shoter oxford -Schizophrenia Treatment and management
175 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Antipsychotic drugs are the primary treatment used for schizophrenia.

True

All clinical guidelines for schizophrenia emphasize pharmacological treatment equally.

False

NICE guidelines for schizophrenia treatment are the most detailed among the available guidelines.

False

Treatment-resistant schizophrenia is a key focus of the Scottish guidelines.

<p>True</p> Signup and view all the answers

Antipsychotic medication has no side effects.

<p>False</p> Signup and view all the answers

The use of antipsychotic drugs significantly reduces the risk of relapse in schizophrenia.

<p>True</p> Signup and view all the answers

Psychological and psychosocial interventions are not recommended for schizophrenia treatment.

<p>False</p> Signup and view all the answers

There is only one consensus guideline available for the treatment of schizophrenia.

<p>False</p> Signup and view all the answers

The Australasian guidelines include algorithms for pharmacological treatment of first-episode psychosis.

<p>True</p> Signup and view all the answers

Guidelines for schizophrenia management often differ on key issues.

<p>True</p> Signup and view all the answers

Antipsychotic drugs are effective in treating both positive and negative symptoms of schizophrenia.

<p>False</p> Signup and view all the answers

Approximately two-thirds of patients show a significant therapeutic response to antipsychotic medication.

<p>True</p> Signup and view all the answers

Clozapine is the only antipsychotic whose plasma levels are commonly measured.

<p>True</p> Signup and view all the answers

The onset of action for antipsychotic drugs is often delayed, typically taking weeks to show effects.

<p>False</p> Signup and view all the answers

Non-adherence to antipsychotic medication is linked to worse outcomes for patients.

<p>True</p> Signup and view all the answers

All antipsychotics have the same side effect profile.

<p>False</p> Signup and view all the answers

Continuous antipsychotic medication is more effective in preventing relapse than intermittent treatment strategies.

<p>True</p> Signup and view all the answers

The recommended duration for maintenance treatment after an acute episode of psychosis is universally agreed upon by all guidelines.

<p>False</p> Signup and view all the answers

The effect size of antipsychotic medication compared to placebo is 0.44.

<p>True</p> Signup and view all the answers

Adherence to antipsychotic medication increases with more frequent dosing schedules.

<p>False</p> Signup and view all the answers

Antipsychotic medication should be initiated at the higher end of the licensed dose range during an acute episode.

<p>False</p> Signup and view all the answers

Benzodiazepines can be used as adjunctive treatment if sedation is needed during acute episodes.

<p>True</p> Signup and view all the answers

Drug changes should be considered if no response is observed after two weeks of treatment.

<p>True</p> Signup and view all the answers

Both dose and duration of medication should be adequate before switching medications.

<p>True</p> Signup and view all the answers

Gradual withdrawal of medication is unnecessary when it is time to discontinue treatment.

<p>False</p> Signup and view all the answers

Continuous treatment is less effective than intermittent treatment in managing schizophrenia.

<p>False</p> Signup and view all the answers

Depression formulations should be considered only if the patient shows no issues with adherence.

<p>False</p> Signup and view all the answers

Psychological interventions should be disregarded when introducing or changing medications.

<p>False</p> Signup and view all the answers

Monitoring for side effects, including metabolic syndrome, is recommended during treatment.

<p>True</p> Signup and view all the answers

Which antipsychotic drug is ranked highest in efficacy?

<p>Amisulpride</p> Signup and view all the answers

Quetiapine is associated with the smallest effect in terms of weight gain.

<p>True</p> Signup and view all the answers

Identify one antipsychotic drug that is most likely to cause extrapyramidal side effects.

<p>Haloperidol</p> Signup and view all the answers

The antipsychotic with the smallest effect on increased prolactin is __________.

<p>Aripiprazole</p> Signup and view all the answers

Which antipsychotic drug ranks lowest for treatment adherence?

<p>Asenapine</p> Signup and view all the answers

Match the drug with its corresponding side effect category:

<p>Olanzapine = Weight gain Haloperidol = Extrapyramidal side effects Amisulpride = QTc prolongation Risperidone = Increased prolactin</p> Signup and view all the answers

Lurasidone is ranked highest for sedation among antipsychotic drugs.

