Classifications of psychosis Flashcards
1
Q
Commonest symptoms of schizophrenia
A
- insight- 97%
- auditory hallucinations- 74%
- ideas of reference- 70%
- suspiciousness- 66%
- flatness of ffect- 66%
- second person hallucinations-65%
- delusional mood- 64%
- delusions of persecution- 64%
- thought alienation- 52%
- echo de pensee, gedankenlautwerden -50%
2
Q
ICD-10 description
A
- over 1 month criteria
- schneider’s first rank symptoms: delusions, auditory hallucinations, thought disorder, strange behaviour and deterioration in functioning
3
Q
Paranoid schizophrenia
A
- commonest
- onset is usually at a later age compared to hebephrenia and catatonia
- delusions or auditory hallucinations are most prominent
- disorganised speech or behaviour, flat or inappropriate affect, catatonic behaviour- less prominent and may or may not be present
4
Q
Hebephrenic (ICD) or disorganised schizophrenia (DSM)
A
- poor prognosis
- prominent disorganised speech, behaviour and flat or inappropriate affect. Markedly impaired social and occupational functioning. Poor self-care, poor hygiene, extreme social behaviour and disorganised behaviour
- thought disorder
- less prominent is catatonic behaviour
5
Q
Catatonic schizophrenia
A
- more common in developing nations, usually acute onset with episodic course and complete symptom remission- at least 2 of the below required
- motor immobility (catalepsy or stupor) or excess can be prominent
- extreme negativism or mutism can be seen
- posturing or sterotypy, mannerisms, grimacing
- echolalia or echo praxis
Less prominent is oneiroid state (dream like) and visual hallucination
-presents in 3 forms 1. excited catatonia, 2. stuporous catatonia and 3 . catatonia alternating between excitement and stupor
6
Q
Residual schizophrenia
A
- prominent: evidence of full blown acute episode in past with minimum of 2 or more generic symptoms or negative symtpoms (less formed generic symptoms)
- absence of delusions, hallucinations, disorganised speech or behaviour or catatonia
7
Q
Simple schizophrenia
A
- insidious development of negative symptoms without evidence of positive symptoms
- very rare
- gradual deterioration of personality
- occasional brief psychotic episodes may support diagnosis
- duration of 1 year (ICD 10)
8
Q
Undifferentiated schizophrenia
A
-generic symptoms but not falling in other categories
9
Q
Chronic schizophrenia
A
-persistent disability for two years or longer (not a subtype but a descriptive term)
10
Q
Post schizophrenia depression
A
classed under F20s
- some schizophrenic symptoms must be present (mostly negative) but not dominating the picture
- most recent episode of relapse must be within 12 months
11
Q
ICD 10 criteria
A
At least one of: 1. thought echo, thought insertion, withdrawal, broadcast 2. passivity, delusional perception 3. third person auditory hallucination, running commentary 4. persistent bizarre delusions or two of 1. persistent hallucinations 2. thought disorder 3. catatonic behaviour 4. negative symptoms 5. significant behaviour change
More than 1 month
F20-29
Has simple and hebephrenic in
12
Q
DSM 4 criteria
A
At least one of
- bizarre delusions
- third person auditory hallucinations
- running commentary
Or two or more of 1. delusions 2. hallucinations 3. disorganised speech 4. grossly disorganised behaviour 5. negative symptoms 1 month of characteristic symptoms, with 6 moths of social/occupational dysfunction Uses disorganised rather than hebeprhenic 295-298
13
Q
Acute and transient psychotic disorders
A
ICD 10
- onset within 2 weeks
- complete recovery within 2-3 months
14
Q
Schizotypal disorder
A
- classified with schizophrenias in ICD10 but in cluster A PDs in DSM4
- diagnosed in patients with eccentric manners, social withdrawal, magical thinking, suspiciousness and obsessive ruminations
- must not have had schizophrenia
15
Q
Persistent delusional disorders
A
- characterised by persistent, often life-long, typically ‘non-bizarre’ delusion or a set of related delusions arising insidiously in mid-life or later
- transient auditory hallucinations may occur but clear and persistent auditory hallucinations are incompatible with this diagnosis
- must be monothematic delusions
- affect, thought and behaviour are globally normal
- must be present for at least 1 month (DSM 4)
- ICD specifies 3 months
- DSM-5 delusions can be bizarre but must not be better explained by another condition
