Oct 23: Psychosis and Occupation Flashcards
WHAT IS SCHIZOPHRENIA?
- Psychotic Symptoms (delusions,
hallucinations) - Negative Symptoms
- Disorganized Symptoms
- Affective Symptoms
differentiate between Psychosis and Schizophrenia
Psychosis: group of symptoms, NOT a diagnosis, but d/t other MI, usually ST, may come and go
Schizophrenia: a diagnosis, LT, chronic
PSYCHOTIC SYMPTOMS: DELUSIONS
- what are they?
- what are the 2 types?
False beliefs, or distortions of thought
1. Bizarre type: implausible beliefs (aliens)
2. Non-Bizarre, plausible, but untrue in
reality (calls are being monitored)
PSYCHOTIC SYMPTOMS: DELUSIONS
- what is the Ideas of Reference delusion?
Inert stimuli are believed to be associated with the person specifically
PSYCHOTIC SYMPTOMS: DELUSIONS
- what is the Capgras Delusion?
Others have been replaced with ‘imposters’
Psychosis - Negative symptoms:
- what is Avolition?
Avolition: Poor motivation & interest
in participating in activities
Psychosis - Negative symptoms:
- what is Anhedonia?
Anhedonia: Inability to experience
pleasure or sustain interest in activities
BRIEF PSYCHOTIC DISORDER
- symptoms
- cause
- exclusion to diagnosis
- Symptoms: psychosis 1day - 1 month
- cause: may be d/t medical (birth, stress)
- exclusion: must not be d/t substance use
SCHIZOPHRENIA: diagnostic criteria
2 or more of the following, for at least 30 days of a 6-month period:
PSYCHOTIC SYMPTOMS:
- Delusions
- Hallucinations
DISORGANIZED SYMPTOMS:
- Disorganized speech
- Grossly disorganized or catatonic bx
- Negative symptoms
SCHIZOAFFECTIVE DISORDER: diagnostic criteria
- Criteria are met for schizophrenia, PLUS a mood imbalance (DEPRESSION OR MANIA) during the active and residual phases of psychosis
DELUSIONAL DISORDER: diagnostic criteria
Bizarre or non-bizarre delusions >1month
*Criteria for schizophrenia not met
*Delusions are focused and fixed
*Daily functioning is mostly unaffected
*Cognitive difficulties are absent
CATATONIA: what are some types? (just read them, don’t know in detail!)
EARLY PSYCHOSIS: PRODROMAL PERIOD
▪Early signs of a psychotic disorder begin to present
▪Functional challenges appear before the onset of psychosis
▪Changes in “thinking, feeling and behaving”
▪Often recognized retrospectively, most ppl recall a prodromal period
SCHIZOPHRENIA: NEUROANATOMICAL DIFFERENCES
- Smaller Thalamus
- Smaller Hippocampus
Enlarged Cerebral Ventricles - More CSF in ventricles
- Less cortical grey matter
SCHIZOPHRENIA: FUNCTIONAL DIFFERENCES
Hypofrontality: reduced cerebral blood flow to frontal lobe
- cause of executive function problems (organization, initiation, memory, attention)
SCHIZOPHRENIA: GENDER DIFFERENCES
- equal prevalence among males
and females - incidence 2x higher in males vs females
- Onset later for females
INFLUENCE OF PSYCHOSIS ON OCCUPATIONAL PERFORMANCE AND
OCCUPATIONAL ENGAGEMENT
Occupational Performance (Function)
- ADLs
- Employment
- Social Skills/ Social participation
- Self-care
Occupational Engagement (Participation)
- More likely to engage in passive leisure than those in the general population
- Poverty may influence participation
- Negative symptoms may prevent enjoyment of daily occupations
OT ASSESSMENT IN PSYCHOSIS: Occupation Focused
- ADL/ Independent Living Skills
- Time Use
- Vocational/ Productivity Assessment
OT ASSESSMENT IN PSYCHOSIS: Occupational Performance Components
- Cognitive Assessment (Memory, Attention, Executive Function)
- Beck Scales (BDI)
EVIDENCE BASED INTERVENTIONS IN PSYCHOSIS
Independent Living Skills Intervention
- ADL/ IADLs
Supported Employment
- IPS = Individual Placement & Support + Cognitive and social skills training
Social Skills Intervention
- SST: Social Skills Training
-PST: Problem Solving Training
- Responsive Social Skills Training
- CBT: Cognitive Behavioural Therapy
