Psychosis and Schizophrenia

Question 1

What is a psychotic episode?

Answer 1

When an individual experiences a different reality to the rest of the world/people around you

Question 2

How long can a psychotic episode last?

Answer 2

Anything from days to months

Question 3

How do psychotic episodes begin?

Answer 3

Can begin quickly or gradually

Question 4

Do patients have insight in a psychotic episode?

Answer 4

No

Question 5

How do pts experiencing a psychotic episode present?

Answer 5

Usually via the police, a CPN/other community MH professional, or by concerned family member

Basically not usually via the GP

Question 6

What 4 key things are part of a psychotic episode?

Answer 6

Hallucinations
Delusions
Formal Thought Disorder
Disorders of self

Question 7

What is it important to find out with a psychotic patient?

Answer 7

If the cause is organic or functional

Question 8

What organic problems can cause a psychotic episode?

Answer 8

Dementia
Delerium
Infections
Endocrine disturbance
Temperal lobe epileps

Question 9

Define schizophrenia

Answer 9

Disorder/group of disorders characterised by psychotic epiodes (positive symptoms) and negative symptoms

Question 10

What are the 3 types of functioning psychosis?

Answer 10

Schizophrenic
Manic
Depressive

Question 11

What are the three patterns to psychotic episodes that a person can experience?

Answer 11

• One off
• Recurrent episodes with normal periods in between
• Episode(s) -> personality changes and recurrent episodes

Question 12

What is the prevalence of schizophrenia?

Answer 12

1% of general population

Question 13

Which demographic groups is schizophrenia more common in?

Answer 13

Afro-caribbean
Identical twins
Users of illicit drugs

Question 14

What essentially is a psychosis?

Answer 14

Experiencing a different reality to everyone else, and unaware that what they are experiencing is abnormal.

Question 15

Define a delusion

Answer 15

Fixed firmly held belief in things which are not true, and go against the persons own (usual) beliefs

Question 16

What kinds of delusions can a person experience?

Answer 16

Guilt, erotomanic, grandiose, persecutory, hypochondriacal, and delusions of reference

Question 17

Define a delusion of guilt.

Answer 17

Patient feels great amounts of guilt at minor things they may have done

Question 18

Define a erotomanic delusion

Answer 18

Belief that people are in love with you

Question 19

Define a grandiose delusion

Answer 19

Belief that you are a very importnt/famous person e.g. royalty or Christ

Question 20

Define a persecutory delusion

Answer 20

The belief that people are persecuting you/out to get you

Question 21

Define a hypochondriacal delusion

Answer 21

The belief that they have a terrible illness

Question 22

Define a delusion of reference

Answer 22

Believing that every day events have some massive significance, blowing coincidences out of proportion

Question 23

Define a hallucination

Answer 23

Perception in the absence of external stimulus

Question 24

What are the most commonly experienced hallucinations?

Answer 24

Auditory and tactile

Question 25

What is thought broadcasting?

Answer 25

Thinking that everyone can hear your thoughts

Question 26

What is thought insertion?

Answer 26

Thinking that other people's thoughts are becoming implanted in your brain, thoughts/dreams are not your own

Question 27

What kind of symptoms will pts with schizophrenia experience?

Answer 27

Positive and negative symptoms, occuring sometimes at the same time and sometimes not

Question 28

What are the positive symptoms of schizophrenia?

Answer 28

Delusions, hallucinations, formal thought disorder, disorders of self (thought insertion/withdrawal)

Question 29

What are the negative symtpoms of schizophrenia?

Answer 29

Lack of will and interest Social isolation Living in their own world

Question 30

How long must a pt have had symptoms to diagnose schizophrenia? How many symptoms?

Answer 30

1 month/28 days One or more clear cut, or 2+ mild positive symptoms, or one or more with a negative symptom

Question 31

What should all schizophrenia pts have done?

Answer 31

A risk assessment. Stupid question really, should do a risk assessment in all psych patients.

Question 32

If a pt is low risk, where should we refer them?

Answer 32

Psychosis service

Question 33

Who starts antipsychotic treatment in schizophrenics?

Answer 33

Consultant psychiatrist

Question 34

What is first line for treatment of achizophrenia?

Answer 34

Try on a course of oral antipsychotics and offer CBT

Question 35

How do antipsychotics work?

Answer 35

Block function of dopamine receptors, as well as other receptors

Question 36

What are the 2 types of antipsychotic?

Answer 36

Typical and atypical/1st gen and 2nd gen

Question 37

What are the typical antipsychotics?

Answer 37

Haloperidol Chlorpromazine Piperazine