<p>False</p> Signup and view all the answers

Depot antipsychotics are effective in preventing relapse due to improved compliance.

<p>True</p> Signup and view all the answers

Clozapine is effective for all patients with schizophrenia.

<p>False</p> Signup and view all the answers

Clozapine may reduce the risk of aggression and substance misuse.

<p>True</p> Signup and view all the answers

A recent meta-analysis has confirmed that clozapine is the only antipsychotic with superior efficacy over others.

<p>False</p> Signup and view all the answers

Long-acting injectables are prescribed to about 50% of patients with schizophrenia in the UK.

<p>False</p> Signup and view all the answers

There is substantial evidence-based guidance for treating patients who cannot take clozapine.

<p>False</p> Signup and view all the answers

Adding amisulpride can be an effective augmentation strategy for treatment-resistant schizophrenia.

<p>True</p> Signup and view all the answers

Clozapine has been proven to improve persistent negative symptoms in schizophrenia.

<p>False</p> Signup and view all the answers

A key trial found that at least 30% of patients do not respond to antipsychotic medications.

<p>True</p> Signup and view all the answers

Clozapine's beneficial effects are accompanied by significant risks and side effects.

<p>True</p> Signup and view all the answers

Only clozapine is recommended for patients who do not respond to other antipsychotic treatments.

<p>False</p> Signup and view all the answers

Mood stabilizers have been shown to have a definitive antipsychotic effect in treating schizophrenia.

<p>False</p> Signup and view all the answers

Electroconvulsive therapy (ECT) can be beneficial for severe depressive symptoms in schizophrenia.

<p>True</p> Signup and view all the answers

Benzodiazepines are recommended for long-term use in schizophrenia treatment to augment antipsychotic drugs.

<p>False</p> Signup and view all the answers

Psychosocial approaches in schizophrenia treatment aim to improve social functioning and mitigate symptom severity.

<p>True</p> Signup and view all the answers

Cognitive behavioral therapy (CBT) has been shown to have a significant effect in reducing hallucinations and delusions in schizophrenia.

<p>True</p> Signup and view all the answers

There is a strong consensus on the efficacy of antidepressants in treating depression among schizophrenia patients.

<p>False</p> Signup and view all the answers

Family therapy is primarily aimed at increasing expressed emotion in family members of patients with schizophrenia.

<p>False</p> Signup and view all the answers

Cognitive remediation is a psychological approach that primarily focuses on pharmacological interventions for cognitive impairments in schizophrenia.

<p>False</p> Signup and view all the answers

Data confirms that the benefits of lithium in schizophrenia are universally applicable to all patients.

<p>False</p> Signup and view all the answers

Cognitive remediation therapy has shown evidence of improving cognitive performance and functional outcomes.

<p>True</p> Signup and view all the answers

Social skills training is currently recommended in the UK guidelines for schizophrenia treatment.

<p>False</p> Signup and view all the answers

Arts therapies are recommended by NICE guidelines for treating schizophrenia.

<p>False</p> Signup and view all the answers

Dynamic psychotherapy has strong clinical trial support for the treatment of schizophrenia.

<p>False</p> Signup and view all the answers

Exercise has been found to improve various symptoms and quality of life in individuals with schizophrenia.

<p>True</p> Signup and view all the answers

Adherence therapy has been shown to be ineffective in reducing symptoms of schizophrenia.

<p>False</p> Signup and view all the answers

The use of motivational interviewing techniques is a strategy within adherence therapy.

<p>True</p> Signup and view all the answers

A recent meta-analysis indicated that cognitive remediation therapy is ineffective.

<p>False</p> Signup and view all the answers

There is substantial evidence supporting the effectiveness of dynamic psychotherapy in the UK.

<p>False</p> Signup and view all the answers

UK guidelines recommend continuing adherence therapy for schizophrenia treatment.

<p>False</p> Signup and view all the answers

Which of the following is NOT considered a psychosocial intervention for schizophrenia?

<p>Electroconvulsive therapy</p> Signup and view all the answers

Cognitive remediation is one of the psychosocial interventions for schizophrenia.

