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Clinical & Neuropsychology 2 > CP: Lecture 12 Psychotic Disorders > Flashcards

CP: Lecture 12 Psychotic Disorders Flashcards

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1
Q

sommige mensen met psychosis…

A

vinden het juist fijn om psychosis te hebben, bv niet alleen te voelen

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2
Q

wat moet je als psycholoog juist doen bij psychosis?

A

erover praten!! wat is de content??
-> meestal vroegen ze alleen naar de prevalentie, wanneer wel, wanneer niet etc. maar dit vinden de patienten zelf niet fijn

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3
Q

psychosis=

A

disruption in the experience of reality / reality testing

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4
Q

DSM defines psychosis in terms of…

A

symptoms of psychosis (this is broader than reality testing)

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5
Q

how is psychosis defined

A

➢ Symptoms can be subdivided in different ways
➢ In all models: positive (P) and negative (N)
➢ Some models add domains, for example:
➢ Disorganized (DSM)
➢ Thought disorder (ICD-10)

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6
Q

hallucinations =

A

Perception-like experiences which occur without an external stimulus
➢ Lifelike
➢ Full force and impact of normal perceptions
➢ Can occur in all modalities
➢ Most common: auditory (‘voices’)

In some (sub)cultures, hallucinations are considered normal (religious) experiences

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7
Q

prevalence psychotic symptoms

A

Audiovisual hallucinations:
➢ Children around 8 years old: +/- 9%
➢ Generally don’t persist: 76% no longer at 12/13 years old
➢ General population: 5% – 28%

Imaginary friends:
➢ Children 5-12 yrs old: 46%

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8
Q

wat was de definitie in de DSM-IV

A

‘Delusions are erroneous beliefs that usually involve a
misinterpretation of perceptions and experiences’

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9
Q

wat is de definitie in DSM 5

A

Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence

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10
Q

dus verschil dsm iv en dsm 5

A

gaat om of het veranderd kan worden

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11
Q

wat is nu de consensus mbt religie

A

is er een subgroup die hetzelfde denkt? of niet? want als dit wel zo is, dan kunnen we het niet pathologisen.

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12
Q

hoe ga je vanaf belief naar delusion

A

belief - mutability - delusion

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13
Q

mutability=

A

can we change the beliefs? if not, it becomes a delusion

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14
Q

which two symptoms are positive

A

delusions and hallucinations

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15
Q

most common type of delusion =

A

persecutory

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16
Q

persecutory delusion =

A

thinking people are out to get you

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17
Q

second most common type of delusion =

A

referential

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18
Q

less common types of delusions =

A

o Somatic (body experiences, eg. bugs under the skin)
o Grandiosity
o Erotomanic (‘celebrity X is in love with me’)
o Nihilistic (‘impending catastrophe’)

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19
Q

difference schizophrenia and delusional disorder

A

In contrast to schizophrenia which, in addition to delusions, comes with prominent hallucinations, negative, and cognitive symptoms, DD is usually considered a disorder of delusions only.

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20
Q

referential delusion =

A

The term ‘referential delusions’ refers to the mistaken belief that ordinary events and normal human behavior have hidden meanings that somehow relate to the individual experiencing the delusions.

bv bij de wereld draait door: denken dat de presentator specifiek tegen hen praat

= ideas of reference

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21
Q

dsm IV definitie van bizarre delusion

A

‘‘clearly implausible and not understandable and not derived from ordinary life experiences.’

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22
Q

en nu dsm 5 definitie bizarre delusion

A

“Delusions are deemed bizarre if they are
clearly implausible and not understandable to same-
culture peers and do not derive from ordinary life
experiences. ”

dus bizar = vinden andere mensen van dezelfde groep dit ook?

