03-11-23 – Psychosis Flashcards
Learning outcomes
- Define what psychosis means
- Describe the symptoms of schizophrenia
- Discuss potential causes of schizophrenia
- Investigate treatment options for patients with schizophrenia
What are 4 things mental health disorders can vary in?
- 4 things mental health disorders can vary in:
1) Manifestations
2) Severity
3) Duration/ course
4) Prognosis
Why is psychosis?
What are 4 examples of psychosis?
What 4 things can psychosis come secondary to?
- Psychosis is any disorder so severe that the victim loses contact with reality
- 4 examples of psychosis:
1) Schizophrenia
2) Schizoaffective disorders
* Combines schizophrenic and affective (mood) symptoms
3) Persistent delusional disorders
* May not have any symptoms other than delusions
4) Bipolar disorder with psychotic symptoms
- 4 things psychosis can come secondary to:
1) Drug use
2) Focal epilepsy (temporal lobe affected specifically)
3) Dementia
4) Organic brain disease
How common is schizophrenia?
At what age does it typically present in males and females?
- Schizophrenia affects 1% of the world’s population
- Diagnosis:
1) Men early 20’s
2) Women late 20’s
Wheat are 3 reasons Black people (but not other BAME groups) are far more likely to be diagnosed with schizophrenia than white people, despite there being no biological basis for this?
- 3 reasons Black people (but not other BAME groups) are far more likely to be diagnosed with schizophrenia than white people, despite there being no biological basis for this:
1) Differences in life experience- discrimination, social deprivation
2) Differences in access to early support
3) Unconscious bias and lack of cultural competence
* Beliefs of some might be in line with their cultural background, but doctors may not understand this and deem the patient psychotic
Describe the following %s for those with schizophrenia:
1) % who have a first episode recover
2) % will suffer either another acute episodes or a more chronic condition
3) % die by suicide
4) % are employed
- Following %s for those with schizophrenia:
1) 20% who have a first episode recover
2) 80% will suffer either another acute episode or a more chronic condition
3) 10% die by suicide
4) 19% are employed
Describe the DSM-5 (American) and ICD-11 (British) criteria for diagnosing schizophrenia (in picture)
How do positive schizophrenia symptoms tend to present?
What are 5 positive schizophrenia symptoms?
- Positive schizophrenia symptoms tend to be transient and during acute episodes
- 5 positive schizophrenia symptoms:
1) Delusions- can be bizarre
* Fixed false belief out of keeping with cultural and religious norms for the patient
* They are unshakeable
2) Hallucinations
* Can have visual hallucinations, which are a big red flag
* Can also have auditory, where patients belief they can hear other people talking, potentially about them
* Can also have command hallucinations, where patients can hear voices telling them to do things
3) Thought disorder aka derailing
* Speech breaking down due to thoughts breaking down
* No logical connection between thoughts
* Can lead to work salad
4) Disorganised/bizarre behaviour
* Driven by bizarre self-beliefs
5) Disorder of self-experience- eg passivity, control
* Patients have a sensation that something else is controlling them
- Andy, 21 year old student video example of positive symptoms
How do negative schizophrenic symptoms tend to present?
What are 7 negative schizophrenic symptoms?
How can psychosis affect patient insight?
- Negative schizophrenic symptoms tend to be chronic and episodic
- 7 negative schizophrenic symptoms:
1) Alogia (poverty of speech)
* A symptom that causes you to speak less, say fewer words or only speak in response to others.
2) Affective blunting (restricted emotional expression)
* Emotional blunting means you are numb to both positive and negative emotions
3) Avolition
* A total lack of motivation that makes it hard to get anything done
4) Anhedonia
* The inability to feel pleasure
5) Asociality (detached from your environment)
* Refers to the lack of motivation to engage in social interaction, or a preference for solitary activities
6) Ambivalence
* The state of having mixed feelings or contradictory ideas about something or someone.
7) Apathy
* Lack of interest, enthusiasm, or concern
- Psychosis can lead to a lack of insight from the patient, meaning they are out of touch with reality
What 6 aspects are affected due to cognitive deficits/declines from schizophrenia?
- 6 aspects affected due to cognitive deficits/declines from schizophrenia:
1) Sustained attention
2) Planning
3) Verbal and visuo-spatial working memory
4) Language skills
5) Explicit learning and memory
6) Perceptual / motor processing
Is schizophrenia unitary disorder?
- Schizophrenia is not a unitary disorder
- Originally, subtypes were used, but these subtypes have been changed in DSM 5 and ICD 11 which has moved to domains, gradients and dimensions of schizophrenia
What are 3 types of risk factor for schizophrenia?
- 3 types of risk factor for schizophrenia:
1) Biological
* Genetics - generates a predisposition/ vulnerability to developing schizophrenia
* Physiological
* Anatomical
2) Environmental
* Difficult labour
* Hypoxia at birth
* Cannabis
* Stressors/ environmental risk factors push an individual over a threshold which leads them to develop schizophrenia
3) Early indicators
* Few childhood friends
* Withdrawn
What is the diathesis-stress model?
- The diathesis-stress model, also known as the vulnerability–stress model, is a psychological theory that attempts to explain a disorder, or its trajectory, as the result of an interaction between a predispositional vulnerability, the diathesis, and stress caused by life experiences.
How genetics predispose to schizophrenia (in picture)
How can schizophrenia affect the anatomy of the brain?
