Schizophrenia and Psychotic Disorders Flashcards
(77 cards)
The 3 principle psychotic disorders
Delirium
Schizophrenia
Affective psychosis
Definition of psychosis
Represents an inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality
Main symptom of schizophrenia
lack of insight
What does a predisposing factor mean?
putting you at risk
What does a precipitating factor mean?
something that starts it
What does a perpetuating factor mean?
keeping it going
Presentation of psychosis
Hallucinations - full force and clarity of true perception - located in external space - no external stimulus - not willed or controlled Delusional beliefs - grandiose - paranoid (correctly persecutory) - hypochondrial - self referential Lacks insight
5 special senses of hallucinations
Auditory Visual Tactile (touching you) Olfactory Gustatory (Taste)
Definition of delusion
An unshakable idea or belief which is out of keeping with the persons social or cultural background; it is held with extraordinary conviction
Illnesses that have psychotic symptoms
Schizophrenia
Delerium
Severe affective disorder
What is severe affective disorder?
Either
- depressive episode with psychotic symptoms
OR
- manic episode with psychotic symptoms
Differential diagnosis of psychosis
Delerium Acute organic brain syndrome Depressive episodes with psychotic symptoms Manic episodes with psychotic symptoms Schizophrenia Making it up e.g. in a police case
Features of psychosis caused by delirium or acute organic brain syndrome
Prominent visual experience, hallucinations and illusions
Affect of terror
Delusions are persecutory and evanescent (quickly disappear)
Fluctuating worse at night
Definition of an illusion
Abnormal perception of a real thing
Features of psychosis caused by depressive episode with psychotic symptoms
Delusions of guilt, worthlessness and persecution
Derogatory and auditory hallucinations
Features of psychosis caused by a manic episode with psychotic symptoms
Delusions of grandeur; special powers or messianic roles
Gross overactivity, irritability and behavioural disturbance
Manic excitement
Treatment of psychosis
Early intervention - family and psychological
Community treatment
Antipsychotics
Treatment to prevent relapse during remission
CBT
Cognitive remediation
Social skills training
Definition of schizophrenia
A severe mental illness affecting thinking, emotion and behaviour
What is the most common cause of psychosis?
Schizophrenia
Who gets schizophrenia?
M = F
onset 15-35 years
Possible biological causes of schizophrenia
genetics neurochemistry (glutamate, GABA) obstetric complications maternal influenza malnutrition and famine winter birth substance misuse e.g. cannabis
Symptoms of schizophrenia
Positive - hallucinations - delusions - disordered thinking Negative - apathy - lack of interest - lack of emotions - alogia - disturbed attention
What is a “positive” symptom?
A dramatic, more obvious symptom
ICD-10 Criteria for schizophrenia
> 1 month in the absence of organic or affective disorder
At least 1 of the following
- alteration of thought; echo, thought insertion, thought withdrawal, thought broadcasting
- delusions of control, influence or passivity (other people controlling you), clearly referred to body or limb movements - actions or sensations
- hallucinatory voices giving a running commentary on patients behaviour, or discussing him between themselves or other voices coming from somewhere in the body
- persistent delusions that are culturally inappropriate and completely impossible (e.g. controlling weather)
And OR at least two of the following
- persistent hallucinations of any modality, when occurring every day for at least 1 month
- Neologisms, breaks or interpolations in train of thought, resulting in incoherence or irrelevant speech
- Catatonic behaviour, such as excitement, posturing or wavy flexibility, negativism, mutism and stupor
