Schizophrenia & related disorders

Answer 1

Group of conditions that cause psychotic symptoms that lead to impairment in thinking, feeling, behaviour and social interactions.

Question 2

What is the average age of onset of schizophrenia?

Answer 2

15 - 35 for men

Later for women.

Question 3

What is the socioeconomic correlation with prevalence of schizophrenia?

Answer 3

Higher in socioeconomically deprived areas & homeless

Question 4

What are the risk factors for schizophrenia?

Answer 4

• Genetic
  
  • Immediate family member (Sibling/Parent) with schizophrenia
• Environmental
  
  • Abnormalities of pregnancy & childbirth
  • Maternal influenza in 2nd trimester
  • Fetal malnutrition
  • Urban birth
  • Migration
  • Winter birth
• Early cannabis consumption

Question 5

What evidence is there for the heritability of schizophrenia?

Answer 5

1. Family studies
   * More common amongst family members than the general population
2. Twin studies
   * Concordance rate is consistently higher amongst monozygotic twins than dizygotic twins
3. Adoption studies
   * Children of schizophrenic parents, raised by adoptive parents have the same likelihood of developing schizophrenia as children raised by their schizophrenic parents.

Question 6

How does the acute syndrome of SCZ present?

Answer 6

Pt gains symptoms:

• Unusual experiences / thoughts they did not previously
• Act in bizarre or atypical ways

Question 7

How does the chronic syndrome of SCZ present?

Answer 7

There is a loss of function (Negative symptoms)

Question 8

What are Schneider’s ‘first-rank’ symptoms of SCZ?

Answer 8

1. 3rd person auditory hallucinations
   * Thought echo / running commentary
2. Delusions of thought interference
   * Thought insertion / withdrawal / broadcast
3. Passivity phenomena

• Of affect
• Of impulse
• Of body movements

4. Delusional perception

Question 10

What is the ICD-10 diagnostic criteria for SCZ?

Answer 10

Multiple abnormalities of mental state, including:

• Thoughts - delusions, though interference, delusional perception
• Perceptions - Hallucinations (typically auditory), passivity phenomena
• Affect - blunted
• Normal conscious level & cognition (latter may deteriorate w chronic illness)
• Negative symptoms

Symptoms must be present for at least a month