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Psychiatry > 2: (E): Psychosis and Schizophrenia > Flashcards

2: (E): Psychosis and Schizophrenia Flashcards

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1
Q

Define psychosis

A

Acute mental status, where individual experiences delusions and hallucinations

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2
Q

Define delusion

A

Fixed, stage or irrational belief that if firmly held and not in-keeping with individuals culture background

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3
Q

Define hallucination

A

Sensory perception (auditory, tactile or visual) with no external stimulus

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4
Q

Define an illusion

A

Perceptual abnormality that results in misinterpretation of external stimuli

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5
Q

What age is psychosis more common

A

16-30 years-old

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6
Q

Which gender is psychosis more common

A

Males

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7
Q

How can the causes of psychosis be divided

A
  • Schizophrenia
  • Depressive Disorders
  • Drug-induced
  • Neurological
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8
Q

What depressive disorder can psychosis occur in

A

Both unipolar and bipolar depressive disorder

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9
Q

What delusions are more common in bipolar depressive disorder

A
  • Grandiosity
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10
Q

What delusions are more common in schizophrenia

A
  • Persecutory
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11
Q

What three drugs can cause psychosis

A

Amphetamines
Cannabis
Steroids

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12
Q

What psychosis do steroid produce

A

Psychosis similar to schizophrenia = persecutory delusions

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13
Q

Give 5 neurological (organic) causes of psychosis

A
  • Temporal lobe seizures
  • Head Injury
  • Dementia
  • Vitamin B12 deficiency
  • Hypoglycaemia
  • Cushing’s disease
  • Thyrotoxicosis
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14
Q

Explain delusions in head injury

A

In head injury individual often has auditory delusions that they can talk to, this is rare for psychiatric illness

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15
Q

Define a bizarre delusion and give an example

A

Delusion that cannot be true and are not in keeping with social or culture norms (eg. I can fly)

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16
Q

What is a non-bizarre delusion

A

Delusions that could be true or are in-keeping with social norms (eg. I won the lottery)

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17
Q

What are grandiosity delusions

A

Delusions of importance: the traffic light turned green, therefore, I must be god

