2.4 Schizophrenia + Psychoaffective Disorders Flashcards

(32 cards)

1
Q

define psychosis

A

loss of contact with external reality characterised by impaired perceptions and thought processes

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2
Q

what are the characteristic symptoms of schizophrenia

A

delusions, hallucinations, disorganised speech, grossly disorganised/catatonic behaviour, negative symptoms

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3
Q

how many of the characteristic symptoms must be present for how long, and at least one must be which ones?

A

2+ for a significant portion of a 1 month period, AT LEAST ONE must be EITHER: delusions, hallucinations, or disorganised speech

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4
Q

what are the 4 broad clinical indicators of schizophrenia

A

A. characteristic symptoms
B. clinically significant impact to social/occupational functioning
C. continuous signs of disturbance for 6 months
D-F. not better accounted for by other illness, substance abuse etc

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5
Q

define positive symptoms

A

the presence of problematic behaviours

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6
Q

give examples of positive symptoms

A

hallucinations, delusions, formal thought disorder, behavioural/motor disturbances

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7
Q

define negative symptoms

A

the absence of behvaiours we would expect in a healthy person

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8
Q

give examples of negative symptoms

A

affective flattening, avolition, alogia

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9
Q

define affective flattening subclasses

A

social withdrawal, anhedonia (loss of enjoyment of previously enjoyed activitie)s), emotional blunting, confusion

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10
Q

define avolition subclasses

A

amotivation, apathy, self-neglect

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11
Q

define alogia subclasses

A

poverty of speech + content - might be quiet or incomprehensible despite patient expecting to be understood

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12
Q

define hallucination + give examples of types

A

perception-like experience occurring in absence of external stimulus - vivid, clear, involuntary

  • 75% get hallucination
  • mostly auditory, then visual, smell, taste, tactile
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13
Q

describe the characteristics of auditory hallucinations

A
  • hearing voices distinct from own thoughts
  • third person commentary
  • often start out comforting
  • derogatory
  • commands to perform unacceptable behaviours

NOTE: cross-cultural studies - different interpretation of voices

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14
Q

define delusions

A

false firm beliefs despite what other believe, despite evidence

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15
Q

what are paranoid/persecutory delusions

A

false belief one is being persecuted/harmed by someone/group

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16
Q

what are referential delusions

A

neutral event interpreted to have personal meaning, e.g. a news broadcast interpreted as a personal message

17
Q

what are grandiose delusions

A

false belief one has special powers, status, abilities

18
Q

what are erotomanic delusions

A

false belief that another person is in love with you

19
Q

what is formal thought disorder

A

disorganised thinking, poverty of thought

20
Q

what are formal thought disorder symptoms

A
  • circumlocution - long-winded indirect descriptions
  • derailment - slip from one idea to next
  • tangentiality - irrelevant responses to q’s
  • echolalia - parrot-like repetition
  • word salad - incomprehensible stream of words
  • clang asscn. - phrases linked through sound –> pass me the spoon, moon, I’m cocoon
21
Q

what are examples of grossly disorganised and abnormal motor behaviour

A
  • catatonic behaviour: decrease in reactivity to environment
  • stupor, grimacing, mutism, echolalia, waxy flexibility
22
Q

describe the age of onset of schizophrenia

A
  • adolescence/early adulthood
  • preceded by gradual deterioration in functining
  • coincide w stressful life period
23
Q

what are the primary prognostic factors

A

early onset = poorer outcomes
early treatment = better outcomes

24
Q

what is the typical clinical course?

A
  • highly variable
  • 50% unable to work
  • 30% attempt suicide; 5-10% complete suicide
25
list the stages of clinical course of psychotic disorders
* premorbid phase: cognitive/motor/social deficits * prodromal phase: brief positive symptoms/functional decline * psychotic phase: positive symptoms * recovery phase: negative symptoms, cognitive/social deficits, functional decline
26
what factors indicate someone will respond well to treatment?
* good premorbid functioning * acute onset (recognisable) * precipitating event * low substance use * absense of structural brain abnormalities * no family history of schizophrenia
27
what factors indicate someone will respond poorly to treatment?
* poor premorbid functioning * slow onset * prominent negative symptoms * low socio-economic/migrant * poor social support network
28
outline the aetiological factors of schizophrenia
NOT WELL UNDERSTOOD * wide range of disorders w presumed common underlying biological vulnerability * reasonable genetic vulnerability factors make vulnerable to triggering events neurochemical, neuroatanomical factors
29
outline the neurochemical factors of schizophrenia
dopamine hypothesis posits that there's an overproduction or oversensitivity of dopamine receptors. * dopamine activity assc with +ve symptoms; brain degeneration assc w -ve symptoms
30
what are the neuroanatomical factors/changes assc w schizophrenia?
ENLARGED VENTRICLES - >2x bigger * loss of brain tissue - prefrontal cortex loss = negative symptoms, damage to executive functioning/cognition * non-genetic brain abnormalities predate onset of psychosis and WORSEN W PROGRESSIVE ILLNESS
31
how effective/used are medications for schiz?
PRIMARY INTERVENTION * helps w' +ve symptoms - helps 60% w +ve symptoms * 40% relapse rate treat w antipsychotics + mood stabilisers/antidepressants
32
how do psychological interventions work as treatment?
* tailored to stage of illness * work w families as well * therapy designed to target deficits e.g. social skills, medication compliance, stress, reducing impact of hallucinations * CBT reasonably effective