Schizophrenia is a mental health condition in which a person’s perception, thoughts, mood, and behaviour are significantly altered. It is characterised by:

• ‘positive symptoms’ (e.g., auditory hallucinations, bizarre delusions, and disrupted speech)
• ‘negative symptoms’ (e.g., social withdrawal, demotivation, self-neglect, and flat affect).

Epidemiology:

• In the UK the lifetime prevalence of schizophrenia and schizophrenia-related disorders is approximately 14.5 per 1000 people, although there is considerable variation between estimates.
• there is a 1% background risk of developing schizofrenia in the general population

Pathophysiology:

Neurotransmitter derrangement: Dopamine and seretonin circuits

• Negative Sx - Low dopamine levels in mesocortical pathway
• Positive Sx - High dopamine levels in mesolimbic pathway

Risk factors:

• Main r/f - Family Hx of schizophrenia, the closer the relation the higher the risk
• Environmental effects:
  • Traumatic events in childhood (e.g. poor maternal affection and bonding, poverty, exposure to natural disasters)
  • Heavy cannabis use in childhood
  • Maternal poor health (including malnutrition and infections such as rubella and cytomegalovirus)
  • Birth trauma (hypoxia and blood loss in particular)
  • Living in the city
  • Living in/emigrating to more developed countries

Presentation

First Rank Features

The first rank features of schizophrenia can be divided into auditory hallucination, thought disorders, delusional perceptions and passivity phenomena.