Psychosis Flashcards

Question

What are the diagnostic criteria for schizoprenia in DSM5?

Answer 1

A. Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these must be (1), (2), or (3): 1. Delusions. 2. Hallucinations. 3. Disorganized speech (e.g., frequent derailment or incoherence). 4. Grossly disorganized or catatonic behaviour. 5. Negative symptoms (i.e., diminished emotional expression or avolition). B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning). C. Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences). D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness. E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition. F. If there is a history of autism spectrum disorder or a communication disorder of child hood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated).

Answer 2

A minimum of one very clear symptom (or two or more, if less clear cut) belonging to any one of the groups (a) to (d) or at least two of the symptoms (e) to (h) should have been present most of the time during a period of 1 month or more. (a) thought echo, thought insertion or withdrawal and thought broadcasting (b) delusions of control, influence, or passivity, clearly referred to body or limb movements or specific thoughts, actions or sensations; delusional perception (c) hallucinatory voices giving a running commentary on the patient’s behaviour, or discussing the patient among themselves, or other types of hallucinatory voice coming from some part of the body (d) persistent delusions of other kinds that are culturally inappropriate and completely impossible, such as religious or political identity, or superhuman powers and abilities ______________________________________ (e) persistent hallucinations in any modality, when accompanied either by fleeting or half-formed delusions without clear affective content, or by persistent overvalued ideas, or when occurring every day for weeks or months on end (f) breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech or neologisms (g) catatonic behaviour, such as excitement, posturing, or waxy flexibility, negativism, mutism and stupor (h) negative symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses, usually resulting in social withdrawal and lowering of social performance (i) a significant and consistent change in the overall quality of some aspects of personal behaviour, manifest as loss of interest, aimlessness, idleness, a self-absorbed attitude and social withdrawal

Answer 3

0.2–1.1%

Answer 4

About a third of cases have their first psychotic episodesduring adolescence. The onset of schizophrenia is earlier in males than females

Answer 5

Comorbid alcohol and substance use is common in schizophrenia. Symptoms of post-traumatic stress disorder (PTSD) in response to the experience of psychotic symptoms and hospitalizationare common among trauma survivors with psychosis. Psychosis occursin up to 6% of people with seizure disorders.

Answer 6

The onset of schizophrenia typically occurs in late adolescence or early adulthood and may be acute or insidious. Typically the onset takes place over 5 years, starting with negative and depressive symptoms, followed by cognitive and social impairment and finally positive symptoms. Longitudinal studies suggest that there is an early deterioration phase that extends over 5–10 years, a stabilization phase and a final gradual improvement phase. For 50–70% of cases the condition follows a chronic relapsing course, typically with incomplete remission between episodes. However, up to 40% of service-users show one or more periods of complete recovery with good adjustment for at least a year and 4–20% show complete remission

Answer 7

1-6 months, some extending up to a year. Usually there will be a prodromal periode leading up to the psychosis.

Answer 8

The lifespan of people with schizophrenia is about 9 years shorter than that of the general population, and this is partly accounted for bythe high rate of suicide during the first 10 years of the disorder and the high rate of comorbid medical disorders.

Answer 9

About half of all people with schizophrenia attempt suicide or self-harm; the lifetime riskfor completed suicide is 5%; and suicide usually occurs in the early phase of the disorde

Answer 10

4–20% show complete remission.

Psychosis Flashcards

(38 cards)