Task 8 - Psychotic disorders Flashcards
(37 cards)
What is psychosis?
Inability to tell the difference between what is real and what is unreal, e.g. see things that don’t really exist, believe others already know what the person is thinking
What are the features that define psychotic disorders?
- Delusions
- Hallucinations
- Disorganized thinking
- Grossly disorganized/abnormal motor behavior
- Negative symptoms (diminihed emotional expression or avolition)
Define delusions
Fixed ideas that individuals believe are true but instead are highly unlikely or impossible even if showned with conflicting evidence.
Define hallucinations
Perception-like experiences (i.e. vivid and clear, not under voluntary control!) without an external stimulus
Explain disorganized thinking
Detected from speech, e.g. derailment/loose associations: unrelated speech/ person says many ideas but they are not coherent/part of a story; In extreme cases, it can resemble aphasia
Explain the abnormal motor behavior
Ranges from childlike “silliness” to unpredictable agitation;
–> Catatonic behaviour: decrease in reactivity to environment, e.g. negativism: resistance to instructions, mutism: inappropriate/bizarre posture or excessive motor
Define diminished emotional expressions
Reductions in expression of emotions in face, eye contact, intonation of speech, movements of head/face
Define avolition
Decrease in motivated self-initiated purposeful activities, e.g. patient sits for long periods of time, shows little interest in participating social events
How is the severity of schizophrenia assesed?
delusions, hallucinations, disorganized speech Abnormal behaviour and negative symptoms assessed on 5-point scale (0 = not present, 5 = present and severe)
Explain the psychotic disorders along a continuum of severity
SC symptoms appear in mild to moderate forms in many people who do not meet the full criteria for any disorder
Further along continuum: personality disorders (PD), e.g. schizoid PD, paranoid POD, schizotypal PD: moderate symptoms but keep grasp of reality
Further along continuum: loss of touch with reality: individuals hold beliefs contrary to reality but lack other key SC symptoms and usually are not impaired in functioning, e.g. delusional disorder: delusions without hallucinations
Even More dysfunctional: schizophreniform disorder, where symptoms present for more than 1 month but less than 6
What are other associated features with SC?
- Inappropriate affect, e.g. laughing for no reason
- Dysphoric mood, e.g. depression, low mood, anger
- Disturbed sleeping pattern
- Lack of interest in eating or food refusal
- Depersonalization and/or derealization
- Anxiety or phobias
- Cognitive problems, e.g. working memory (WM) impairments, reductions in attention, some show lack of theory of mind
- Anosognosia
- Aggression can be shown, more frequently by males
What is anosognosia?
Lack of awareness of symptoms of the disorder; high predictor of non-adherence/compliance to treatment and/or relapse, poorer course of illness, increased number of involuntary movements, poorer functioning
What is the prevalence of SC?
03.7% to 0.7%; Gender differences: more negative symptoms and longer duration is higher in males
SC emerges between late teens (in men) and late-20s (in women); mos individual show a slow and gradual development
Is there a suicidal risk?
Yes,
Approximately 20% attempt suicide, 5-6% of SC patients die by suicide
Is there comorbidity with other disorders?
Yee,
Over half have tobacco use disorder also comorbid with anxiety, OCD, panic disorders, Schizotypal or paranoid PD
The schizophreniform disorders has 2 different types. What are these?
- Schizophreniform with good prognostic features: good premorbid social and occupation functioning, absence of blunted affect/emotions
2: Without good prognostic features: features of good prognostics are absent
What is the prevalence of Schizophreniform disorder?
5 times lower than schizophrenia; in developing countries higher rates of good prognostic features
What is the genetic contribution to developing a psychotic disorder?
- Strong genetic component in SC
- Finish study estimated SC heritability around 80%! (very high)
What are the structural and functional brain abnormalities influencing the development of psychotic disorders?
- Enlarged ventricles, reductions in prefrontal areas and abnormal connections between PFC and amygdala and hippocampus
- Abnormalities in volume, density and metabolic rate in frontal cortex, temporal lobe, basal ganglia, hippo., thalamus, and maygdala
- Abnormalities in PFC –> deficits in cognition, emotion processing and social interactions
Do birth complications and prenatal viral exposure affect the developing of a psychotic disorder?
Yes,
- around 30% of SC patients suffered perinatal hypoxia (oxygen deprevation at birth)
- Mothers exposed to viral infections whilst pregnant higher chances for offspring to develop SC
What are the possible explanations (not yet fully understood) for the influence of neurotransmitters?
- Excess dopamine activity in meso-limbic pathway; atypical antipsychotic medication that blocks activation of dopamine - reduced SC symptoms
- Unusually low dopamine in PFC - explains lack of motivation, inability to care for oneself, lack of emotions
- Glutamate abnormalities: glutamate is excitatory, especially in limbic system, thalamus and basal ganglia - explains movement sometimes observed in SC patients
What does the Integrative model explain?
Abnormalities in PFC –> working memory deficits (WM) –> difficult to keep away/ignore irrelevant information –> difficulties in reasoning, communication and problem solving, all observed in SC patients
What are the psychological perspectives of developing a psychotic disorder?
- Social drift and urban birth
- Stress and relapse
- SC and family: expressed emotion families
- Cognitive perspectives
Explain the social drif and urban brith
o Social drift: SC symptoms interfere with ability to complete education/hold a job - SC patients show history of living in impoverished inner-city neighbourhoods and low-status occupations or unemployment
o Urban birth: SC patients show history of living in big cities; SC more prevalent in higher cities due to higher rates of diseases/viruses that are available
