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PSYC3102 > Lecture 3 Schziophrenia > Flashcards

Lecture 3 Schziophrenia Flashcards

1
Q

What does Dementia praecox mean? (by Emil Kraeplin)

A

Dementia of young people

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2
Q

According to Eugene Bleuler what were the four core disturbances of Schizophrenia (splitting of the mind)?

A

Affect
Ambivalence
Associations (changes in thoughts)
Preference for fantasy over reality

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3
Q

How prevalent is schizophrenia?

A

Approximately 1% prevalence in general population

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4
Q

What is the peak age of onset of schizophrenia for males and females?

A

Males: 15-25 yrs
Females: 25-35 yrs

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5
Q

Is schizophrenia associated with a lower lifespan? True or False?

A

True

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6
Q

Is schizophrenia the most expensive of all mental disorders? True or False?

A

True.
Direct treatment costs
Low employment rate
Public assistance costs

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7
Q

What are the characteristic symptoms of schizophrenia?

A

A. Individual needs to have TWO or MORE during 1 month and at least one of the symptoms needs to be 1, 2, or 3 below.

  1. Delusions (fixed beliefs that are not open to change in light of conflicting evidence)
  2. Hallucinations (sensory experiences that aren’t real)
  3. Disorganised speech (frequent derailment or
    incoherence in speech)
  4. Grossly disorganised or catatonic behaviour

(1-4 are positive symptoms - the addition of something unusual to normal types of behaviours)

  1. Negative symtpoms (absence of typical types of behaviours)
    • Affect flattening (reduced emotional expression)
    • Alogia (impoverished thinking - seen through diffs in
      speech)
    • Avolition (lack of motivation)
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8
Q

What are the other criteria for schizophrenia?

A

B. Social Occupational Dysfunction - often loss of jobs,
difficulty studying

C. Duration: continuous signs for 6 months

D. Schizoaffective & Mood Disorder (individual SHOULD NOT meet this criteria in order to be diagnosed with schizophrenia - EXCLUSION CRITERIA)

E. Substance/general Medical Condition (individual SHOULD NOT meet this criteria in order to be diagnosed with schizophrenia - EXCLUSION CRITERIA)

F. Relationship to Autism Spectrum Disorder or
communication disorder (if person already diagnosed
with these disorders, they can receive a diagnosis for
schizophrenia as well, so long as they do have
prominent delusions or hallucinations over at least a
month period.

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9
Q

What are the two things needed for Criterion D to be marked Yes?

A

1) no major depressive or manic episodes have
occurred concurrently with the active-phase symptoms

OR

2) if mood episodes have occurred during active-phase
symptoms, they have been present for a minority of
the total duration of the active and residual periods of
the illness.

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10
Q

Characteristic symptoms

What are the 3 most common delusions?
Delusions (disturbances in CONTENT of thought)

A

Persecutory delusions - belief that one is going to be harmed, harassed and so forth by an individual, organisation or other group)

Referential delusions - belief that certain gestures, comments, environmental cues, and so forth are directed at oneself

Grandiose delusions - belief that you have exceptional abilities, wealth or fame

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11
Q

Characteristic symptoms

What are the 5 loosening of associations? 
Disorganised speech (disturbances in production and organisation of thought)
A

Neologism: making up words

Perseveration: repeating particular phrases or words/sounds

Word salad: using a mixture of words that don’t make sense together

Circumstantiality: beginning to make a point, going on track a little bit, then veering off track to less important points but then eventually COMING BACK TO ORIGINAL POINT.

Tangentiality: talking about one thing, go off on a tangent, and u never come back to ur original point.

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12
Q

Characteristic symptoms

What are hallucinations and what senses are involved?
Disturbances of Perception

A

Hallucinations - Percept like experience occurring in the absence of appropriate stimulus and not under voluntary

Auditory (Most common and hearing voices)
Visual
Olfactory 
Gustatory 
Tactile

Sometimes voices can be pleasant

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13
Q

Characteristic symptoms

Disturbances in Affect

A

Expression of outward emotion

Restricted affect (Least severe)

Blunted affect (or affect flattening)
- indifferent to their surrounding  
Flat affect (Most severe)
- complete absence of emotional expression
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14
Q

Characteristic symptoms

Disturbances in Psychomotor Behaviour

A

Collectively called Catatonia

  • Catatonic stupor: incredibly slow, deliberate
    movements

Catatonic rigidity: being ‘stuck’ in certain postures

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15
Q

What are positive symptoms of schizophrenia?

“extra unusual” behaviours

A

Delusions
Hallucinations
Loose associations (Speech problems)
Disorganised behaviour

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16
Q

What are negative symptoms of schizophrenia?

“taking away of normal behaviours”

A

Flat affect: taking away variation in normal emotional expression

Apathy: Lethargy, not wanting to do things

Social withdrawal

Poor attention

17
Q

What are schizophrenia specifiers?

A

To be used after 1-year duration

Extra info. about how the disorder is presented in a particular individual.

Catatonia can also act as a specifier
- Catatonia is marked psychomotor disturbance which may involve stupor, rigidity, excitement or posturing

18
Q

How is the severity of the primary symptoms of psychosis (Delusions, Hallucinations, Disorganised speech, Abnormal psychomotor behaviour, and Negative symptoms) assessed?

A

Current severity (past 7 days) is assessed on a 5 point scale where 0 - not present to 4 - present and severe

19
Q

What are the characteristics of Type 1 schizophrenia?

A

Sudden onset

Normal intellect

No brain damage

No negative symptoms

Good drug response (or medication)

20
Q

What are the characteristics of Type 2 schizophrenia?

A

Slower onset

Intellectual deterioration

Brain abnormality

Prominent negative symptoms

Poor drug response

21
Q

What are the three course phases of schizophrenia and in what order?

A

Prodromal phase
Active phase
Residual phase

22
Q

What happens in the prodromal phase?

A

Where there is a gradual and obvious deterioration in role functioning. Social withdrawal, stopping activities they would typically do.

Marks a CHANGE IN HIS PERSONALITY

symptoms of prodromal phase include peculiar behaviours (talking to urself in public), unusual perceptual experiences, outbursts of anger, increased tension, and restlessness.

Social withdrawal, indecisiveness, and lack of willpower are often seen during the prodromal phase.

23
Q

What happens in the active phase?

A

The active phase is where we see the psychotic symptoms such as hallucinations, delusions, and disorganised speech.

They become really out of touch with reality, and believing that those experiences are real.

24
Q

What happens in the residual phase?

A

The residual phase is where those main psychotic symptoms are no longer present, but often the negative symptoms are still there, so withdrawing from others.
At this point most dramatic symptoms of psychosis have improved, but the person continues to be impaired in various ways.

25
Q

What does it mean if schizophrenia has different potential courses of the phases?

A

The courses of schizophrenia is VERY VARIABLE how the schizophrenia course looks like for different individuals

26
Q

What is the prognosis of schizophrenia?

A

~ 20-30% are able to lead “normal” lives

~ 20-30% experience moderate symptoms

~ 40-60% remain significantly impaired

27
Q

List the good outcome predictors

The dominance of positive symptoms - delusions, hallucinations are more associated with GOOD OUTCOMES

A

Good premorbid (period of time before diagnosis) adjustment

No family history of schizophrenia

Sudden onset

(identifiable) Precipitating stress

Good response to medication

Positive symptoms

Later age of onset

Female gender

28
Q

List the bad outcome predictors

Negative symptoms are more likely to have an impact on life and living.

A 
Poor premorbid adjustment
Family history of schizophrenia
Slow onset
No precipitating stress
Poor response to medication
Negative symptoms
Early age of onset
Male gender
29
Q

Name and describe other psychotic disorders?

A

Schizophreniform Disorder

  • Duration at least 1 month but less than 6 months
  • Impaired social/occupational functioning not required
  • Essentially SHORTER form of schziophrenia

Schizoaffective Disorder
- Symptoms fall on the boundary between schizophrenia
and mood disorders
- Prominent episode of mood disturbance concurrent
with Criterion A schizophrenia symptoms
- Delusions/hallucinations for at least 2 weeks in absence
of prominent mood disturbance
- Overlap of schizophrenia with mood disorder

Delusional Disorder
- Person experiences one or more delusions and never
meets Criterion A of Schizophrenia
- They are preoccupied for at least one month with delusions that are not bizarre (things that could actually happen to you)

Brief Psychotic Disorder
- Sudden onset of at least one: delusions, hallucinations,
disorganised speech, disorganised/catatonic behaviour
- Lasts at least one day but less than month and full
return to premorbid functioning
- This most commonly happens to a very stressful event

30
Q

How does neuroleptic work?

A

Decreases dopamine and results in calm behaviour

31
Q

Schizophrenogenic mother

A

The mother of the person with schizophrenia is blamed for the development. (NO SUPPORT)

32
Q

What has expressed emotion (Psychosocial factors) been useful for?

A

Expressed emotion has become important when we’re looking for how to prevent relapse

33
Q

What is expressed emotion referring to?

A

Very high levels of

criticism
hostility
emotional over-involvement … within families.

A person with schizophrenia is 3.7 times more likely to relapse if living in a High vs. a Low EE family

Expressed emotion is low specificity meaning it is not only specific to schizophrenia

PSYC3102 (3 decks)

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