Schizophrenia and Affective disorders Flashcards
(48 cards)
What is Psychosis?
Heterogeneous syndromes of various etiologies characterized by loss of touch with reality.
How can Psychosis be classified?
1.Primary or secondary
2. Affective or non affective
What is the difference between primary and secondary psychosis?
Primary -there’s no identifiable external medical, neurological or substance related cause.
Secondary - there is identifiable external factor
Give 5 examples of primary psychotic disorders?
1.Schizophrenia
2.Schizoaffective disorder
3.Delusional disorder
4.Schizophreniform disorder
5. Brief psychotic disorder
List 3 ways to group secondary causes of Psychosis?
1.Substance/medication induced psychotic disorder
2.Psychotic disorder due to medical condition
3.Trauma to the brain
What is the difference between affective and non affective schizophrenia?
1.Affective
Characterized by the presence of psychotic symptoms along with significant mood disturbances
2. Non affective
Psychotic disorders where mood disturbances are not a prominent feature.
What are the key features of psychotic disorders?
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or abnormal motor behavior
Negative symptoms (Avolition, Anhedonia, Alogia, Asociality, flat Affect)
Define a delusion?
1.fixed false beliefs that are not based in reality and are resistant to reasoning or contrary evidence
What is a hallucination?
A sensory experience that occurs without any external stimulus.
Hallucinations can be (auditory, visual, tactile, olfactory, gustatory)
What are the types of delusions seen in psychotic disorders (14).Describe them.
1.Grandiose- Heightened value ,knowledge, power and identity or special relationship to a famous person.
2.Persecutory -Believing that subject or someone close to them is attacked, harassed ,deceived or conspired against
3.Delusion of reference-the belief that unrelated events in the outside world have a special or unique relevance in the subject’s life.
4.Somatic Delusion-feeling that the subject is being affected by a physical illness or having some type of physical defect.
5.Erotomania -when one imagines that another person with a higher status is in love with him or her.
6. Bizarre -a type of delusion that is total implausible in reality.
7. Delusion of perception- a delusion where the a person believes that a normal percept has a special meaning to him or her.
8..Thought echo
9.Thought withdrawal
10.Thought insertion- thinking that their thoughts are not their own but is rather inserted by an external force.
11.Thought broadcast- subject believes that their ideas are being broadcasted aloud causing other to notice them.
12.Delusional jealousy-involves feelings where one’s sexual partner is being unfaithful.
13. Mood incongruent psychotic feature
14. Mood Congruent psychotic feature.
Describe the features of the disorganized speech in Psychosis?
In psychosis:
1.Their loose connections between topics. the topics are connected by less meaningful associations. e.g. a clang association where someone answers a question based on the sound of the word but not the actual meaning.
2.There is Neologism-where people make up words
3.There is Echolalia - where a patient repeats what someone else says without regard to its meaning.
4.There is Perseveration-where there is repetition of a word or phrase or thought beyond the point where it is relevant or appropriate.
5. You can have a world salad where the words coming out of the patient’s mouth are nonsense.
6.Speech can also be tangential, circumferential , incoherent speech
Describe features of the grossly disorganized or catatonic behavior?
In psychosis the patient s could :
Walking around aimlessly
Repeat hand movements
Copy an action being done by someone
Be agitated /uncontrolled physical movements/ prone to attack someone
Lack movement/hypoactive or responsiveness to an external stimuli or bizarre posturing
What is the diagnostic criteria for A brief psychotic disorder?
REFER TO HANDOUT
What is the diagnostic criteria for Schizophreniform?
refer to handout
What is the diagnostic criteria for Schizoaffective disorder?
refer to handout
What is the diagnostic criteria for Delusional disorder?
Refer to handout
What is schizophrenia?
It is a syndrome characterized by a heterogeneous cluster of symptoms and signs
What was the significance of Schneider’s first rank symptoms?
He believed that they were highly indicative of schizophrenia.
List the first rank symptoms ?(9)
1.3rd person auditory hallucinations
2.Running commentary
3.Thought echo
4.Thought withdrawal
5.Thought insertion
6.Thought broadcast
7.Delusional perception
8.Passivity (volition, affect, action)
9. Somatic hallucinations
What is passivity?
- Belief that one’s thoughts or actions are influenced or controlled by an external agent.
What is the typical age of onset in Schizophrenia? And which gender has a higher incidence?
Late teens to mid -30s
men between 18-25
females between 25-35
Men have a higher incidence than women( 1.4 : 1)
List risk factors for developing schizophrenia?(8)
1.Genetic (monozyogotic twins (50-70%), both parents(40-60%)
2.Developmental factors
3.Brain abnormalities (big ventricles and reduced grey matter)
4.Neurotransmitter abnormalities (The Glutamate hypothesis and dopamine hypothesis)
5.Adverse life events
6.Cannabis
7.Paternal age > 35
8. Male gender
According to DSM4 list the 5 subtypes of Schizophrenia and explain them?
1.Paranoid Schizophrenia – prominent hallucinations and delusions
2.Disorganized (Hebephrenic) schizophrenia – prominent disorganized
speech, affect and behavior
3.Catatonic schizophrenia – prominent catatonic features
4.Simple schizophrenia – prominent negative symptoms
5.Undifferentiated schizophrenia – no clear prominent features
What is the glutamate hypothesis ?
The glutamate hypothesis is a theory that suggests an imbalance in the neurotransmitter glutamate plays a central role in the pathophysiology of schizophrenia and other psychotic disorders.
The glutamate system plays a role in regulating other neurotransmitter systems including dopamine .
Thus a dysregulation in the NMDA receptors will result in a dysfunction in dopamine leading to increased amounts in the mesolimbic pathway and reduced amounts in the mesocortical pathway
