Schizophrenia and Psychotic disorders Flashcards

1
Q

What makes someone psychotic?

A

inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Clinical presentation of psychosis - hallucinations

A

Have the full force and clarity of true perception
located in external space
no external stimulus
not willed or controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

grandiose means?

A
over confident 
think highly of themselves
- I can do anything
- think anything
- be anything
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

paranoid (correctly persecutory) means?

A

everyone is against me etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hypochondriacal means?

A

there are things wrong with me

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

self referential means?

A

everything refers to me

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what illnesses may have psychotic symptoms? (4)

A
  • schizophernia
  • delirium
  • severe affective disorder (depressive episode with psychosis)
  • manic episode with psychosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Common positive symptoms of schizophrenia?

A

Hallucinations
Delusions
Disordered thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common negative symptoms of schizophrenia?

A

Apathy
Lack of interest
Lack of emotions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ICD-10 of schizophrenia (For more than a month in the absence of organic or affective disorder) - need one of the following?

A
  • Alienation of thought
  • passivity
  • Hallucinatory voices
  • Persistent delusions (ones that are impossible)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Need at least 2 of what symptoms to get a diagnosis?

A
  • Persistent hallucinations in any modality, when occurring every day for at least one month.
  • Neologisms (new terminology), breaks or interpolations in the train of thought
  • Catatonic behaviour, such as excitement, posturing or waxy flexibility, negativism, mutism and stupor
  • “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common schizophrenia?

A

paranoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Biological factors - genetic risks

A

Genetics
- monozygotic twins (50%), di = 10%

1 parent = 10%
2 parents = 40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

specific genes in schizophrenia

A

Neuregulin (chromosome 8p)

Dysbindin (chromosome 6p)

Di George Syndrome (22Q)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Neurochemical factors causing schizophrenia (6)

A
  • Dopamine hypothesis” – increased level of dopamine in the brain
  • Revised dopamine hypothesis – mesolimbic hyperdopaminergia and mesocortical hypodopaminergia
  • Glutamate
  • GABA
  • Noradrenaline
  • Serotoninergic transmission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Positive symptoms are caused by?

A

too much dopamine in mesolimbic areas - positive symptoms

17
Q

negative symptoms are caused by?

A

not enough dopamine in the mesocortical areas

18
Q

Neurological abnormalities that can be found in schizophrenic patients? (7)

A
  • Reduced brain volume 3%
  • Ventricular enlargement 25% (but overlaps with normal)
  • Cytoarchitectural abnormalities
  • Reduced frontal lobe performance
  • Eye tracking (saccadic)
    abnormalities
  • Soft neurological signs
  • EEG abnromalities
19
Q

Obstetric complications that can lead to schizophrenia?

A
  • Maternal influenza
  • Malnutrition and famine
  • Winter birth
  • Substance misuse
20
Q

Social and Psychosocial Factors

A

Occupation and social class but be aware of “drift hypothesis

  • Migration
  • Social Isolation
  • Life Events as Precipitants
  • Cultural factors NOT IMPLICATED
21
Q

Differential diagnosis for psychotic illnesses - Delirium or Acute Organic Brain Syndrome (however caused)

A
  • Consequent upon brain or systemic disease
  • Prominent visual experience, hallucinations and illusions
  • Affect of terror
  • Delusions are persecutory and evanescent
  • Fluctuating, worse at night
22
Q

Differential diagnosis for psychotic illnesses - Depressive episode with psychotic symptoms

A

SEVERE
- Delusions of guilt, worthlessness and persecution
Derogatory auditory hallucinations

23
Q

Differential diagnosis for psychotic illnesses - Manic episode with psychotic symptoms

A
  • Delusions of grandeur; special powers or messianic roles

- Gross overactivity, irritability and behavioural disturbance: Manic excitement

24
Q

Schizoaffective Disorder is?

A

A mix of affective and schizophrenia like features

25
Q

% recovery after first episode?

A

80%

26
Q

Good prognostic factors include?

A
  • Absence of family history
  • Good premorbid function - stable personality, stable relationships
  • Clear precipitant
  • Acute onset
  • Mood disturbance
  • Prompt treatment
  • Maintenance of initiative, motivation
27
Q

Poor prognostic factors?

A
  • slow onset with negative symptoms
  • mortality is higher in general population
  • high suicide risk
  • substance misuse patients - smoking
  • poorer starts in childhood
28
Q

Chronic schizophrenic patients show poorer ?

A

cognition than first onset patients