Schizophrenia

Howard CH Khoe; Cheryl WL Chang; Cyrus SH Ho

doi:10.1017/9781009458634.001

Case 1: - Schizophrenia

from Part 1: - Vignettes

Published online by Cambridge University Press: 04 September 2025

Howard CH Khoe ,

Cheryl WL Chang and

Cyrus SH Ho

Show author details

Howard CH Khoe: Affiliation:
National Psychiatry Residency Programme, Singapore
Cheryl WL Chang: Affiliation:
National University Hospital, Singapore
Cyrus SH Ho: Affiliation:
National University Hospital, Singapore

Book contents

Get access

Summary

Chapter 1 covers the topic of schizophrenia. Through a case vignette with topical MCQs for consolidation of learning, readers are brought through the management of a patient with schizophrenia from first presentation to subsequent complications of the conditions and its treatment. Things covered include the different forms of delusions, psychopathology, negative and positive symptoms of schizophrenia, co-morbid conditions, typical investigations carried out, the use of pharmacological treatment, adverse effects of commonly used medications, extrapyramidal side effects and treatment-resistant schizophrenia.

Keywords

schizophrenia delusional disorder hallucinations antipsychotics

Information

Type: Chapter
Information: Practise Psychiatry
A Guide Through Vignettes and MCQs
, pp. 3 - 25

DOI: https://doi.org/10.1017/9781009458634.001 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2025

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Thomas, P, Mathur, P, Gottesman, II, Nagpal, Nimgaonkar, R VL, Deshpande, SN. Correlates of hallucinations in schizophrenia: a cross-cultural evaluation. Schizophr Res. 2007 May;92(1–3):41–9.10.1016/j.schres.2007.01.017CrossRef Google Scholar PubMed

Andreasen, NC, Flaum, M. Schizophrenia: the characteristic symptoms. Schizophr Bull. 1991;17(1):27–49.10.1093/schbul/17.1.27CrossRef Google Scholar PubMed

Jaspers, K, Jaspers, K. General psychopathology: volume two. Baltimore: Johns Hopkins University Press; 1997. (A Johns Hopkins paperback.)Google Scholar

Gage, SH, Hickman, M, Zammit, S. Association between cannabis and psychosis: epidemiologic evidence. Biol Psychiatry. 2016 Apr 1;79(7):549–56.10.1016/j.biopsych.2015.08.001CrossRef Google Scholar PubMed

Gage, SH, Jones, HJ, Burgess, S, Bowden, J, Davey Smith, G, Zammit, S, et al. Assessing causality in associations between cannabis use and schizophrenia risk: a two-sample Mendelian randomization study. Psychol Med. 2017 Apr;47(5):971–80.10.1017/S0033291716003172CrossRef Google Scholar

Power, RA, Verweij, KJH, Zuhair, M, Montgomery, GW, Henders, AK, Heath, AC, et al. Genetic predisposition to schizophrenia associated with increased use of cannabis. Mol Psychiatry. 2014 Nov;19(11):1201–4.10.1038/mp.2014.51CrossRef Google Scholar PubMed

Nieman, DH, Dragt, S, van Duin, EDA, Denneman, N, Overbeek, JM, de Haan, L, et al. COMT Val(158)Met genotype and cannabis use in people with an At Risk Mental State for psychosis: exploring gene × environment interactions. Schizophr Res. 2016 Jul;174(1–3):24–8.10.1016/j.schres.2016.03.015CrossRef Google Scholar

Boland, RJ, Verduin, ML, Ruiz, P, Shah, A, Sadock, BJ, editors. Kaplan & Sadock’s synopsis of psychiatry, 12th edition. Philadelphia: Wolters Kluwer; 2022.Google Scholar

Van Winkel, R, Kuepper, R. Epidemiological, neurobiological, and genetic clues to the mechanisms linking cannabis use to risk for nonaffective psychosis. Annu Rev Clin Psychol. 2014 Mar 28;10(1):767–91.10.1146/annurev-clinpsy-032813-153631CrossRef Google Scholar

Jones, PB, Barnes, TRE, Davies, L, Dunn, G, Lloyd, H, Hayhurst, KP, et al. Randomized controlled trial of the effect on Quality of Life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch Gen Psychiatry. 2006 Oct;63(10):1079–87.10.1001/archpsyc.63.10.1079CrossRef Google Scholar

Németh, G, Laszlovszky, I, Czobor, P, Szalai, E, Szatmári, B, Harsányi, J, et al. Cariprazine versus risperidone monotherapy for treatment of predominant negative symptoms in patients with schizophrenia: a randomised, double-blind, controlled trial. Lancet. 2017 Mar 18;389(10074):1103–13.10.1016/S0140-6736(17)30060-0CrossRef Google Scholar PubMed

Siskind, D, Siskind, V, Kisely, S. Clozapine response rates among people with treatment-resistant schizophrenia: data from a systematic review and meta-analysis. Can J Psychiatry. 2017 Nov;62(11):772–7.10.1177/0706743717718167CrossRef Google Scholar PubMed