<p>True</p> Signup and view all the answers

Name one psychosocial intervention for managing comorbid substance misuse in schizophrenia.

<p>Integrated treatment</p> Signup and view all the answers

____ therapy uses creative processes to help individuals express themselves and is categorized as a psychosocial intervention.

<p>Art</p> Signup and view all the answers

Match the psychosocial interventions to their descriptions:

<p>Family therapy = Enhances understanding and support within the family unit Social skills training = Teaches effective communication and interpersonal skills Cognitive behaviour therapy = Addresses negative thoughts and behaviors Supported employment = Assists individuals in finding and maintaining jobs</p> Signup and view all the answers

Which of the following is NOT an element of family intervention in schizophrenia?

<p>Increasing medication dosage</p> Signup and view all the answers

Expanding social networks is considered an important part of family intervention in schizophrenia.

<p>True</p> Signup and view all the answers

Name one strategy for lowering expressed emotions within a family context for someone with schizophrenia.

<p>Improving communication</p> Signup and view all the answers

Adjusting expectations of family members can help in __________ emotions in schizophrenia.

<p>lowering</p> Signup and view all the answers

Match the family intervention strategies with their corresponding purposes:

<p>Education about schizophrenia = Enhances understanding of the condition Lowering expressed emotion = Reduces family conflict Reducing daily contact = Prevents emotional overload Expanding social networks = Encourages integration into the community</p> Signup and view all the answers

Lowering expressed emotion is a strategy that can help in family intervention for schizophrenia.

<p>True</p> Signup and view all the answers

What is the purpose of expanding social networks in family intervention for schizophrenia?

<p>To provide support and reduce isolation.</p> Signup and view all the answers

Reducing the number of hours of daily contact may help adjust family __________ for individuals with schizophrenia.

<p>expectations</p> Signup and view all the answers

Match each family intervention in schizophrenia with its description:

<p>Education about schizophrenia = Informs families about the illness Lowering expressed emotion = Creates a supportive environment Expanding social networks = Reduces feelings of isolation Adjusting expectations = Realigns family perceptions of recovery</p> Signup and view all the answers

Successful management of schizophrenia primarily relies on establishing a strong rapport with the patient.

<p>True</p> Signup and view all the answers

Home treatment is typically recommended for all episodes of schizophrenia due to its numerous advantages.

<p>False</p> Signup and view all the answers

The role of crisis teams is to treat and support acutely ill patients primarily in hospital settings.

<p>False</p> Signup and view all the answers

Medication for schizophrenia should only be discussed after other interventions have failed.

<p>False</p> Signup and view all the answers

Admitting a patient to the hospital is ultimately to create an unsafe environment for assessment.

<p>False</p> Signup and view all the answers

Careful assessment and observation are crucial in establishing a diagnosis of schizophrenia.

<p>True</p> Signup and view all the answers

A drug-free observation period is a common practice during the initial treatment of schizophrenia.

<p>False</p> Signup and view all the answers

Realistic plans for managing schizophrenia must be acceptable to both the patient and their carers.

<p>True</p> Signup and view all the answers

The reluctance of patients to engage may complicate the symptoms elicitation process.

<p>True</p> Signup and view all the answers

All guidelines for schizophrenia management are aligned in their recommendations regarding treatment.

<p>False</p> Signup and view all the answers

The Care Programme Approach (CPA) is primarily used for individuals with schizophrenia.

<p>True</p> Signup and view all the answers

The key worker in a care plan is responsible for delivering medical treatment to patients.

<p>False</p> Signup and view all the answers

Regular reviews of patients' progress and needs are an essential part of a care plan.

<p>True</p> Signup and view all the answers

Only mental health professionals are involved in the care planning process.

<p>False</p> Signup and view all the answers

Care plans do not require documentation of responsibilities for service delivery.

<p>False</p> Signup and view all the answers

A care plan must identify and record a systematic assessment of health and social needs.

<p>True</p> Signup and view all the answers

The treatment plan must be agreed upon only by the relevant staff members.

<p>False</p> Signup and view all the answers

The responsibilities of a key worker include ensuring the treatment program is being delivered.

