Schizophrenia Flashcards
(43 cards)
What is psychosis?
A mental health problem that causes the patient to be out of touch with reality. The patient experiences a different reality to others, and is unaware of this.
What are the main symptoms of psychosis?
- Hallucinations
- Delusions
- Confusion
- Lack of insight
What are hallucinations?
Perceptions in the absence of an external stimulus
Which type of hallucination is commonest in psychosis?
Auditory
What is are the common causes of visual hallucinations?
- Delirium
- Organic pathology
What do olfactory hallucinations tend to indicate?
Frontal lobe pathology
Define delusions
- A fixed firmly held belief in light of insufficient evidence
- Cannot be reasoned with
- Outside of sociocultural norms
List four types of delusions
- Grandiose
- Persecutory
- Reference
- Guilt
- Erotomanic
What are mood congruent delusions?
Delusions that align with a patients mood
In depression these include persecutor, guilt, poverty, hypochondriac and nihilism.
Mania commonly features grandiose, erotomanic.
How must insight be assessed?
- Is the patient able to recognize they have a problem?
- What does the patient think is the cause?
- Does the patient want help with their problem?
Define schizophrenia
A disorder characterised by the presence of positive symptoms and negative symptoms.
What are positive symptoms of schizophrenia?
- Hallucinations
- Delusions
Name four negative symptoms of schizophrenia?
- Marked apathy
- Passivity of speech
- Blunting of emotion
- Lack of awareness of socially appropriate behavior
- Difficulty in abstract thinking
Name two subtypes of schizophrenia
- Paranoid
- Hebephrenic: disorganised thoughts and behaviours
- Catatonic
What are Schneider’s symptoms of first rank?
- Auditory hallucinations
- Repeating subjects thoughts ‘echo de la pensee’
- Third person
- Running commentary
- Thought insertion, withdrawal, or broadcasting
- Passivity of affect, impulse, or volition - under external control
- Somatic passivity - somatic sensations by external agency
- Persistent delusions
What is the ICD-10 diagnostic criteria for schizophrenia?
Symptom(s) appear on most days for one month in duration:
- Any one of Schneider’s symptoms of first rank; or
- eg. Running commentary, thought insertion, passivity of affect.
- Any two of:
- Persistent hallucinations of any modality
- Breaks in train of thought - incoherent/irrelevant speech
- Catatonic behaviour: stupor or posturing etc.
- Negative symptoms
- Must not be an organic cause, or alcohol or drug related.
List four features of catatonic behavior consist?
- Excitement: bizarre, non-goal directed hyperactivity and impulsiveness
- Posturing; waxy flexibility
- Negativism: opposition or no response to instruction
- Aversion
- Mutism; stupor
- Agitation; grimacing
- Echolalia; echopraxia
When does the first episode of schizophrenia typically occur?
20’s
Name three differential diagnoses of schizophrenia
- Subtance-induced psychosis
- Organic disease
- Mood disorders with psychosis
- Dementia; delirium
- PTSD
- Anxiety; paranoid personality disorder
- OCD
Name two predisposing factors for schizophrenia
- Bio: Genetics, head trauma
- Psycho: Conflict
- Social: Environment/role
Outline two precipitating factors of schizophrenia
- Bio: Substance use, head trauma
- Psycho: Expressed emotion, life events, coping style
- Social: Poverty, isolation
Outline two perpetuating factors of schizophrenia
- Bio: Substance use, poor compliance
- Psycho: Expressed emotion, hopelessness
- Social: Social network, work, family
How does the initial presentation of schizophrenia differ between males and females?
Males tend to have earlier onset (23 vs 26), and develop more severe illness.
There is equal likelihood of developing schizophrenia in both genders.
What is expressed emotion?
A measure of family environment of a psychiatric patient.
High EE family members are more hostile, critical and intolerant of the patient.
