19 - Psychosis Flashcards
What is the definition of psychosis?
Presences of hallucinations or delusions but patients have a lack of insight (don’t believe they are unwell)
This is not a diagnosis, it is symptoms
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/517/a_image_thumb.png?1582880657)
What is a hallucination?
- Perception of a stimulus without a stimulus e.g hearing, feeling, seeing
- Visual are often due to a problem with the brain or the eyes
- Normal to have hallucinations when going to sleep or waking up
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/520/a_image_thumb.jpeg?1582880746)
What is a delusion?
A fixed false belief that is unshakeable and outside of cultural norms, e.g may think being spied on by the police
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/523/a_image_thumb.png?1582880827)
What are some different types of psychosis?
- Schizophrenia
- Drug induced
- Affective
- Post partum
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/525/a_image_thumb.png?1582880906)
What are the symptoms (first rank) of schizophrenia?
Thought withdrawal: patient believes someone is taking thoughts from their mind or broadcasting them
Delusional perceptions: seeing something and giving it a new meaning, e.g red traffic light means aliens are coming
Passivity experience: patient believes their body is being moved by an external force
Somatic hallucinations: patient can feel their insides moving
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/527/a_image_thumb.jpeg?1582880996)
What are some of the different types of auditory hallucinations?
- Thought echo: hearing their thoughts echoed back to them
- Running commentary: someone is commenting on their actions e.g he is brushing his teeth and now sitting down
- Third person: voices referring to patient in third person and conversing with each other about the patient
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/529/a_image_thumb.png?1582881230)
What is thought withdrawal?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/531/a_image_thumb.jpeg?1582881267)
What are some other symptoms of schizophrenia apart from the first rank ones?
Often patients that are treated can be left with the negative symptoms
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/533/a_image_thumb.jpeg?1582881341)
What are some organic causes of psychosis?
- Delirium caused by infection
- Hypercalcaemia
- Acute drug/alcohol intoxication (amphetamines causing release of dopamine)
- Post-ictal psychosis
- Hyperthyroidism
- Steroids - L-Dopa
iWhat is the pathophysiology behind schizophrenia in general?
- Too high dopamine binding to D2 receptors
- Overactive mesolimib pathway and underactive mesocortical pathway
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/537/a_image_thumb.jpeg?1582883266)
What is the mesolimbic and mesocortical pathway?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/538/a_image_thumb.jpeg?1582883348)
What are some of the brain changes that occur in a schizophrenic patient?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/540/a_image_thumb.jpeg?1582883393)
What is the neuropathology of schizophrenia?
- Decreased pre-synaptic markers
- Decreased oligodendroglia
- Fewer thalamic neurones
Theory of aberrant connectivity
Apart from changes in the dopamine pathway, what other areas in the brain are affected in schizophrenia?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/542/a_image_thumb.jpeg?1582883504)
How is schizophrenia treated pharmacologically?
Typical Antipsychotics: (e.g haloperidol)
- Block D2 receptors in all 4 dopaminergic pathways but mainly mesolimbic and mesocortical
- Side effects from D2 antagonists, e.g parkinsonism
Atypical Antipsychotics (e.g clozapine)
- Lower affinitity for D2 receptors so fewer side effects
- Also block 5HT2 receptors
![](https://s3.amazonaws.com/brainscape-prod/system/cm/432/335/545/a_image_thumb.png?1582883614)