Lecture five - Psychotic Disorders Flashcards

1
Q

What are prodromal symptoms?

A

They are symptoms that arise prior to the full expression of a diagnosis/syndrome.

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2
Q

What defines delusions?

A

Fixed beliefs that are not amendable to change in the light of conflicting evidence.

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3
Q

Does psychosis affect individuals socially, culturally, and professionally?

A

Yes.

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4
Q

What are psychotic symptoms?

A
  1. Delusions.
  2. Hallucinations.
  3. Disorganized thinking (shown through speech).
  4. Grossly disorganised motor behaviour.
  5. Negative symptoms - such as lack of emotional experiences.
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5
Q

What are the most common delusions people experience?

A

Persecutory delusions - beliefs that one is going to be harmed or harassed by someone, a group, or institution.

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6
Q

What are persecutory delusions?

A

Beliefs that one is going to be harmed or harassed by someone, a group, or institution.

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7
Q

What are some other types of delusions?

A

Grandiose delusions or erotomanic delusions.

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8
Q

What is the difference between bizarre and non-bizarre delusions?

A

Bizarre delusions are delusions that are very implausible.

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9
Q

What are hallucinations?

A

Perception-like experiences that occur without an external stimulus.

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10
Q

What are the most common hallucinatons?

A

Auditory hallucinations.

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11
Q

Are auditory hallucinations always a negative experience?

A

No. Sometimes people experience their auditory hallucinations that pleasurable, supportive, affirming.

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12
Q

Are hallucinations culturally accepted and/or expected for some cultures?

A

Yes.

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13
Q

What is disorganized thinking (observed through speech)?

A

Historically referred to as Formal Thought Disorder.

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14
Q

What are some of the ways speech can present as disorganized?

A

Clanging.
Circumstantiality/Tangentiality.
Flight of ideas.
Derailment.
Incoherence.
Pressure of speech.

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15
Q

What are some forms of ‘grossly disorganised or abnormal motor behaviour’?

A

Can be catatonia, which is a marked decrease in reactivity to the environment.
Unpredictable agitation can be another form it can take.

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16
Q

What are some negative symptoms that are characterised as psychotic symptoms?

A
  1. Diminished emotional expression.
  2. Avolition - inability to engage in or initiate goal-oriented behaviours.
  3. Alogia - diminished speech output.
  4. Anhedonia.
  5. Asociality.
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17
Q

Is there a common myth that people are either psychotic or they are not.
True or false?

A

True.

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18
Q

Does the prevalence of hallucinations decrease with age, and peak in adolescence?

A

Yes.
This is theorized to occur due to brain maturation.

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19
Q

Is InterVoice a Hearing Voices network that aims to destigmatize the experience of hearing voices and form community for individuals with these experiences?

A

Yes.

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20
Q

In our society, is it culturally ok for children have imaginary friends?

A

Yes.

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21
Q

What defines a brief psychotic disorder?

A

The duration of symptoms in less than one month and at least one day.

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22
Q

What are the disorders that listed in the DSM-5 for psychotic disorders?

A
  1. Brief psychotic disorders.
  2. Delusional disorder.
  3. Schizophreniform disorder.
  4. Schizophrenia
  5. Schizoaffective Disorder.
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23
Q

What is delusional disorder?

A

Characterised by experience of dellusions, but no hallucinations.
Delusions are present for at least one month.
Delusions are not bizarre and individual is not markedly impacted by the experience beyond how the beliefs are influencing the individual.
Behaviour is not bizarre or odd.

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24
Q

What is Schizophreniform disorder?

A

Presence of two or more experiences of delusions, hallucinations or disorganized thinking, and or grossly disorganised behaviour or negative symptoms.
Episodes last over a month, but less than 6 months and symptoms are present for a significant amount of time within this time frame.

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25
Q

How is Schizophrenia defined?

A

Presence of one or more of hallucinations, dellusions, disorganized speech/thinking, and negative symptoms or disorganised or catatonic behaviour.
Symptoms significantly negatively impact the individual’s functioning in or more domains of their life.
Continuous signs of the disturbance persist for at least 6 months.

26
Q

What is Schizoaffective Disorder?

A

Criterion A for schizophrenia is met AND there is a major mood disturbance (manic or depressive).
AND there is a period of at least two weeks where the individual experiences the delusions or hallucinations in the absence of mood disturbance.

27
Q

When taking into account grief, are practitioners less likely to diagnose schizophrenia?

A

Yes.

28
Q

Do men tend to develop psychosis earlier than women?

A

Yes.

29
Q

On average is schizophrenia diagnosed in early adulthood?

A

Yes.

