Scizophrenia

Question 1

Definition

Answer 1

At least two of the following symptoms: delusions, hallucinations, disorganised speech, disorganised/catatonic behaviour, or negative symptoms occurring for a significant period of time during a 1-month period (active phase) and associated with continuous problems over at least a 6-month period.

Question 2

What are negative symptoms

Answer 2

Affective flattening, avolition, anhedonia, attention deficit, or impoverishment of speech and language

Question 3

How to diagnose schizophrenia

Answer 3

2 symptoms, one must be a positive symptom

Question 4

Types of hallucinations

Answer 4

Auditory, visual, olfactory, and gustatory

Question 5

which type of hallucination is most common in schizophrenia

Answer 5

auditory - 3rd person

command, derogatory, conversing, and/or running commentaries.

Question 6

Delusions

Answer 6

Delusions refer to fixed beliefs that are not reality based and cannot be explained as part of the patient’s cultural background. Common types include persecutory, grandiose, nihilistic, or religious delusions. Other types of delusions include thought control delusions, such as thought insertion (false beliefs that someone is putting thoughts in the patient’s head) or thought withdrawal delusions, thought broadcasting.

Question 7

Symptoms of schizophrenia

Answer 7

1. thought insertion, thought broadcasting, thought withdrawal
2. Delusion that thought and feelings are being controlled by an external force
3. Hallucinatory voices giving a running commentary or discussing the patient among themselves
4. persistent delusions
5. Persistent hallucinations in any modality
6. breaks or interpolations in train of thought- eg knights move thoughts
7. Catatonic behaviour- strange purposeless behaviour
8. Negative symptoms

Question 8

Types of schizophrenia

Answer 8

Paranoid
catatonic
hebephrenic- 15-25yrs, poor prognosis, fluctuating affect,

Question 9

Prodromal symptoms

Answer 9

Precedes first episode of psychosis by up to 18months- gradual deterioration in functioning - sometimes conceptualised as altered life trajectory

Question 10

Schizoaffective disorder

Answer 10

when a patient experiences both symptoms of a mood disorder and schizophrenia at the same time and of the same intensity without another medical disorder or substance misuse cause

Question 11

Treatment of schizoaffective disorder

Answer 11

antipsychotic and mood stabiliser

Question 12

what is passivity phenomena

Answer 12

delusion that an external agency is controlling them- can effect thoughts - thought insertion, withdrawal, broadcasting

Question 13

Differential diagnosis of psychotic symptoms

Answer 13

schizophrenia
psychoactive substance abuse
mania
depression
delirium
dementia
other organic cause

Question 14

incidence and prevalence of schizophrenia

Answer 14

lifetime risk 1%
men- peak incidence 15-25yrs
women- 25-35yrs
Increased incidence in lower socioeconomic class

Question 15

Bad prognostic indicators

Answer 15

poor pre morbid adjustment, insidious onset, early onset,

Question 16

Good prognostic indicators

Answer 16

older age of onset, female gender, marked mood disturbance, FH of mood disorder

Question 17

Pathophysiology of schizophrenia

Answer 17

assumed that schizophrenia is related to overactivity of dopamine pathways in the brain- drugs which release dopamine or D2 receptor agonists produce a psychotic state

Question 18

identified gene alterations in schizophrenia

Answer 18

neurkgulin, dysbindin, DISCI