Week 4

Question 1

define the schizophrenia diagnostic class?

Answer 1

schizophrenia spectrum and other psychotic disorders comprises schizophrenia and related disorders, other major psychoses, and disorders with subthreshold psychosis

Question 2

What are the 5 domains of psychopathology for the schizophrenic spectrum?

Answer 2

• Delusions
• Hallucinations
• Disorganised thinking
• Grossly disorganised or catatonic behaviour
• Negative symptoms

Question 3

What are ‘negative symptoms’ when referring to the schizophrenia spectrum

Answer 3

symptoms characterised by the absence of something that should be present, such as emotional expression

Question 4

What is avolition?

Answer 4

absence of verbal expression

Question 5

What are some causes of schizophrenia (the aetiology)

Answer 5

Neurodevelopmental

Genetic

Question 6

What are neurodevelopmental causes of schizophrenia?

Answer 6

abnormalities of dopamine and serotonin
atrophy of grey matter
telomere shortening

Question 7

what are generic causes of schizophrenia?

Answer 7

no single genetic cause found, however

twins are more likely to develop it if the other twin has it

Question 8

what is the chance of developing schizo in the general population?

Answer 8

0.8%

Question 9

what is the chance of developing schizo if both parents affected?

Answer 9

40%

Question 10

What is the diagnostic criteria for schizophrenia?

Answer 10

Two or more of the following present for a significant portion of time during a 1 month period (at least one must be from 1-2).

1. delusions
2. hallucinations
3. disorganised speech
4. Grossly disorganised or catatonic behaviour
5. Negative symptoms

Question 11

What are symptoms of schizophrenia?

Answer 11

Positive symptoms

Negative symptoms

Question 12

what is anhedonia?

Answer 12

lack of finding pleasure

Question 13

Define delusions?

Answer 13

Fixed beliefs that don’t change in light of conflicting evidence

Question 14

what are some types of delusions?

Answer 14

• persecutory
• referential
• somatic
• grandiose
• thought insertion

Question 15

Define hallucinations?

Answer 15

a perception-like experience that occurs without an external stimulus

Question 16

What is catatonic behaviour?

Answer 16

marked decrease in reactivity to the environment such as:

• resistance to instruction
• maintaining a rigid or bizarre posture

Question 17

What are the main negative symptoms of schizophrenia

Answer 17

• diminished emotional expression

- avolition

Question 18

What are some additional negative symptoms of schizophrenia?

Answer 18

alogia - diminished speech
anhedonia - no pleasure
asociality - lack of interest in social activities
avolition - dont wanna do shit

Question 19

what is a schizotypal disorder?

Answer 19

chronic, attenuated form of schizophrenia in which beliefs stop short of being delusional and the sensort experiences are not quite hallucinatory

Question 20

What are the general treatments for schizophrenia?

Answer 20

antipsychotic drugs work well for positive symptoms
- clozapine

Most schizo pts need psychological and social interventions as part of management

Question 21

What are the most common antipsychotic drugs?

Answer 21

Clozapine
Risperidone
Quetapine
Olanzapine

Question 22

What do antipsychotics do?

Answer 22

almost all atypical antipsychotics are dopamine antagonists

Question 23

when is clozapine prescribed?

Answer 23

when 2 or more other antipsychotics have failed in the past

Question 24

What are the most common side effects of Clozapine?

Answer 24

• potentially fatal agranulocytosis
• associations with venous thromboembolism, myocarditis and cardiomyopathy
• seizures

Question 25

What are examples of extra-pyramidal symptoms?

Answer 25

dyskinesias - repeatitive movements
dystonic reactions - muscle contractions
parkinsonism - shuffling etc
akinesia - loss of involuntary movement
akathisia - internal and extrenal restlessness

Question 26

how long should antipsychotics be used for?

Answer 26

1-2 years after first instance of psychosis

as 98% relapse after 2 years - it is recommended that they take them for 5 years

Question 27

what are some signals of aggression in patients?

Answer 27

• veiled or overt threats of harm
• outbursts of anger and agression for no reason
• violent and aggressive gestures
• body language
• intoxication

Question 28

what is aggression usually a manifestation of in patients?

Answer 28

a response to frustration

Question 29

what are some physical de-escalation strategies?

Answer 29

• calmer personal space
• approach patient with caution
• don’t startle patient
• be aware of exits and never turn your back
  remove dangerous objects from your person and be aware of environment
• encourage pt to sit but dont force them to

Question 30

what are some psychological deescalation strategies?

Answer 30

• offer limited choices to allow pt to retain sense of control
• encourage pt to gain control over their behaviour
• try to identify and understand the reasons for their anger
• use of distraction and redirection
• suggest more appropriate behaviour
• allow person an ‘out’ so they can back down without losing face
• keep the patient and or carer informed where possible