Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Estelle Royal College > Scz_EO > Flashcards

Scz_EO Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

Suicide and scz: what is the risk %

A

5-6%

20% will attempt suicide on one or more occasions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Suicide and scz: when is risk highest?

A

Earlier in the illness and after hosp discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Suicide and scz: additional risk factors?

A 
DEPRESSED MOOD
Young age
Male
Higher education and IQ
good insight
Command hall and paranoia
Poor med adherence
Comorbid subst use
Past suicide attemp
Family hx depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Conversion rate of ultra high risk?

A

10-18% per year
35% sur 10ans

80% convert to mood do, anxiety do, SUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 groups of ultra high risk?

A

GRD: genetic risk and deteriorating: schizotypal pd or psychotic do in family, decline in functionning within the past yr
BLIPS : brief limited intermittent psychotic sx (episode less than a week, at least several times per week)
APS: attenuated positive psychotic sx

All between age 15-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the scales used for evaluating ultra high risk?

A 
SIPS: structured interview of prodromal sx
4 parts interview 
1) scale of prodromal sx (+ and 1)
2) GAF
3) criteria for schizotypal PD
4) family psych Hx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are relapse rates in scz?

A

At 1 yr: with tx = 3%, without tx =77%
At 2 ys without tx = 94%
At 5 yr with tx = 825

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cannabis and psychosis: risk factors?

A

Younger age at onset of cannabis use
Cumulative dose (consommation regulière)
THC potency
Pre-existing vulnerability factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cannabis and psychotic episode: causal link in numbers

A
  • 2-6 year younge age of onset of psychosis
  • Of those who develop psychotic episode, 50% go on to develop primary psychosis
  • Doubles the risk of scz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Characteristics of late onset scz?

A
  • women
  • less fam hx of scz
  • persecuroty delusion
  • less negative sx
  • more coherent thought process
  • better response to AP (dose necessaire faible)
  • possible cluster A PD premorbid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Delusional disorder caracteristics?

A

Women
Single
Sensorial deficits (surdité partielle)
No cognitive disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Definition of recovery in scz?

A

2 years without major positive sx
Social role (employment, volunteer…)
12-15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the main negative sx in scz?

A
  • alogia
  • affect flattening
  • associability
  • avolition
  • anhedonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which scale to measure cognitive deficits in scz?

A

Matrics consensus cognitive battery

7 cognitive domains (social cog, memory, problem solving, processing speed, attention…)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Course of cognitive deficits in scz?

A

Deficits identified in 1st episode and before antipsy started
Often present before onset of illness, become more severe during FEP, then tend to remain stable during early course of illness
Usually memory, exec functions and attention are most impaired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the guidelines for scz in : family interventions

A 
Priority 
Min 10 sessions over 3 mo
Skills: problem solve, psychoed and communivation
Reduces re-admissions
Highly exprssive = higher relaspe
17
Q

what are the guidelines for scz in : employment programs

A

Supported employment is more efficient than prevocation training
Rapid job search
Competitive setting
Supported employment and ongoing support
Integration of vocational and mental health services

18
Q

what are the guidelines for scz in : CBT?

A

Can be started during acute, recovery and in patient setting
Min 16 sessions
For patient who remain symptomatic despite AP
Efficacy provent in reducing severity, admission, relapse and depressive sx
Not clear if ind or group bettwer

19
Q

what are the guidelines for scz in : cognitive remediation

A

Limited evidence

May be considered

20
Q

what are the guidelines for scz in : social skills?

A

Limited impat on positive sx, admissions, relapse

Improves social functionnning and negative sx

21
Q

what are the guidelines for scz in : life skills?

A

Low evidence level

22
Q

what are the guidelines for scz in : psychoed to patient and or family?

A

Should be an integral part of tx but no robust effect on outcome
Good to empower pt

23
Q

acute psychotic tx?

A

If no response after 4 weeks despite dose optimization (adequate dose is defined as >half the therapeutic dose), change rx
If partial response, continue for 8 weeks before considering changing rx
A rx should be continued for at least 2 weeks

For LAI, 6 weeks after reaching steady state

24
Q

Maintenace of tx?

A

After FEP: 18 months after no more positive sx
> 1 episode: at least 2 yrs, possible ad 5 or more
Dose: at leat 4-6mg of risperidone (300-400mg chlorpromazine0

25
Q

What is treatment resistant scz?

A

Less than 20% change in positive sx after 2 adequate course of non clozapine AP
In 25-30% pt with scz

26
Q

What is clozapine resistanc scz?

A

8-12 week trial of clozapine at >400mg (or clozapine blood level 350ng/ml. 1100 nM/L)
And
Less than 20% change in + sx

27
Q

What is the CATIE study?

A
  • Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Project.
  • To determine the long-term effects and usefulness of antipsychotic medications in persons with schizophrenia.
  • The study involves the newer atypical antipsychotics (olanzapine, quetiapine, risperidone, clozapine, and ziprasidone)and the typical antipsychotics (perphenazine and fluphenazine).
  • For most participants the study will last up to 18 months.

-Conlcusion: Except for clozapine, SGA=FGA, with olanzapine slighlty superior but with greater risk of metabolic sydrome

28
Q

What’s to know about schizoaffective?

A

Better prognosis if more affective sx than psychotic sx
Depressive type 2F:1M more older adults; bipolar F+M younger

Apparition plus tardive chez femme
Prevalence a vie 0.5-0.8%

29
Q

What’s to know about Brief psychitic episode?

A

2F:1H 50% will end up having a dx of mood do or scz chronic

Good prognostic factor: sudden onset, severe stressor, affective sx, good premorbid funcionning, less restricted affect, few schizoid traits, short duration, no fam hx of scz

Maitenance of tx: few studies, recommend gradual reduction over 6-12 mo

30
Q

what’s to know about schizophreniform?

A

5M:1F
Lifetime prevalenc 0.11%
2/3 will convert to scz or scz-aff

More rapid treatment response que scz

Duration of tx 3-6mon

31
Q

Delusion disorder: risk factors

A 
Advance age
sensorial deficits
Fam hx
Immigration
Social isolation
Hypersensibilité interpresonnelle

Often an stressful event triggers the disorder

More delusion disorder in family with scz, but not more scz in family with delusional do

50% recovery
30% chronic
20% reduction in sx

Better prognosis when erotmania, perscutory and somatic

Depression is NOT a risk factor

32
Q

What are good prognostic factors in scz?

A 
Sudden onset
Triggering event
Late onset
\+ sx
Women
Short period of not treated + sx
Type pyknic
Fam Hx of mood do
33
Q

What are worst prognostic factors of scz?

A 
tx non-adherence (Anosognisia is best predictor of tx non adherence)
Insidious onset
Not precipiting factors
Early onset
Fam hx of scz
Negative sx
Perinatal complications
Neurological sighs/neurodevelopmental issues
Frequent relapse
Low IQ
Cannabis
Aesthenic or athletic type
34
Q

Difference between male and female in scz

A

Women:
bimodal and later onset (25-35 and after 40 in 3-10%)
more risk of prolactin increase
More hall, persecutory delusion and affective sx
Better prognosis

Men
Onset 18-25
More - sx
More fam hx of schizotypal/schizoir PD
Worse prognosis
35
Q

Risk factors of scz?

A 
Urbanicity
Migration
Winter baby
Paternal age>35
Infection (influenza) 1-2 trimester
Perinatal complucation (hypoxia at birth)
Male
Cannabis
Trauma during childdood

Estelle Royal College (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions