Introduction to Psychosis Flashcards
What are some classic experiences of someone with Schizophrenia?
Paranoid that people can read their mind
Inability to ignore irrelevant stimuli
General paranoia that people mean them harm
Their mind is being broadcast
Depression
Voices are misinterpreted worries
Nihilistic delusions, feelings of body decay
How long have we known about Psychosis and what event saw an increase in it’s visibility?
Since ancient times.
The increase was due to industrialisation increasing the number of “mad houses” like Bedlam, built in 1247
What key aspects were seen as important to the “new” asylums?
Good accommodation
Outside of cities (green areas)
Healthy food and environment (lifestyle)
Away from victorian cities
Think Imperial War Museum
What happened to the initial idea of asylums?
Originally beautiful buildings and well kept,
However: Patients did not recover and Conditions worsene due to:
Overcrowding
Families did visit due to distance
result was segregations of patients
What was one of the advantages of the asylums?
There was an abundance of patients with uniques mental disorders to see and study. Originally by alienists.
These were: Paralysis of the insane, alzhiemers, mental handicap
How did Kraeplin conceptualise schizophrenia?
As Dementia praecox, effectively Alzheimers in your early years.
It was distinctly different from Manic Depressive insanity as it was deteriorating and not fluctuating, as well as having a worse outcome.
When did we see the first use of the term Schizophrenia and what was an issue?
1911 from Eugen Bleuler
Saw it as a group of types:
Four A’s: Loose Association, Ambivalence, Autism, Ambiguous Affect
Postive about outcome.
Unfortunately criteria allowed for over diagnosis
Who gave us first rank order symptoms and what were they?
Schnieder:
Thought withdraw, Thought insertion, Auditory haluciantaions- Echo, commentary, third person, Delusions (meaning without logic), Made acts (rare)
What are the positive symptoms of Schizophrenia?
Delusions: Fixed and False, not shared by others
Hallucinations: Perception in the absence of stimuli
Formal thought disorder
What are the negative symptoms of Schizophrenia?
Flat or Blunt affect Poverty of speech Loss of initiative Cognitive difficulty Self neglect Social disinhibition
What is the time course of schizophrenia and how does it affect men and women differently?
General onset is in mid adolescents and young adulthood, most likely in 20s for men (Possible neurodevelopment issues)
For females more common after menopause (Possible oestrogen protective factor)
5 years of worsening, then can improve or stay stable. Not deterioration (Manfred Bluer)
After 10 years:
40% remit (20% with continued use of meds)
40% Relapse
20% Chronic and TR
What is a problem with psychosis diagnosis as a Kraeplin Dichotomy ?
Very hard to separate, Schizophrenia and Bi-polar disorder. The middle ground is known as Schizoaffective disorder.
Why would a diagnosis of schizophrenia not be welcome?
Because of the stigma attached to it, particularly violence, and the lack of information regarding treatment and outcomes
Bi-polar is favoured by patients
What is an alternative approach to schizophrenia diagnosis?
To categorise the illness in dimensions and stating which are present:
Positive: Delusions and Hallucinations Depressed Manic Negative Symptoms Disorganised
What evidence is there for schizophrenia as a continuum and what is the ramification of that?
That 15% of the Gen Pop show individual symptoms that meet threshold for diagnosis.
That we should not only address those with psychosis, but understand what pushes people into it.
