Schizophrenia - Burton Flashcards
Schneider’s first rank symptoms of schizophrenia?
Auditory hallucinations - Third person, running commentary, thought echo
Delusions of thought control - Thought insertion, thought withdrawal, thought broadcasting
Delusions of control - Passivity of affect, volition and impulses, somatic passivity
Delusional perception
What is passivity of volition, affect and impulses?
The patient’s volition, affect, and impulses are under the control of an external agency.
What is somatic passivity?
The patient’s bodily sensations are under the control of an external agency?
What is delusional perception?
The patient attributes delusional significance to normal percepts.
What are the three groups of symptoms present in schizophrenia?
Positive symptoms
Disorganised symptoms
Negative symptoms
What are the positive symptoms of schizophrenia?
Delusions
Hallucinations
What are the disorganised symptoms of schizophrenia?
Disorganised thinking/speech
Disorganised behavious
Inappropriate affect
What are the negative symptoms of schizophrenia? (7 A’s)
Affective flattening Apathy Avolition (poverty of motivation) Anergia Anhedonia Alogia (poverty of speech) Asociality Attentional impairment
What symptoms are prominent in the acute phase of schizophrenia?
Positive symptoms come to the fore, whereas cognitive and negative symptoms sink into the background. Antipsychotic started at this point.
In some cases onset of schizophrenia can be preceded by what phase and what are the symptoms?
Prodromal phase
Subtle and non-specific abnormalities or oddities in language, cognition, and behaviour that may be mistaken for depression or normal teen behaviour, associated with loss of function.
As the acute phase remits the chronic phase starts, what symptoms are present here?
Cognitive and negative symptoms start to dominate the picture. Can last for a period of several months or even several years.
This phase may be punctuated with relapses into a state resembling the acute phase.
What can cause relapses into a state resembling the acute phase from the chronic phase?
Sudden reduction or discontinuation of antipsychotic medication, substance misuse, or a stressful life event.
There may be no identifiable triggers in some cases.
How long should you have schizophrenic symptoms for a diagnosis of schizophrenia and what would we describe it as if it were less?
Symptoms should have been present for most of the time during a period of one month or more.
If present for less than one month, a diagnosis of acute schizophrenia-like psychotic disorder should be made.
What are the symptoms of schizophrenia in the ICD 10?
A) Thought echo, thought insertion or withdrawal, thought broadcasting.
B) Delusions of control, influence, passivity; delusional perception.
C) Hallucinatory voices of running commentary, third-person discussion, or other types of voices coming from some part of the body.
D) Persistent delusions of other kinds that are culturally inappropriate and completely impossible.
E) Persistent hallucinations in any modality if accompanied by fleeting or half-formed delusions that are not affective delusions, or by persistent over-valued ideas, or if occurring every day for months on end.
F) Breaks in the train of thought resulting in incoherence, irrelevant speech, or neologisms.
G) Catatonic behaviour such as excitement, posturing, waxy flexibility, negativism, mutism, and stupor.
H) Negative symptoms.
I) Significant and consistent change in overall quality of some aspects of personal behaviour, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude, and social withdrawal.
How many of the ICD 10 symptoms do you need to have to make a diagnosis of schizophrenia?
A minimum of one very clear symptom (and usually two or more if symptoms are less clear-cut) from groups (A) to (D)
Or symptoms from at least two of the groups (E) to (I)
What are the 7 different types of schizophrenia?
Paranoid schizophrenia Hebephrenic schizophrenia Catatonic shizophrenia Undifferentiated schizophrenia Post-schizophrenic depression Residual schizophrenia Simple schizophrenia
What is paranoid schizophrenia, what is the onset?
The commonest type. Stable, often paranoid, delusions, usually accompanied by hallucinations and perceptual disturbances. Onset tends to be later than hebephrenic or catatonic schizophrenia, and the course may be either episodic or chronic.
What is hebephrenic schizophrenia what is the onset?
Marked by prominent affective changes. Mood is inappropriate and often accompanied by giggling or self-satisfied, self-absorbed smiling, or by a lofty manner, grimaces, mannerisms, prank, hypochondriacal complaints, and reiterated phrases.
Thought is disorganised and speech rambling and incoherent. Behaviour is characteristically aimless and empty of purpose.
Normally diagnosed for the first time in adolescents or young adults, and has a poor prognosis owing to rapid development of negative symptoms.
What is catatonic schizophrenia?
Diagnosed in the presence of prominent psychomotor disturbances that may alternate between extremes such as hyperkinesis and stupor, and automatic obedience and negativism.
What is undifferentiated schizophrenia?
Conditions that meet the general diagnostic criteria for schizophrenia but don’t conform to any of the above subtypes, or exhibiting features of more than one of them without any predominating.
What is post-schizophrenic depression?
Diagnosis can only be made if the patient had a schizophrenic illness in the past 12 months, and if some schizophrenic symptoms are still present although no longer dominating the clinical picture. Depressive symptoms must independently fulfil the diagnostic criteria for a depressive episode.
What is residual schizophrenia?
For a diagnosis, must have been a clear progression from an early stage (of one or more episodes with psychotic symptoms that meet the general criteria for schizophrenia) to a later stage characterised by long-term negative symptoms.
This later stage should already have lasted for at least one year, and conditions such as dementia, chronic depression, or institutionalisation should have been excluded.
What is simple schizophrenia?
Characterised by the insidious but progressive development of oddities of conduct, an inability to meet the demands of society, and a decline in total performance. The characteristic negative symptoms of residual schizophrenia develop without being preceded by over positive or psychotic symptoms.
Which of the different types of schizophrenia tend to be dominated by positive symptoms, which by negative symptoms and which by disorganised symptoms?
Positive – Paranoid
Negative – Simple
Disorganised – Hebephrenic