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23
Q

negative symptoms most common

A

reduced expressivitiy
avolition

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24
Q

avolition =

A

reduced self-motivation, reduced goal-oriented activities

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25
less common negative symptoms
alogia anhedonia asociality
26
alogia=
reduced speech
27
anhedonia=
reduced enjoyment
28
asociality =
reduced interest in social activities
29
disorganized symptoms
disorganized speech severely disorganized or catatonic behaviour
30
other symptoms
anosognosia disrupted self experience
31
schizophrenia dsm 5
for at least 1 month, unless treated, a significant proportion of time: 2 of these (at least one must be 1/2/3): halucinations delusions disorganized speech grossly disorganized or catatonic behaviour negative symptoms impact on functioning continued signs of disturbance for 6 months
32
when is the onset of schizophrenia usually
between 16-30 years
33
onset for men
early-mid 20s
34
onset for women
late 20s
35
schizoaffective disorder dsm 5
uninterrupted period of illness during which there is a major mood episode (depression or mania) concurrent with criterion A of schizophrenia: 2 or more, at least 1/2/3: delusions hallucinations disorganized speech disorganized behaviour or catatonic negative symptoms
36
delusional disorder DSM 5
presence of one or more delusions with a duration of 1 month or longer criteria A of schizophrenia has never been met functioning is not markedly impaired apart from the delusions, and behaviour is not bizarre
37
differential diagnoses of delusional disorder=
With OCD or BDD: even if the belief of catastrophe / body experience is extremely solidified, and there is anosognosia, OCD or BDD fits better than delusional disorder or With mood disorders: similar to schizoaffective disorder, symptoms of mood have to be relatively short compared to symptoms of delusional disorder
38
6 soorten other psychotic disorders
delusional disorder brief psychotic disorder schizophreniform disorder schizoaffective disorder substance/medication induced psychotic disorder psychotic disorder due to another medical condition
39
niet te verwarren met de PERSONALITY disorders van odd/eccentric cluster, namelijk....
paranoid - distrusting schizoid - distant schizotypical - strange perceptions and behaviour
40
ezelsbruggetje voor schizoid verschil met schizotypical (PERSONALITY DISORDERS!!!)
schizotypical = abnormal behaviour, dus niet zo typical
41
delusional disorder=
delusions are present but not enough for schizophrenia criterion A. functioning is not impaired
42
brief psychotic disorder
one or more symptoms present for a day or more but less than a month. return to normal functioning
43
schizophreniform disorder
duration longer than 1 month, less than 6 months (can be a temporal diagnosis if u suspect schizophrenia)
44
schizoaffective disorder
criterion A for schizophrenia is met (hallucinations, delusions, disorganized behaviour and speech, negative symptoms) but not B (social dysfunction) or F (autism or communication disorder) presence of major mood episode (depression/mania)
45
wat is het verschil tussen schizoaffective disorder en depression or bipolar with psychotic ft:
bij schizoaffective: delusions or hallucinations are present outside of mood episode as well. (dus schizo = hoofd + affective episode). bij psychotic depression is depression = hoofd, en psychotic aspects
46
prevalence schizophrenia
rond de 1%
47
hoe kan je de diagnose stellen voor schizophrenia
semi structured interviews, bijvoorbeeld SCID of MINI plus
48
jumping to conclusions
mensen met schiz jump to conclusions with very limited information
49
hoe meet je neurocognition
via digit span test
50
dopamine hypothesis
dopamine is at the bottom of positive symptoms (but barely for negative symptoms)
51
aberrant salience model
The “aberrant salience” model proposes that psychotic symptoms first emerge when chaotic brain dopamine transmission leads to the attribution of significance to stimuli that would normally be considered irrelevant. dus: dopamine -> irrelevant stimuli become salient
52
being a migrant is a risk factor for schizophrenia
oke
53
urbanicity is also a risk factor for schizophrenia
oke
54
relationship to trauma
50-98% of schiz patients have a trauma 80% finds their psychotic episodes traumatic too prevalence of comorbid ptsd = 16% but 90% of case files do not mention PTSD, though it is present
55
psychosis =
loss of contact with reality
56
voorbeeld van hoe mentalizing ontstaat
Develops in early childhood, environment-driven ➢ Deafness / deprivation impedes development ➢ Association found between hearing difficulties, trauma in development, and later psychotic symptoms / disorders
57
kijken naar cognitive model van morrison et al
oke
58
social defeat hypothesis =
sense of social exclusion (migrants, deaf children) leads to dopamine sensitization -> increased risk of psychotic disorders
59
wat is de overlappende etiology
biopsychosocial model en diathesis stress model
60
wat voor treatment voor psychotic episodes
antipsychotics (maar hele heftige side effects, vooral motor skills (parkinsonism)
61
en psychosocial interventions?
psychotherapy kan enorm helpen
62
kijken naar het model van cognitive behavioural therapy
oke
63
wat voor treatment voor de trauma
treating trauma in psychosis TTIP EMDR
64
wat doet de staging model
describes schizophrenia in stages every stage is increased severity and duration treatment is intended to avoid progression to the next stage
65
stage 1:
prodromal phase/at risk mental state subclinical positive symptoms present negative symptoms functional deterioration mood swings indications of cognitive problems
66
stage 2:
first episode positive symptoms not very different from chronic phase worsening cognitive symptoms
67
stage 3:
multiple episodes with stable phases or remission progress is very different per person!
68
wat is de outcome van stage 3
incomplete remission of first episode new episodes with less recovery more relapse with further reduction in functioning
69
there are no indications of progressive neurodegeneration until about 65 yrs old
oke
70
wat is de prognosis voor schizophrenia?
➢ Depends on your definition of recovery ➢ Symptom-free? Unlikely – 20 % ➢ Meaningful personal recovery: very possible

Clinical & Neuropsychology 2 (30 decks)

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