychilogy
Enviromental

17
Q

Genetic cause of Schizophrenia

A

Dysbindin (Chrm 6p), neurogulin(8p) and G72 (13q) are found to be susceptible

18
Q

Chances of schizophrenia when sibling has it

A

10%

19
Q

Chances of Schizophrenia when one parent has it

A

5%

20
Q

Chances of Schizophrenia in monozygotic twin when the other twin has it (concordance)

A

46%

21
Q

Chances of Schizophrenia in dizygotic twin when the other twin has it (concordance)

A

14%

22
Q

Neurochemistry cause of Schizophrenia (dopamine hypothesis)

A

Excessive activity in mesolimbic dopamine pathway precipitates positive sx of psychosis

Decreased dopamine in the frontal cortex may mediate negative and cognitive sx of Schizophrenia

23
Q

Neuroanatomy causes of Schizophrenia

A

Enlarged lateral ventricles
Smaller brain volume
Cortical atrophy (brain shrinking)
Widening of third ventricle
Smaller hippocampus

24
Q

Neuroendocrine causes of Schizophrenia

A

Abnormal growth hormone
Abnormal cortisol
Abnormal prolactin

25
Q

Neuropsychological cause of Schizophrenia

A

Global defects in attention, language and memory
Suggesting disrupted connectivity of neural pathways

26
Q

Environmental causes of Schizophrenia

A

Drug use
Cannabis increases chances of getting Schizophrenia
Geographical variance
Winter season of birth (suggesting perinatal/prenatal exposure of child to certain microorganisms
Obstetrics complications

27
Q

What are the clinical features of Schizophrenia

A

Positive sx - hallucinations
- delusions

Negative sx - avolition (lack of motivation)
- alogia (poverty of speech)
- flattened affect
- anhedonia (inability to experience pleasurable activities)
- Asociality (lacking capacity for social interactions)

Cognitive sx - disorganized dimension
- thought disorder (thought form and content)
- disorganized behaviour (catatonic behaviour)

Other sx - lack insight
- memory problems
- attention problems
- disturbances in sleep and sexual interest

28
Q

Schneider’s first rank sx of Schizophrenia

A
  • Delusional perception
  • 3rd person auditory hallucinations (2 voices speaking in patients head)
  • Thought interference
  • Passivity phenomenon
29
Q

What are the different typea of Schizophrenia

A
  1. Paranoid type
  2. Disorganized type
  3. Catatonic type
  4. Undifferent type
  5. Residual type
  6. Post schizophrenic depression
  7. Simple schizophrenia
30
Q

The DSM 5 dx criteria of Schizophrenia

A
31
Q

Specifiers - severity of Schizophrenia

A

Eaxh sx may be rated for uts current severity in the last 7 days on a 5 point scale

0 - not present
1 - present
2 - present but mild
3 - present and moderate
4 - present and severe

32
Q

How do you manage Schizophrenia

A

** Biological tx**
Acute tx - Antipsychotics
- 1st Line
(1st generation Antipsychotics Haloperidol)
( 2nd generation Antipsychotics Risperidone and Olanzapine)
- 2nd Line
(Clozapine)

Maintanance Therapy
- Initial episode - treat for 1 - 2 years because there is high risk of relapse
- Multiple episodes - treat for 5 years

Adjunctive
- Mood stabilizers for aggression / impulsiveness- lithium, valproate and carbamazepine
- Anxiolytics Benzodiazepines with or w/o ECT
- Antidepressants - for depression
- Electroconvulsive Therapy (ECT)
- for concurrent depression and catatonic sx

33
Q

Schizophrenia psychological intervention

A

CBT
Supportive therapy - group or family
Assertive Community Treatment
- help with medication adherence
- basic living skills
- social support
- job placement and resources
- social skills training
- vocational rehabilitation
- disability benefits
-appropriate housing

Psychiatry (14 decks)

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