34 Psychosis

Question 1

Definitions of psychosis

Answer 1

• Lack of REALITY TESTING - losing touch with reality
• Delusions (fixed, incorrect beliefs)
• Lack INSIGHT - unaware of their disorder
• Impaired functioning (social, occupational, etc)

Question 2

List some psychotic disorders

Answer 2

• Schizophrenia ***
• Bi-polar disorder
• Depression
• Post-partum depression
• Dementia
• Drug-induced psychosis

Question 3

List the DSM5 criteria for schizophrenia

Answer 3

> 2 symptoms, present for significant time during 1 month

• Delusions
• Hallucinations
• Disorganised speech
• Disorgansied or CATATONIC behaviors
• Emotional FLATNESS
• Impaired function

Question 4

Define the POS/NEG features of schizophrenia

Answer 4

POS = UNIQUE to schizophrenia (absent in normal)
NEG = NOT present in schizophrenia (present in normal)

Question 5

List POS features of schizophrenia

Answer 5

• delusions
• Hallucinations
• Disorganised SPEECH and thought
• Disorganised MOVEMENT or catatonic behavior (stupor)

Question 6

List NEG features of schizophrenia

Answer 6

• Emotional reactions distorted
• Speaking very little
• LOSS of motivation

Question 7

What is the biological model for schizophrenia

Answer 7

• GENETIC predisposition in families

- Overactive DOPAMINE theory (brain differences)

Question 8

what are some side-effects of anti-psychotic DRUGS

Answer 8

Weight gain
Insomnia
Dysphoria
Acne
Sexual dysfunction

Question 9

3 factors that predict psychosis, according to the PSYCHOSOCIAL model

Answer 9

1. Trauma + abuse
2. Parental loss
3. Poverty

Question 10

Evidence for trauma+abuse predicting psychosis

Answer 10

3 types of trauma = 18x more likely

5 types of trauma = 193x more likely

Question 11

Evidence for parental LOSS predicting psychosis

Answer 11

2. 4x more likely to have lost parents before 16

3. 1x more likely to have parental DEATH (esp MOTHER = 12.3x more likely)

Question 12

Evidence for POVERTY predicting psychosis

Answer 12

DEPRIVED children 8x more likely to develop schizophrenia as adults
esp. Maori + Pacific in NZ

Question 13

What is the BEST model to predict psychosis?

Answer 13

Vulnerability-Stress model

Question 14

Explain the concept of the Vulnerability-Stress model

Answer 14

Individuals have different vulnerabilities to mental illness

• STRESSORS can make people DROP BELOW personal line of wellness (loss, abuse, events)
• PROTECTIVE factors provide resilience and keep people ABOVE the line (intelligence, support, family)

Question 15

Side effects of some OLD anti-psychotic drugs?

Answer 15

• Movement disorders (similar to Parkinsons)
• Mouth movements
• Shuffling walk

Question 16

Name a typical anti-psychotic often used

Is it effective?

Answer 16

Risperidone

• marginal benefit
• many side effects

Question 17

Why is risperidone still prescribed, despite its limitations?

Answer 17

• protects us from confronting difficult social issues?

- POWERFUL companies (drugs, medicine, psychiatry)

Question 18

List some possible psychological Tx for psychosis

Answer 18

• Counselling
• Psychoeducation
• CBT to establish sense of CONTROL
• Family Tx
• Skills training
• Early Psychosis Intervention Teams

Question 19

What type of Tx shows LOWER relapse rate than standard Tx?

Answer 19

CBT is better!

Question 20

What is hearing voices?

Answer 20

Misinterpretation of inner thoughts
= part of NORMAL experience (10-15% people_
= MIRROR neurons activated (Brocas)

Question 21

Treatment for hearing voices?

Answer 21

• Identify characteristics + content of voices

- TALING Tx about unresolved EARLY or CURRENT difficulties

Question 22

how do NON-Westernised views of schizophrenia differ?

Answer 22

• UNDERSTOOD differently
• TREATED differently

eg. communication with spirits = power