<p>True</p> Signup and view all the answers

Baseline examination for metabolic syndrome should be conducted after initiating antipsychotic medication.

<p>False</p> Signup and view all the answers

Complex care planning is unnecessary for patients with schizophrenia due to their straightforward needs.

<p>False</p> Signup and view all the answers

The choice of antipsychotic drug should not consider the side effect profile.

<p>False</p> Signup and view all the answers

The responsibilities of delivering care are not formally defined in the UK.

<p>False</p> Signup and view all the answers

Patients presenting with a first episode of psychosis are generally started on high doses of antipsychotic medication.

<p>False</p> Signup and view all the answers

Antipsychotic medication can lead to metabolic syndrome in about 10% of unmedicated first-episode psychosis patients.

<p>True</p> Signup and view all the answers

The patient's family should not be involved in decisions about treatment.

<p>False</p> Signup and view all the answers

Improvement in psychotic symptoms after starting antipsychotic drugs is usually gradual.

<p>True</p> Signup and view all the answers

Short-acting depot preparations of antipsychotics are recommended for patients whose tolerance has not been determined.

<p>False</p> Signup and view all the answers

Anticholinergic drugs can be prescribed routinely for extrapyramidal side effects.

<p>False</p> Signup and view all the answers

Rapid tranquillization may be required when a patient is acutely disturbed.

<p>True</p> Signup and view all the answers

Increasing the dose of antipsychotic medication is the preferred treatment for ongoing agitation and distress.

<p>False</p> Signup and view all the answers

Which of the following is a recommended intervention for managing schizophrenia?

<p>Cognitive behavioral therapy</p> Signup and view all the answers

Crisis resolution and home treatment teams are alternatives to inpatient admission for managing schizophrenia.

<p>True</p> Signup and view all the answers

What type of drug trial is recommended for all patients who meet the criteria for treatment in schizophrenia?

<p>Clozapine</p> Signup and view all the answers

Maintaining realistic therapeutic __________ is essential in the management of schizophrenia.

<p>optimism</p> Signup and view all the answers

Match the following components to their corresponding principles in the management of schizophrenia:

<p>Early intervention = Prevention of future episodes Multidisciplinary working = Collaborative care across specialties Cognitive remediation = Improvement of cognitive functioning Family interventions = Support system enhancement</p> Signup and view all the answers

Chronic schizophrenia treatment focuses primarily on drug therapy and not on individual support.

<p>False</p> Signup and view all the answers

Cognitive remediation is beneficial for improving cognition and social functioning in schizophrenia patients.

<p>True</p> Signup and view all the answers

Antipsychotic depot preparations have short half-lives, allowing rapid dose adjustments.

<p>False</p> Signup and view all the answers

Support and psychoeducation have been demonstrated to increase distress in families and carers of schizophrenia patients.

<p>False</p> Signup and view all the answers

Patients with chronic schizophrenia should be encouraged to withdraw from treatment and follow-up.

<p>False</p> Signup and view all the answers

It is common for olanzapine pamoate to cause significant sedation and confusion immediately after administration.

<p>True</p> Signup and view all the answers

All patients receiving antipsychotic medication should receive a full dose without any prior testing.

<p>False</p> Signup and view all the answers

Social skills training is an unrelated therapeutic approach to the management of schizophrenia.

<p>False</p> Signup and view all the answers

Managing comorbid conditions in patients with schizophrenia is unnecessary if antipsychotic treatment is effective.

<p>False</p> Signup and view all the answers

Changes in drug dosage should be carefully monitored due to the delayed effects of antipsychotic medications.

<p>True</p> Signup and view all the answers

Maintenance medication should normally continue for at least 3–4 years after an acute episode.

<p>False</p> Signup and view all the answers

Integrated care for schizophrenia solely focuses on medication management without other interventions.

<p>False</p> Signup and view all the answers

Patients with schizophrenia who have excellent recovery can be returned to the care of their GP with a good prognosis.

<p>True</p> Signup and view all the answers

Long-term support is unnecessary for patients whose schizophrenia is refractory to treatment.

