Schizophrenia & psychotic disorders Flashcards
What is meant by positive and negative symptoms of schizophrenia?
Positive symptoms - Symptoms which the general population usually never experience, but are common in a person with schizophrenia
Negative symptoms - Deficits in normal emotions or other thought processes
What are the positive symptoms of psychiatry?
Hallucinations
Delusions
Disordered thinking
What are the negative symptoms of schizophrenia?
Apathy
Lack of interest
Lack of emotion
How is Schizophrenia diagnosed according to ICD-10?
The following must be present for more than 1 month and in the absence of organic or affective disorder:
At least one of the following:
a) Thought disorders (insertion, withdrawal, broadcasting)
b) Passivity (the belief that your body is controlled by someone else)
c) Auditory hallucinations
d) Delusional perceptions
OR at least 2 of the following:
e) Persistent hallucinations
f) Breaks or interpolations in train of thought (thought insertion or withdrawal)
g) Catatonic behaviour
h) Negative symptoms (loss of interest, motivation)
What are the factors thoughts to be involved in causing psychosis?
1 - Biological factors
2 - Psychological factors
3 - Social factors
What are the genes thought to be involved in schizophrenia?
- CF
- Neuregulin
- Dysbindin
- Di George syndrome
What are the neurochemicals thought to be involved in schizophrenia?
- Dopamine
- Glutamate
- GABA
- Serotonin
What biological factors have been implicated in schizophrenia?
1 - Obstetric complications (maternal stress)
2 - Maternal influenza
3 - Malnutrition & famine
4 - Winter birth
5 - Substance misuse
What are the social and psychosocial factors implicated in schizophrenia?
- Social isolation
- Life events as precipitants
What familial factor is thought to be important in the development of schizophrenia?
Expressed critical emotion - families that are very expressive towards their family member suffering with mental disorder
What are the differential diagnosis for schizophrenia?
Psychotic illnesses:
- Delirium
- Acute organic brain syndrome
Affective Psychoses:
- Depressive episode with psychotic symptoms
- Manic episode with psychotic symptoms
How can delirium or acute organic brain syndrome be seperated from schizophrenia?
Delirium/ Acute organic brain syndrome:
- Caused by brain or systemic disease
- Prominent visual experiences, hallucinations and illusions
- Affect of terror
- Delusions are persecutory and evanescent
- Fluctuating, worse at night
How can depressive and manic episodes with psychotic symptoms be differentiated from schizophrenia?
Depressive episode with psychotic symptoms:
- Delusions of guilt, worthlessness and persecution
- Derogatory auditory hallucinations
Manic episode with psychotic symptoms:
- Delusions of grandeur, special powers
- Gross overactivity, manic excitement
How is a schizophrenic patient managed?
1st episode psychosis:
- Prescribe antipsychotic (Risperidone, Olanzapine, Clozapine)
2nd episode psychosis:
- Consider olanzapine if not already prescribed
Treatment resistent schizophrenia (2 previous antipsychotics failed):
- Clozapine
Once schizophrenia is thought to be in remission, how should the patient be treated?
Maintenance treatment for minimum of 2 years - Olanzapine or Risperidone
