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Flashcards in Psychosis Deck (44):
1

What is schizophrenia and how is it characterised?

Group of brain disorders characterised by disorders of thought, behaviour, perception and emotion

2

What is the one pathognomonic symptom of schizophrenia?

There isn't one!
Having more than one symptom increases the risk

3

There is a strong genetic link to schizophrenia. True/False?

True

4

List 3 "positive" symptoms of schizophrenia

Delusions
Hallucinations
Thought disorder

5

List 4 "negative" symptoms of schizophrenia

Apathy
Lack of volition
Social withdrawal
Cognitive impairment

6

Positive symptoms are harder to treat than negative symptoms in schizophrenia. True/False?

False
Positive symptoms are often easier to treat

7

According to Schneider's first rank symptoms for schizophrenia, list some thought disorders

Thoughts spoken out loud
Running commentary
3rd person voices talking
Thought withdrawal, broadcasting or insertion

8

What is passivity phenomena?

Experience where acts/emotions/feelings are being controlled by an external party

9

A patient must have Schneider's first rank symptoms to be diagnosed with schizophrenia. True/False?

False
They are not pathognomonic and can be seen in other psychoses

10

What is a delusion?

A fixed belief that cannot be changed by logical thought or evidence

11

What is a hallucination?

Perceptual, fantastical experience that is believed to be real without evidence

12

List the different modalities by which hallucinations can occur

Auditory (most common)
Visual
Olfactory
Gustatory
Tactile
Kinaesthetic

13

Which type of auditory hallucination - 1st, 2nd or 3rd person - is more typical of schizophrenia?

3rd person

14

What is meant by "word salad"?

Mish mash of words that together don't make sense

15

What is meant by thought withdrawal?

Belief that thoughts are being removed by an external party - a delusional explanation for thought blocking

16

What is meant by thought broadcasting?

Belief that people understand your thoughts without you having to voice them

17

List features of emotional disorder that can occur in psychoses such as schizophrenia

Blunted affect
Incongruent mood
Apathy
Lack of motivation
Anhedonia

18

What is the main motor disorder that may occur in schizophrenia?

Catatonia

19

What is catatonia?

State of increased tone of muscles at rest, abolished by voluntary activity

20

What are the main treatments for catatonia?

ECT
Benzodiazepines

21

What is the peak incidence of schizophrenia for men and women?

Men: 15-25
Women: 25-35

22

List factors that indicate good prognosis for schizophrenia

Older age of onset
Being female
Mood disturbance (elation especially)
Family history of mood disorder

23

List factors that indicate poor prognosis for schizophrenia

Long duration of untreated psychosis
Insidious early onset
Cognitive impairment
Enlarged brain ventricles

24

Psychosis is a diagnosis. True/False?

False
Description of symptoms rather than diagnosis

25

What is psychosis?

Inability to distinguish subjective experience from reality, characterised by lack of insight

26

List psychotic experiences

Hallucinations
Delusions
Thought disorders
Emotional disturbance
Physical disruption

27

List the main differential diagnoses of psychosis

Schizophrenia
Schizoaffective disorder
Drug toxicity
Mania
Depression
Delusional disorder
Puerperal psychosis
Delirium
Dementia

28

What is meant by flight of ideas?

Jumping from topic to topic by associating words together inappropriately

29

How does tangential thinking differ from circumstantial thinking?

Tangential: wander off from topic/question and never return
Circumstantial: excessive detail relating to topic, eventually return to topic

30

What is meant by self-referential experience?

Belief that environment is reacting to you, i.e. external events are related to oneself
e.g. tv/radio is talking to you specifically

31

List some common drugs that can cause psychosis

Steroids
Cannabis
Amphetamine
Cocaine
Tobacco
Alcohol
Opioids

32

How is depressive psychosis classically typified?

Mood congruent with psychosis - delusions of guilt/pessimism on top of depressed mood

33

What is a grandiose delusion?

Delusion where one thinks they are vastly superior and have superhuman like qualities

34

What is schizoaffective disorder?

Mixed picture of schizophrenia + bipolar disorder where someone displays schizophrenia but their mood is also affected

35

At what time of day is delirium typically worse at?

Night

36

What are the 3 main cortical changes that occur in schizophrenia?

Reduced frontal lobe volume
Reduced frontal lobe grey matter
Enlarged ventricles

37

Which neurotransmitter causes a psychotic state when in excess?

Dopamine

38

List the 3 main dopaminergic pathways in the brain

Nigrostriatal
Mesolimbic
Tuberoinfundibular

39

Which dopaminergic pathway is typically involved in schizophrenia?

Mesolimbic system

40

Name some dopamine antagonists (anti-psychotics) that can be used for schizophrenia

Haloperidol
Raclopride
Clozapine

41

Subcortical dopamine hyperactivity/hypoactivity leads to psychosis

Subcortical dopamine hyperactivity leads to psychosis

42

What is the benefit of atypical antipsychotics over typical antipsychotics?

Less likely to induce extra-pyramidal side effects
Better efficacy

43

List some atypical antipsychotics

Clozapine
Aripiprazole
Risperidone

44

What is the fatal side effect of clozapine that makes it a 3rd line agent for psychosis?

Agranulocytosis