W10: Schizophrenia & Psychotic Disorders Flashcards
(40 cards)
What is psychosis?
A ‘break with reality’
It is a symptom, not an illness. Caused by a variety of conditions
What are the five key features of psychosis?
- Hallucinations
- Delusions
- Disorganised thinking (speech)
- Grossly disorganised or abnormal behaviour (catatonia)
- Negative symptoms
What is the most severe of the schizophrenia spectrum and other psychotic disorders listed in the DSM?
Schizophrenia
What is typically diagnosed when someone has psychotic symptoms but not severely enough to be included in this part of the DSM?
Schizotypal Personality Disorder
What is a positive symptom?
Things that are ‘added’ or new things experienced that they didn’t before
What is a negative symptom?
Something ‘subtracted’
A loss or absence of normal traits of abilities
What positive symptoms are involved in schizophrenia and psychotic disorders?
Hallucinations
Delusions
Bizarre behaviour
Positive formal thought behaviour
What negative symptoms are involved in schizophrenia and psychotic disorders? (5)
Alogia Affective flattening Avoilation-apathy Anhedonia-asociality Attentional impairment
Alongside positive and negative symptoms, what is the 3rd grouping of symptoms?
Disorganisation
chaotic speech, thought and behaviour
What does the DSM say about schizophrenia?
Need to have 2 or more of the following - for most of one month - with at least one being one of the top 3 Delusions Halluncinations Disorganised speech Disorganised or atatonic behaviour Negative symptoms
Level of functioning in one or more areas (work, self care) is below the level achieved prior to onset
Persists for at least 6 months (including one month of symptoms that meet the first point)
Schizoaffective disorder and depressive or bipolar disorder have been ruled out (no depressive or manic episodes have occurred)
Not attributable to a substance or another medical condition
What if there is a history of autism or a communication disorder in a schizophrenia diagnosis?
Diagnosis should only be made if prominent delusions or hallucinations in addition to the other required symptoms of schizophrenia are present for at least one month
What are delusions?
Strange beliefs that are maintained despite evidence to the contrary
Can people with schizophrenia rationalise their delusions?
Some people, particularly high functioning people, can rationalise their delusional beliefs
BUT it may be a constant struggle because while they can rationally see that their belief is not supported by evidence, it just doesn’t ‘feel’ right
What are hallucinations?
Perception in the absence of sensory stimulation
May be: Auditory Visual Somatic/tactile Olfactory
Not just like imagining someones voice - like you are hearing actual voices.
What are the different kinds of disorganization symptoms?
Means disturbances in the logical process of thought - apparent in speech and behaviour
Positive thought disorder
Bizzare behaviour
What is positive formal thought disorder?
Derailment Tangentiality (go off on tangents) Incoherence Illogicality Circumstantiality Pressure of speech Distractable speech Clang associations (grouping words together)
What is bizarre behaviour?
Bizarre clothing and appearance
Bizarre social and sexual behaviour
Aggressive and agitated behaviour
Repetitive or stereotyped behaviour
What is affective blunting?
Unchanged facial expression
Decreased spontaneous movements
Poor eye contact
Lack of vocal inflections
What is alogia?
Poverty of speech
Blocking
Increased latency of response
What is avolition-apathy?
Poor grooming and hygiene
Impersistence
Physical anergia
What is anhedonia-asociality?
Decrease in recreational interests and activities
Decrease in sexual interest
Decreased ability to feel intimacy and closeness
Diminished relationship with friends and peers
What factors promote a good prognosis?
Late onset
Obvious precipitating factors (identified trigger = management plan)
Good pre-morbid social, sexual and work history
Acute onset
Married (if male)
Mood disorder symptoms
Good support systems
Fewer psychotic episodes
Continued use of medications
What factors contribute to a poor prognosis?
Young onset
No precipitating factors
Insidious onset
Poor social, sexual and work history
Withdrawn, autistic behaviour
Single, divorced, widowed
Family history of schizophrenia
Poor support systems
Negative symptoms (lead to withdrawal)
Many psychotic episodes
Inconsistent use of medication
Explain the bio-psycho-social model of schizophrenia
Genetic: family history, inheritance of certain gene variants
Neuro-developmental: prenatal, obstetric complications
Environmental/social: childhood trauma, low SES backgrounds (access to timely interventions), substance use
Psychological: information processing biases, maladaptive self and world schemas (core beliefs)
