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TCD > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

what is psychosis

A

grossly impaired reality testing

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2
Q

which disorder is characterised by primary psychosis

A

schizophrenia

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3
Q

which disorders occur with secondary psychosis

A

bipolar disorder
substance use
neurological conditions
depression

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4
Q

DSM criteria for schizophrenia

A

delusions
hallucinations
disorganised speech
disorganised or catatonic behaviour
negative symtptoms

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5
Q

how many criteria must one have for SCZ diagnosis

A

2 or more
but must feature
- delusions
- hallucinations
- disorganised speech

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6
Q

how long must SCZ be ongoing for diagnosis

A

greater than 6 months

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7
Q

what are negative symptoms of SCZ

A

diminished emotional expression or motivation

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8
Q

what are the positive symptoms

A

hallucinations and delusions

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9
Q

what is a hallucination

A

sensory perception in absence of corresponding external or somatic symptoms

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10
Q

do hallucinations have insight

A

they can or they can not

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11
Q

examples of hallucinations

A

visual
auditory
olfactory
tactile
gustatory

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12
Q

which are the most common SCZ hallucinations and examples

A

auditory
- hearing thoughts spoken out loud
- multiple voices speaking to you
- non verbal sounds

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13
Q

what are delusions

A

false believe based on incorrect inference about external reality that is firmly held despite what constitutes as incontrovertible and obvious proof/evidence to the contrary

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14
Q

do delusion have insight

A

no

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15
Q

what are delusions of reference

A

believe that someone on radio/tv is talking to scz directly, who has special awareness of them

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16
Q

what are persecutory delusions

A

that someone is out to get you, harm you

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17
Q

what are grandiose delusions

A

that you have special powers, play an important, huge role in saving planet etc

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18
Q

what are erotomanic delusions

A

where people are entangled in romantic relationships with someone they’ve never met

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19
Q

what are somatic delusions

A

fixed and firm beliefs about bodily symptoms, metal in blood etc

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20
Q

what are thought insertion delusions

A

idea that someone has put thoughts in your head

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21
Q

what is loose association

A

incoherence in linking ideas

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22
Q

what are neologisms

A

words that do not exist

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23
Q

what are metonyms

A

words which are related but not correct

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24
Q

what is flight of ideas

A

comes out incomprehensibly, too fast

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25
Q

what is echolalia

A

meaningless repetition of someones words

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26
Q

what is disorganised behvaiour

A

behaviour which is not typical of a persons culture or inappropriate to context it takes place in

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27
Q

outcomes of disorganised behvaiour

A

decline in daily functioning, hygiene
inappropriate or unusual emotional responses
dressing in odd manner
catatonia

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28
Q

what is catatonia

A

muscular rigidity
stupor
repeated gesturing
flailing
unusal postures

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29
Q

what is avolition/apathy

A

lack of motivation or interest in things

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30
Q

what is asociality

A

social withdrawal, tend to spend time alone

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31
Q

what is anhedonia

A

inability to find pleasure in things

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32
Q

what is alogia

A

poverty of speech
does not talk

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33
Q

what is a blunted affect

A

lack of outward expression of emotion

34
Q

lifetime prevalence of SCZ

A

0.7%

35
Q

SCZ and sex differences

A

men - 1.4
women - 1

36
Q

what is peak age of onset of SCZ

A

~25
(slightly later in women)

37
Q

theories on why SCZ appears later in women

A

having children may explain gap in development
secondary bump in psychological symptoms happens in menopause

