4 - Psychotic disorders Flashcards
(41 cards)
Name some organic causes of psychosis:
- Drug-induced
- Medication-induced
- Complex partial epilepsy
- Delirium
- Dementia
- Huntington’s disease
- SLE
- Syphilis
- Endocrine disturbances ie Cushing’s
- Metabolic disorders ie Vit B12 deficiency, porphyria, hypercalcaemia
What is the name given to ‘latent schizophrenia’, where the patient has eccentric behaviour, suspiciousness, unusual speech, thinking and affect similar to schizophrenia, but without delusions/hallucinations?
Schizotypal disorder
What is the name given to describe the disorder in which a single or set of delusions are experienced for >3 months?
Persistent delusional disorder
What is ‘folie a deux’?
Induced delusional disorder, characterised by the presence of similar delusions in 2+ people
What is schizoaffective disorder?
Both schizophrenic and mood symptoms present in the same episode of illness
What is the dopamine hypothesis of schizophrenia?
Schizophrenia is secondary to over-activity of the mesolimbic system - ^^dopamine in the ventral segmental aresa
What is the peak age of onset range of schizophrenia?
15-35 yrs
What are the types of schizophrenia?
1) Paranoid
2) Hebephrenic
3) Catatonic
4) Residual
What are Schneider’s 1st rank symptoms?
ABCD:
Auditory hallucinations
Broadcast (thought)
Control - someone can control mood/actions ‘Passivity phenomenon’
Delusional perceptions
What is the passivity phenomenon?
A 1st rank symptom of schizophrenia, in which the patient believes someone can control their mood/actions
What are the risk factors for schizophrenia?
- FH
- Obstetric complications
- Low birth weight
- Childhood abuse
- Substance misuse
- Low socioeconomic status
Which group of symptoms are caused by overactivity of the mesolimbic system?
Positive symptoms of schizophrenia
Why do D2 antagonists treat the positive symptoms of schizophrenia?
Positive symptoms caused by over-activity of dopamine in the mesolimbic system
What are the positive symptoms in schizophrenia?
- Delusions
- Hallucinations
- Formal thought disorder
- Thought interference
- Passivity phenomenon
What type of hallucinations is most common in schizophrenia?
3rd person auditory, may be running commentary
What are the negative symptoms of schizophrenia?
- Apathy
- Blunted affect
- Social isolation
- Poverty of speech and thought
- Poor self-care
What are the psychological interventions recommended for schizophrenia?
- CBT
- Family psychoeducation
- Art therapy
- Social skills training
What are the social interventions recommended for schizophrenia?
- Support groups ie Rethink for rehab into community
- Peer support
- Supported employment programmes
What are the 2 classes of antipsychotics?
- Typical ie Haloperidol
- Atypical ie Olanzapine
All antipsychotics target which receptors?
D2 and D3 receptors to reduce dopamine transmission
Which class of drugs is 1st line for schizophrenia?
Atypical antipsychotics ie Olanzapine
Name some atypical antipsychotics:
- Quetiapine
- Olanzapine
- Risperidone
- Aripiprazole
- Amisulpride
Atypical antipsychotics antagonise which receptors?
- Dopamine
- Serotonin
- α
- Histamine
- Muscarinic
One of the main side effects of all antipsychotics is weight gain. Why doesn’t Aripiprazole cause weight gain to the same degree as the others?
It is a partial agonist, rather than a pure antagonist like the others