Sanahan, R, Sreeraj, VS, Suhas, S, Kumar, V, Thirthalli, J, Venkatasubramanian, G. Response to clozapine and its predictors in treatment-resistant schizophrenia spectrum disorders: a retrospective chart review. Schizophr Res. 2025 Jan;275:179–88.10.1016/j.schres.2024.12.015CrossRef Google Scholar PubMed

National Institute for Health and Care Excellence (NICE). Psychosis and schizophrenia in adults: prevention and management. Clinical guideline [CG178]. NICE; 2014. Available from: www.nice.org.uk/guidance/cg178 Google Scholar

Fitzgerald, I, O’Connell, J, Keating, D, Hynes, C, McWilliams, S, Crowley, EK. Metformin in the management of antipsychotic-induced weight gain in adults with psychosis: development of the first evidence-based guideline using GRADE methodology. Evid Based Ment Health. 2022 Feb;25(1):15–22.10.1136/ebmental-2021-300291CrossRef Google Scholar PubMed

Howes, OD, McCutcheon, R, Agid, O, de Bartolomeis, A, van Beveren, NJM, Birnbaum, ML, et al. Treatment-resistant schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology. Am J Psychiatry. 2017 Mar 1;174(3):216–29.10.1176/appi.ajp.2016.16050503CrossRef Google Scholar

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Association Publishing; 2022. Available from: www.psychiatry.org/psychiatrists/practice/dsm Google Scholar

Semple, D, Smyth, R. Oxford handbook of psychiatry, 4th edition. Oxford: Oxford University Press; 2019.10.1093/med/9780198795551.001.0001CrossRef Google Scholar

Meltzer, HY, Alphs, L, Green, AI, Altamura, AC, Anand, R, Bertoldi, A, et al. Clozapine treatment for suicidality in schizophrenia: International Suicide Prevention Trial (InterSePT). Arch Gen Psychiatry. 2003 Jan;60(1):82–91.10.1001/archpsyc.60.1.82CrossRef Google Scholar PubMed

Novick, D, Haro, JM, Bertsch, J, Haddad, PM. Incidence of extrapyramidal symptoms and tardive dyskinesia in schizophrenia: thirty-six-month results from the European schizophrenia outpatient health outcomes study. J Clin Psychopharmacol. 2010 Oct;30(5):531–40.10.1097/JCP.0b013e3181f14098CrossRef Google Scholar PubMed

Ortí-Pareja, M, Jiménez-Jiménez, FJ, Vázquez, A, Catalán, MJ, Zurdo, M, Burguera, JA, et al. Drug-induced tardive syndromes. Parkinsonism Relat Disord. 1999 Apr;5(1–2):59–65.10.1016/S1353-8020(99)00015-2CrossRef Google Scholar PubMed

World Health Organization (WHO). Schizophrenia. 2022. Available from: www.who.int/news-room/fact-sheets/detail/schizophrenia Google Scholar

Puri, BK, Hall, AD, Ho, R. Revision notes in psychiatry, 3rd edition. Boca Raton: CRC Press/Taylor & Francis Group; 2014.Google Scholar

Taylor, DM, Barnes, TRE, Young, A. The Maudsley prescribing guidelines in psychiatry, 14th edition. Chichester Hoboken, NJ: Wiley Blackwell; 2021.10.1002/9781119870203CrossRef Google Scholar

Yung, AR, McGorry, PD, McFarlane, CA, Jackson, HJ, Patton, GC, Rakkar, A. Monitoring and care of young people at incipient risk of psychosis. Schizophr Bull. 1996;22(2):283–303.10.1093/schbul/22.2.283CrossRef Google Scholar PubMed

Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell’Olio, M, et al. Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States. Aust N Z J Psychiatry. 2005;39(11–12):964–71.10.1080/j.1440-1614.2005.01714.xCrossRef Google Scholar PubMed

Orygen, The National Centre of Excellence, in Youth Mental Health. Australian Clinical Guidelines for Early Psychosis, 2nd edition. Parkville: Orygen; 2016.Google Scholar

Accessibility standard: Inaccessible, or known limited accessibility

The PDF of this book is known to have missing or limited accessibility features. We may be reviewing its accessibility for future improvement, but final compliance is not yet assured and may be subject to legal exceptions. If you have any questions, please contact accessibility@cambridge-org.demo.remotlog.com.

Content Navigation

Table of contents navigation
Allows you to navigate directly to chapters, sections, or non‐text items through a linked table of contents, reducing the need for extensive scrolling.

Index navigation
Provides an interactive index, letting you go straight to where a term or subject appears in the text without manual searching.

Reading Order & Textual Equivalents

Single logical reading order
You will encounter all content (including footnotes, captions, etc.) in a clear, sequential flow, making it easier to follow with assistive tools like screen readers.

Short alternative textual descriptions
You get concise descriptions (for images, charts, or media clips), ensuring you do not miss crucial information when visual or audio elements are not accessible.

Visual Accessibility

Use of colour is not sole means of conveying information
You will still understand key ideas or prompts without relying solely on colour, which is especially helpful if you have colour vision deficiencies.

Structural and Technical Features

ARIA roles provided
You gain clarity from ARIA (Accessible Rich Internet Applications) roles and attributes, as they help assistive technologies interpret how each part of the content functions.