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18
Q

In which condition do grandiosity delusions occur

A

Bipolar depressive disorder

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19
Q

What are ideas of reference delusion

A

There are special meanings in news or on TV for that person

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20
Q

What are paranoid delusions

A

Distrust of others

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21
Q

What are persecutory delusions

A

Person believes they are being cheated on or harassed

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22
Q

In which condition is persecutory delusions more common

A

Schizophrenia

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23
Q

What is erotomania

A

Person believes someone else is in love with them

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24
Q

What is morbid jealousy

A

Believes partner is cheating on them with no justficiation

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25
What is somatic
Experiencing body function, when it is not happening
26
How are delusions assesed
- Psychiatric assessment - Risk assessment - Medication-review - Physical health - work-up for organic causes
27
Explain prevention of psychosis
If someone has any of the following they should be assessed by a specialist mental health service and may receive CBT: - Previous psychosis - First-degree relative with psychosis - Other indicate behaviour
28
How is psychosis first managed
Oral antipsychotic CBT Family Intervention
29
If someone has recurrent episodes of psychosis how is it managed
Organise follow-up with crisis resolution and home treatment team (CRHT) to manage in the community. CBT, Family Intervention and Antipsychotic
30
Define schizophrenia
Severe psychiatric disorder characterised by chronic or recurrent delusions
31
What are the four points ICD-10 states must be present to make a diagnosis of schizophrenia
1. >1-months 2. One of: - Thought Disorder - Auditory hallucinations - third person - Delusions of control 3. Or, two of: - Any Hallucination - Catatonic - Negative symptoms - Incoherent or irrelevant speech 4. Disorder not due to substance mis-use or organic brain disorder
32
When is the peak onset of schizophrenia in men
18-25
33
What is the peak onset of schizophrenia in women
25-35
34
In which gender is schizophrenia more common
Female
35
What ethnicity is schizophrenia more common
Afro-Carribean
36
What are the 3 hypothesis of schizophrenia
- Neurochemical - Neurodevelopment - Disconnection
37
Explain neurodevelopment hypothesis
Those with obstetric complications have a higher risk of schizophrenia. Motor deficits often seen in individuals with schizophrenia when younger
38
What is concordance in monozygotic twins
50%
39
What is chance of schizophrenia if parent affected
15%
40
What is chance of schizophrenia if sibling affected
10%
41
What is the greatest RF for schizophrenia
Afro-Carribean
42
What is a mnemonic to remember risk factors of schizophrenia
COAL FAME
43
What are the risk factors of schizophrenia
Cannabis use Obstetric complications Afro-carribean Low IQ FH Abuse Migrant Enviroment-Urban-Urban
44
How are symptoms of schizophrenia divided
1. Positive 2. Negative 3. Cognitive
45
What are the 5 broad categories for positive symptoms
``` Hallucinations Delusions Thought Disorder Speech Disorder Other ```
46
What are primary delusions
Hallucinations start with disorder
47
What are secondary delusions
Hallucinations start after primary disorder
48
What are delusions of passivity
Synonymous with delusion of control. Individual believes their actions, feelings or impulses aren't their own
49
What hallucinations are more common in schizophrenia
Auditory hallucinations: | - Where individual believes a third person is commentating on their actions
50
What do visual or gustatory hallucinations indicate
Organic pathology
51
What do auditory hallucinations where individual can talk to the voice indicate
Head trauma
52
Explain the effect of treatment on hallucinations in schizophrenia
Voices may become: - Quieter - Disappear - More positive
53
What are the 4-types of thought disorder
- Insertion - Broadcasting - Withdrawal - ECHO
54
What is thought insertion
Individual believes thoughts are being put inside their head
55
What is thought withdrawal
Individual believes thoughts are being taken from their head
56
What is thought broadcasting
Individual believes others can hear their thoughts
57
What is thought ECHO
Individual hears their thoughts repeated soon after
58
As part of speech disorder, what is neologism
Creating new words
59
As part of speech disorder, what is word salad
Individual says words in no logical sequence
60
What is flight-of-ideas
Rapidly moves from one idea to the next
61
What is knight's move thinking (Derailment)
Loosening of associations, where there is no logical connection between one word and the next
62
What is circumstantiality
Focus of conversation drifts, will eventually come back to original point
63
What is tangentiallity
Individual wanders during conversation, rarely returns to original point
64
What is pressure of speech
Frantic rushing of speech
65
What is clanging
Individual moves on in conversation using similar sounding words, opposed to logical progression through topic
66
What is echolalia
Individuals repeats phrases said by other person
67
What are the negative symptoms of schizophrenia
Alogia Avolition Psychomotor retardation
68
What is alogia
- Poverty of ideas. Alogia may progress to poverty of speech
69
What is avolition
Lack of interest and motivation
70
Describe purpose of Schneider's
If present, increase risk of schizophrenia. | However, can be present in other disorders such as organic and affective psychoses
71
What is a the method to remember schneider's first rank symptoms
ABCD
72
What is the A of Schneider's first rank symptoms
Auditory Hallucinations
73
What are two types of auditory first-rank symptoms
- Commentary | - Arguing voice
74
What is the B of Schneider's first rank symptoms
Broadcasting thought - Thought Disorder
75
What are Thought disorder symptoms
Broadcasting ECHO Insertion Withdrawal
76
What does the C of Schneider's first rank symptoms
Control
77
What are the 3C's of schender's first-rank
Made affect Made impulse Made violation
78
What is made voilation
Individual feels their will is controlled by an external force
79
What is D of Schneider's first-rank symptoms
Delusion of perception
80
What are delusions of perception
Delusion of content following experience of normal perception
81
What are the main differential diagnosis of schizophrenia
Schizotypal diaorder | Schizoaffective disorder
82
What is schizotypal disorder
Where eccentric behaviour and thinking anomalies are present that mirror that of schizophrenia. However, no characteristic schizophrenia anomalies occur at any stage
83
What are three particular features of schizotypal disorder
- Magical thinking - Discomfort in close relationships - Quasi-psychotic episodes triggered by external events
84
Define schizoaffective disorder
Schizophrenic and affective symptoms are present but neither are sufficient to cause diagnoses of schizophrenia
85
What is first-line management for schizophrenia
Atypical antipsychotic CBT Family Intervention
86
What needs to be checked before starting antipsychotic
- Weight - Waist circumference - HbA1c - Lipid Profile - Prolactin - Assessment for movement disorders - Assessment nutritional status
87
What is second-line for schizophrenia
Clozapine
88
When is clozapine indicated
If symptoms do not improve on two different antipsychotics
89
What must anyone on clozapine engage with
Clozapine monitoring system (CPMS)
90
What does clozapine monitoring system check and why
FBC - due to agranulocytosis
91
What is given to support social factors in schizophrenia
Vocational support
92
What are 5 poor prognostic factors
- Social withdrawal in pre-morbid personality - FH - Gradual-onset - Low IQ - Negative symptoms - Lack precipitant

Psychiatry (13 decks)

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