30
Q

Is there an increase in schizophrenia diagnosis occur in women around menopause?

A

Yes.

31
Q

What is the lifetime prevalence of schizophrenia?

A

1-2%.

32
Q

Are men more likely to be diagnosed with schizophrenia than women?

A

Yes.

33
Q

Is there evidence that there is a higher prevalence in urban areas compared to rural areas?

A

Yes.

34
Q

Do people with psychotic disorders have higher levels of substance use than the rest of the population?

A

Yes.

35
Q

Can people get PTSD from their experience of psychotic episodes/symtpoms?

A

Yes.

36
Q

Is there a cultural myth that individuals with psychotic disorders are dangerous,, unpredictable, and out of control?

A

Yes.

37
Q

Are individuals who have psychotic disorders 14 times more likely to be victims of violence than to perpetrate violence than those who do not have one of these disorders?

A

Yes.

38
Q

What are some of the historical conceptualisations of shcizophrenia that have led to the stigma around schizophrenia?

A

A lot of people that studied schizophrenia through the 1800 and 1900s focused on individuals with advanced expressions of the disorder. This is one reason that culture has a very stigmatised view of schizophrenia.

39
Q

For monozygotic twins, is there around a 50% of one of them developing schizophrenia if the other twin has the disorder?

A

Yes.

40
Q

Is Schizophrenia a purely genetic disorder?

A

No.

41
Q

Is COMT gene indicated in schizophrenia?

A

Yes.

42
Q

What does the COMT gene do?

A

COMT encodes an enzyme that aids in the breakdown of dopamine and other neurotransmitters.

43
Q

Is there a cultural myth that psychosis is caused by a character flaw?

A

Yes.

44
Q

What is the DOPAMINE HYPOTHESIS for psychosis?

A

That it is excessive activity or levels of dopamine in the CNS that cause/perpetuate psychotic symptoms.
This theory has arisen due to medications that decrease levels or activity of dopamine can aid in ameliorating symptoms of psychosis.

45
Q

What are some brain structures that are implicated in schizophrenia?

A

Enlarged ventricles - which is indicative of reduced brain tissue.
Hippocampa volume has also been found to be decreased in those with schizophrenia.
Reduced grey and white matter in the prefrontal cortex.

46
Q

There are differences in brain structure that have been observed in those with schizophrenia. Are these differences in brain structure diagnostic of schizophrenia?

A

No.

47
Q

Is social cognition impaired in those experiencing psychosis or psychotic disorders?

A

Yes.
However, it should be noted that social cognition is also impaired in those with ASD and depression and other mental health conditions.

48
Q

In the early 1900s was there a psychoanalytic theory about the SCHIZOPHRENOGENIC mother?

A

Yes.
The theory was the a cold, aloof, or overprotective mother causes the child to develop schizophrenia. This has been discredited.

49
Q

What is the SOCIAL DEFEAT HYPOTHESIS when it comes to the aetiology of schizophrenia or psychosis?

A

The social defeat hypothesis states that experiencing social exclusion and negative social experiences sensitises the mesolimbic dopamine system, thereby increasing risk of experience psychotic symptoms.
This may explain why people that are part of oppressed groups or minority groups experience heightened risk of experiencing psychotic symptoms.

50
Q

Do a significant proportion of those that develop a psychotic disorder report childhood trauma, such as sexual or physical abuse?

A

Yes.

51
Q

What is the stress-vulnerability model?

A

This model suggests that we all have a level of vulnerability, which is determined by genetics and experiencces etc. We then experience stress, and some of us have more capacity to deal with and move through the stress than others, i.e some of us are more vulnerable to overwhelm from stress.
This may explain why some develop psychotic symptoms.

52
Q

What is substance-induced psychosis?

A

Psychosic symptoms brought on by the use of certain substances, such as cannabis, cocaine, hallucinogens.

53
Q

Has cannabis been linked to the develoment of psychotic symptoms?

A

Yes. Although, I am not entirely convinced by the studies. Seem a bit black and white, but perhaps there is something there…

54
Q

Does gender influence risk of relapse of psychotic symptoms?

A

No.

55
Q

Do carer critical comments increase risk of relapse?

A

Yes.

56
Q

Can people recover from psychotic disorders?

A

Yes.

57
Q

Do around 23% of those who experience schizophrenia experience the disorder in a chronic and deteriorating manner?

A

Yes.

58
Q

Is in-patient treatment for those experiencing psychosis the first line of treatment?

A

No.
Preference is to help support individuals in their community.

59
Q

Is pharmacological treatment one of the first treatment options for acute psychotic symptoms?

A

Yes.

60
Q
A