<p>False</p> Signup and view all the answers

Negative symptoms in schizophrenia often do not affect a patient's level of functioning.

<p>False</p> Signup and view all the answers

Regular follow-up with a community mental health team is vital for maintaining recovery in schizophrenia.

<p>True</p> Signup and view all the answers

Cognitive and behavioral deficits are unimportant in the long-term management of schizophrenia.

<p>False</p> Signup and view all the answers

Patients who do not return to their premorbid functioning should not be evaluated for other potential causes.

<p>False</p> Signup and view all the answers

Multidisciplinary care can include support for activities such as education and job-seeking.

<p>True</p> Signup and view all the answers

The severity of residual symptoms does not influence the duration of ongoing care after an acute episode.

<p>False</p> Signup and view all the answers

Patients with a longer duration of untreated psychosis tend to have a poorer longer-term prognosis.

<p>True</p> Signup and view all the answers

The evidence supporting the effectiveness of Early Intervention in Psychosis Service teams is considered conclusive.

<p>False</p> Signup and view all the answers

Substance misuse among schizophrenia patients is increasingly becoming a rarity.

<p>False</p> Signup and view all the answers

Clozapine has been shown to reduce the risk of conversion to psychosis in individuals at high risk.

<p>False</p> Signup and view all the answers

Comorbid substance misuse is linked to an increased risk of violence among schizophrenia patients.

<p>True</p> Signup and view all the answers

Patients with schizophrenia are more likely to be perpetrators of violence than victims.

<p>False</p> Signup and view all the answers

Management strategies for violent patients with schizophrenia are different from those for non-violent patients.

<p>False</p> Signup and view all the answers

Male gender is a risk factor for suicide in schizophrenia.

<p>True</p> Signup and view all the answers

All schizophrenia patients with depressive symptoms are likely to attempt suicide.

<p>False</p> Signup and view all the answers

Antidepressants are associated with reduced suicide rates in patients with schizophrenia.

<p>True</p> Signup and view all the answers

One in three patients with schizophrenia is classified as treatment-resistant.

<p>True</p> Signup and view all the answers

Clozapine is effective without the need for regular blood monitoring.

<p>False</p> Signup and view all the answers

A minimum trough level of 300 μg/l is required for clozapine to be effective.

<p>False</p> Signup and view all the answers

Assessment for treatment-resistant schizophrenia should rule out non-adherence to medication.

<p>True</p> Signup and view all the answers

Clozapine should be recommended after one failed antipsychotic medication in treatment-resistant schizophrenia.

<p>False</p> Signup and view all the answers

Clozapine does not have serious side effects.

<p>False</p> Signup and view all the answers

Early intervention in schizophrenia may improve long-term prognosis.

<p>True</p> Signup and view all the answers

Half of patients labeled as treatment-resistant have low or undetectable antipsychotic plasma levels.

<p>True</p> Signup and view all the answers

Monitoring plasma levels of clozapine is considered unnecessary in clinical practice.

<p>False</p> Signup and view all the answers

All patients with refractory schizophrenia benefit equally from clozapine treatment.

<p>False</p> Signup and view all the answers

Early-onset schizophrenia is often associated with poorer treatment response compared to later-onset forms.

<p>True</p> Signup and view all the answers

Schizophrenia must present prominent hallucinations or delusions for at least three months to be diagnosed in children.

<p>False</p> Signup and view all the answers

There is a clear distinction between adult and childhood schizophrenia in diagnostic criteria.

<p>False</p> Signup and view all the answers

The prognosis for a single acute episode of early-onset schizophrenia is often poor.

<p>False</p> Signup and view all the answers

Family involvement in treatment decisions for schizophrenia is considered unimportant.

<p>False</p> Signup and view all the answers

Early detection and intervention in at-risk mental states can minimize untreated psychosis duration.

<p>True</p> Signup and view all the answers

Misapprehensions about schizophrenia should be addressed to prevent unnecessary guilt among families.

<p>True</p> Signup and view all the answers

There are no stigmas associated with schizophrenia compared to other psychiatric diagnoses.

<p>False</p> Signup and view all the answers

Psychotic symptoms in childhood are commonly associated with a range of risk factors similar to those of adult schizophrenia.