38
Q

how long do symptoms last after first psychotic episode before medical attention

A

avg 1 year

39
Q

what occurs in the prodromal phase

A

odd behaviours
subtle negative symptoms

40
Q

what occurs in the acute phase

A

positive symptoms
negative symptoms
remissions
relapses

41
Q

what occurs in the final phase

A

poor social functioning
negative symptoms
cognitive symptoms

42
Q

who was emile kraepelin

A

one of the founders of scientific psychiatry
distinguished 2 forms of psychosis

43
Q

what were Kraepelin’s forms of psychosis

A

dementia praecox
manic depression

44
Q

what is dementia praecox

A

progressive neurodegenerative disease

45
Q

what does dementia praecox result in

A

irreversible loss of cognitive function
- hallucinations arise

46
Q

what is manic depression

A

alternation between depression and manic psychosis

47
Q

who proposed the term schizophrenia

A

paul eugen bleuler

48
Q

what did paul eugen bleuler want to emphasise

A

the loss of normal relational linages between thoughts, misattributions to wrong sources, disconnection in brain, mental confusion

49
Q

what did paul eugen bleuler characterise SCZ as

A

a breaking of associative threads

50
Q

which neurotransmitter’s hyperactivity is associated with psychosis

A

dopamine

51
Q

how do antipsychotic medications help SCZ

A

reduce dopamine

52
Q

how do amphetamines work in patients with SCZ

A

amplify SCZ symptoms

53
Q

what are the issues with the model of dopamine dysregulation in explaining SCZ

A

does not account for the array or heterogeneity of SCZ symptoms

54
Q

what neuro activity are negative symptoms associated with

A

hypo-activity of dopamine neurons in prefrontal cortex

55
Q

what are changes in SCZ brains over time

A

enlargement of ventricles
thinning of cortex mostly in PFC

56
Q

what functions does the PFC control

A

decision making
working memory
reasoning
judgement
goal directed behaviour
top down control over impulses

57
Q

what happens when grey matter is reduced

A

fewer neurons

58
Q

SCZ and synaptic pruning

A

overzealous pruning due to issues in evalauting information based on evidence

59
Q

what is predictive coding theory

A

how the brain functions in a bayesian way
how people establish beliefs about world and updates beliefs when new information is acquired

60
Q

what is prediction error

A

represents a mismatch between what we expect and what happens

61
Q

which neurotransmitter is foundational for prediction error

A

dopamine

62
Q

SCZ and predictive coding

A

SCZ patients overweight evidence in favour of beliefs, and underweight evidence contrary

63
Q

pre-pulse inhibition and SCZ

A

do no reduce startle when given a warning

64
Q

how heritable is SCZ

A

80%

65
Q

environmental risk factors for SCZ

A

birth complications
prenatal exposure to infection
adolescent drug use
early cognitive deficits
low SES
early trauma and abuse

66
Q

what is the social selection hypothesis

A

SCZ leads people to earn less and other socioeconomic indicators

67
Q

medications for SCZ - names

A

neuroleptics (antipsychotics)

68
Q

which receptors do conventional antipsychotics act on

A

dopamine 2 receptors

69
Q

conventional antipsychotics and efficacy

A

effective for positive symptoms and disorganisation
more severe side effects

70
Q

side effects of conventional antipsychotics

A

blurred vision
tremors, lip smacking
sexual dysfunction

71
Q

2nd gen antipsychotics

A

weight gain
sedation

72
Q

2nd gen antipsychotics efficacy

A

better on negative symptoms

73
Q

how does social skills training help SCZ

A

improves functionality

74
Q

how does CBT help SCZ

A

manages negative symptoms and stress

75
Q

how does family therapy and psycheducation help SCZ

A

improves level of support and understanding
but not a cure

76
Q

rates of crime and SCZ

A

2x bigger in SCZ than general population
SCZ 14x more likely to be victim

77
Q

typical applicant of not guilty by reason of insanity defence

A

SCZ patients

78
Q

what are the conditions of NGRI defence

A

should not be held responsible is attribute to disorder which
- did not know nature / quality of act
- did not know they were doing something wrong
- unable to refrain from committing act

79
Q

SCZ and NGRI

A

did not know nature or quality of act

80
Q

ID and NGRI

A

did not know nature or quality
did not know they were doing something wrong

81
Q

john hickey jr

A

tried to assassinate ronald reagin in 1981
- because in love with jodie foster, wanted to impress her
- found NGRI, institutionalised for 35 years

TCD (17 decks)

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