Schizophrenia Case Study

Question 1

What is psychosis ?

Answer 1

Associated with significant alterations to a persons perception, thoughts, mood and behaviours

Question 2

What are the two categories of symptoms associated with someone experiencing psychosis ?

Answer 2

Positive symptoms

Negative symptoms

Question 3

Give examples of positive symptoms

Answer 3

Disorganised behaviour

Disorganised speech

Thought disturbances

Delusions (fixed or falsely held beliefs)

Hallucinations (perceptions in the absence of stimulus)

Question 4

Give examples of negative symptoms

Answer 4

Emotional blurting

Reduced speech

Loss of motion

Self neglect

Social withdrawal

Question 5

What is the most common psychotic disorder ?

Answer 5

Schizophrenia

Question 6

What can psychosis be caused by ?

Answer 6

Certain medication

Substance misuse

Sepsis

Question 7

What complications can arise in psychotic disorders ?

Answer 7

Increased of premature death due to suicide, cardiovascular disease and type 2 diabetes

Difficulties in social functioning

Substance misuse

Question 8

What is the classification system of schizophrenia called ?

Answer 8

ICD-10

Question 9

What does ICD-10 stand for ?

Answer 9

International classification of Disease

10 because its the 10th version

it classify a range of diseases

Question 10

What does the classification system allow for ?

Answer 10

The systematic recording, analysis, interpretation, and comparison of mortality and morbidity data collected in different countries or regions at different times

It also ensures the reusability of recorded data from the different use cases beyond mere health statistics, including decision support, resource allocations, reimbursement, guidelines and more

Question 11

What is the 136 suite ?

Answer 11

Police are able to take you to a hospital or police station if you are in a public place and of serious risk of harming yourself or others

Question 12

What is section 136 of the mental health act ?

Answer 12

The police can detain you under this section due to the concern that you have a mental health disorder and should be seen by a health care processional.

Police think that they need immediate care

Question 13

How long can you be detained under the mental health act section 136 for ?

Answer 13

up to 24 hours

Extendable for up to 12 hours if you can not be assessed from clinical reasons

Question 14

When are you free to leave if a doctor or health professional has not seen you ?

Answer 14

After 24 hours (or 36 hours) if a doctor has not seen you

Question 15

What is first person auditory hallucinations ?

Answer 15

Patient hears their own thoughts spoken out load as they think them

Question 16

What is second person auditory hallucinations ?

Answer 16

Patients hear voice, or voices, taking directly to them

Second person hallucinations can be persecutory, highly critical, complimentary or issue commands to the patient (command hallucination).

These kind of hallucinations can often be mood-congruent i.e. a patient with low mood will more often experience hallucinations of a persecutory or critical nature, and similarly a patient with an elevated mood will more often experience hallucinations of a complimentary nature.

Question 17

What is third person auditory hallucinations ?

Answer 17

Patients hear a voice or voices speaking about them, referring to them in the third person.

This may take the form of two or more voices arguing or discussing the patient among themselves; or one or more voices giving a running commentary on the patient’s thoughts or actions.

Question 18

What is procyclidine used for

Answer 18

Extrapyidamol side effects associated with antiphycotoc medicinal side effects

Question 19

What are examples of extrapyridamol side effects

Answer 19

Pseudo-parkinsonism (tremour and/or rigidity)

Tardive dyskinesia (abnormal movements)

Akathisia (restlesssness)

Dystonia

Question 20

When are long-acting antipsychotic injections (LAI) AKA depot considered and why?

Answer 20

LAI can be prescribed to ensure that a patient received their medication.

They are considered fro patients who relapse due to non-compliance to their medication

Question 21

What are the two options for LAIs ?

Answer 21

Risperidone consta LAI

Paliperidone palmitate LAI

Question 22

What is Risperidone consta LAI used ?

Answer 22

Risperdal Consta is intended for patients who are currently treated with oral (e.g. tablets, capsules)
antipsychotics.

Question 23

When is Paliperidone used ?

Answer 23

Xeplion can help alleviate the symptoms of your disease and stop your symptoms from coming back.

Question 24

What is schizophrenia ?

Answer 24

Schizophrenia is a disease with “positive” and “negative” symptoms. Positive means an excess of
symptoms that are not normally present. For example, a person with schizophrenia may hear voices or
see things that are not there (called hallucinations), believe things that are not true (called delusions),
or feel unusually suspicious of others. Negative means a lack of behaviours or feelings that are
normally present. For example, a person with schizophrenia may appear withdrawn and may not
respond at all emotionally or may have trouble speaking in a clear and logical way. People with this
disease may also feel depressed, anxious, guilty, or tense

Question 25

Are risperidone consta LAI and Paliperidone palmitate LA suitable if a aptient is taking risperidone ?

Answer 25

yes

This is because one of the LAI’s is risperidone in an injection forumlation and the other (paliperidone) is the main active metabolite of risperidone, and therefore is very similar to risperidone

Question 26

What are some of the aims of the community mental health team ?

Answer 26

Collaboration - working with patients, carers, family and partner organisations towards discharge from the service as safely, quickly and effectively as possible.

Recovery - enabling patients to live a meaningful life in the presence or absence of symptoms and as defined by the individual.

Self management - enabling individuals to successfully manage their illness / condition.

Trauma-informed - recognising the impact of traumatic experiences on individuals, and providing appropriate response.

Positive risk taking - involving shared decision making, personalised care, minimising variation in practice and outcomes, effective risk management within realistic expectations.