<p>True</p> Signup and view all the answers

The Recovery Approach prioritizes patient aspirations and strives for a fulfilling life despite the illness.

<p>True</p> Signup and view all the answers

The prevalence of psychotic symptoms is higher in adolescents aged 13-18 years than in children aged 9-12 years.

<p>False</p> Signup and view all the answers

Psychiatrists focus more on the nature of symptoms rather than their content while discussing the patient's experiences.

<p>True</p> Signup and view all the answers

Early-onset schizophrenia is viewed as clinically and biologically distinct from adult schizophrenia.

<p>False</p> Signup and view all the answers

There is a significant association between psychotic symptoms in children and factors such as maternal negativity or physical maltreatment.

<p>True</p> Signup and view all the answers

Non-clinical psychotic symptoms are uncommon in 12-year-olds.

<p>False</p> Signup and view all the answers

Psychotic symptoms do not need to be assessed in preadolescent psychiatric patients.

<p>False</p> Signup and view all the answers

Most children with psychotic symptoms meet strict criteria for adult psychotic disorders.

<p>False</p> Signup and view all the answers

Antipsychotic medication should be administered with greater caution and reduced dosage in children and adolescents compared to adults.

<p>True</p> Signup and view all the answers

Psychological interventions are deemed less important in treating schizophrenia in children than in adults.

<p>False</p> Signup and view all the answers

Reports of hallucinations are infrequent among 12-year-olds.

<p>False</p> Signup and view all the answers

Study Notes

Schizophrenia Treatment

  • Antipsychotic drugs are the primary treatment, used cautiously alongside psychological and psychosocial interventions.
  • Recent clinical guidelines vary in detail, but generally agree on key issues.
  • NICE guidelines (UK) offer relatively less detail, compared to Australasian guidelines, which are more comprehensive and provide specific recommendations for various situations (e.g., comorbid substance abuse, acute behavioural disturbance). Scottish guidelines prioritize medication, treatment-resistant schizophrenia, and perinatal issues.
  • Antipsychotics effectively prevent relapse, but have limits and side effects. Efficacy is well-established in acute schizophrenia treatment, with a median effect size of 0.44 compared to placebo.
  • Antipsychotics primarily target positive symptoms, with little benefit for negative or cognitive symptoms (unless specific treatments like cariprazine are used).
  • Efficacy doesn't substantially differ between antipsychotics (except clozapine) or their typical/atypical categories, but various side effects exist. Further differing tolerabilities are supported by research.
  • Antipsychotics show rapid onset of action, usually improving symptoms and sedation within 24 hours, although significant improvement might not be seen after 2 weeks, reducing response chances in that time frame.
  • Dosage is frequently guided by dopamine receptor occupancy (measured via PET and SPECT), emphasizing lowering to minimum effective dose. Dosing is influenced by treatment phase; lower initial dose is recommended for first episodes and adolescents. Clozapine requires specific plasma level monitoring.
  • Antipsychotic continuation is highly effective in preventing relapse, with discontinuation increasing relapse rates significantly (e.g., 65% vs 27% relapse rate over 1 year).
  • Maintenance treatment after an acute episode of schizophrenia may range from 1-2 years to 2-5 years, depending on the guidelines followed.

Treatment Adherence

  • Non-adherence to antipsychotic treatment is frequent (up to 52%) and linked to poor insight and negative medication attitudes.
  • Treatment frequency significantly impacts adherence; once-daily dosing is associated with higher adherence rates than more frequent doses.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Description

This quiz explores the various treatment options for schizophrenia, focusing on antipsychotic medications and clinical guidelines. It covers the effectiveness of these drugs, their side effects, and their impact on different symptoms of schizophrenia. Additionally, it includes comparisons of guidelines from different regions, highlighting how they address treatment-resistant cases and other specific conditions.

More Like This

Schizophrenia Treatment Options
16 questions
Antipsychotics Overview
39 questions

Antipsychotics Overview

RetractableElation2925 avatar
RetractableElation2925
Antipsychotic Medications Study Notes
16 questions
Use Quizgecko on...
Browser
Browser