Psych Flashcards
Define Psychosis
Mismatch between reality and patients perception
What’s the difference between Hallucination and Illusion
Hallucination is perception without a stimulus whereas illusion is incorrect perception of a real stimulus
Define Delusion
A fixed unshakeable belief that is out of line with cultural norms
What are the auditory First rank symptoms of schizophrenia?
Third person auditory hallucinations
running commentary
Thoughts spoken aloud
Name 5 First rank symptoms (non auditory)
Thought withdrawal, Thought insertion Somatic hallucinations Delusional perception Passivity Phenomena
In what peoples is psychosis more prevalent
Lower Ses Immigrants Afro-caribbeans Males Unmarried peoples
Name two developmental factors in the onset of schizophrenia.
Complications later in birth
Maternal influenza infection
What brain abnormalities can be resent in schizophrenia
Ventricular enlargement
Reduced brain size (frontal and temporal lobes, hippocampus and amygdala)
In terms of brain physiology what can potentiate schizophrenia.
Overactive mesolimbic dopamine
Drugs can potentiate this pathway
What is expressed emotion
Over criticism from family or friends
Which has more negative symptoms Chronic or Acute schizophrenia
Chronic,
What is a pseudohallucination
A hallucination from the patients ‘inner eye’
What is the difference between a Hypnagogic and Hypnopompic Hallucination
Hypnagogic –> Falling asleep
Hypnopompic –> Waking up
What is a hygric hallucination
A hallucination of water or fluid in or outside the body
What is Echolalia, Palilalia?
A) repeating words or phrases spoken
B) Repeating the last word of a sentence
Which drugs can produce reality distortion (name 3)
Dopamine agonists (amphetamine / cocaine) Serotonin 5HT2 agonists such as LSD Glutamatergic blockers (ket)
What are the 4 A’s of schizophrenia
Allogia, Avolition, Affective flattening, Anhedonia
What are the 2 age peaks for schizophrenia
20 and 33
What are 3 genes possibly responsible for schizophrenia
Polymorphisms in ZNF804A
22q11 deletion
SETD1A
What is schizoaffective disorder?
Schizophrenic and affective symptoms come at the same time and equally prominent
What is delusional disorder?
Non bizarre delusions, absence of prominent hallucinations, no thought disorder, flattening or affect.
What are Acute and transient psychotic disorders
Sudden onset, preceded by acute stressor, associated with certain personality types
What are the cardinal symptoms of depression
Depressed mood or irritable mood
Anhedonia
Avolition
Name 4 Biological symptoms of depression
insomnia, Appetite changes fatigue constipation pain
What is somatic syndrome?
The biological symptoms of depression
What hallucination tend to be more common in depression
Second person auditory Hallucinations (accusatory or defamatory)
Olfactory Hallucinations- Rotting/ decomposing
How would you differentiate between mild moderate and severe depression in terms of number of symptoms.
Mild: 2/3 core symptoms + 1 additional
Moderate 2/3 core symptoms + 2/3 additional =6
Severe 3/3 core symptoms + additional symptoms = 8
What are three indications for ECT?
Catatonia
Severe Depression
Mania in bipolar
What are two examples of SNRIs
Venlafaxine, Nortiptyline
What is a potentially fatal effect of MAOIs
Serotonin syndrome, (Tyramine)
What is needed in terms of episodes for Bipolar I or Bipolar II
Bipolar I- At least one Manic (or mixed) episodes
Bipolar One hypo manic and one depressive episode
What are the differences between mania and hypomania
Mania: More persistent, (over 1 week) VS hypomania is over 4 days
Marked impairment in mania VS can still complete projects in hypomaina.
Mania- Psychosis may be present VS hypomania psychosis not be present.
What are three forms of treatment for bipolar maina, (3/5)
Atypical antipsychotic Medication: Quetiapine, Olanzapine, Aripiprazole
Antiepileptic Medication: Valporate, Carbamazepine,
Lithium
Stop Antidepressants
May use Benzodiazepines
Name the treatment for bipolar depression
Atypical antipsychotic Medication: Quetiapine, Olanzapine, Aripiprazole
Antiepileptic Medications: Lamotrigine,
Lithium
Antidepressant medication.
Neuromodulation- ECT, rTMS
Name the treatment for bipolar maintenance
Atypical antipsychotic Medicaiton
Antiepileptic medication
lithium
psycho education
psychotherapies
Whats the difference between discrete vs diffuse social anxiety disorder
Discrete- Restricted to eating in public, public speaking or talking to other sex,
Diffuse everything except family circles
What is Panic disorder
Recurrent, unpredictable attacks of severe anxiety not restricted to any situation
What is generalised anxiety disorder?
Generalised and persistent anxiety but not restricted to any circumstances- Free floating anxiety
Define Antecedent
Exceptionally threatening or catastrophic traumatic event likely to cause pervasive distress in anyone
How long is the latency period in PTSD?
Weeks to months, rarely exceeds six months.
Whats an example of a 5HT partial agonist int he treatment of anxiety.
Buspirone
Which is a sort life and which is long life, Lorazepam VS diazepam
Loazepam -short
Diazepam- Long
What is the weight of people with anorexia nervosa,
<15% expected bodyweight
BMI <17.5
Whats the difference between Ego-syntonic and ego-dystonic symptoms
Ego-syntonic - Don’t usually cause distress to the patient
Ego-Dystonic - Usually cause distress to the patient
What is EMDR (eye movement …..)
Eye movement desensitisation and reprocessing. Pt recalls experience while being fixed on a moving finger in front of them
What is an acute stress reaction?
A brief response >3 days but <1 month,
Anxiety, depression, insomnia, denial, avoidance,
What is adjustment disorder?
Psychological reaction to adapting to new set of circumstances.
Starts within 3 months of stressful events,
aggression, palpitations, anxiety, depression, impaired social functioning, alcohol abuse.
What is the triad of PTSD symptoms
Hyperarousal,
Re-experiencing
Avoidance
What are the hallmarks of a dysfunctional personality
Pervasive- occurs in all area of life
Persistent- evidence from adolescence and carries on to adulthood
Pathological - causes distress to self or others. Impairs function.
What are Cluster A personality disorders
Schizoid, Paranoid, Schizotypical
What are cluster B personality disorders?
Antisocial
Histrionic
Borderline
Narcissistic
What are cluster C personality disorders?
obsessive compulsive
Anxious
Dependant
What does SUSPECT stand for in regards to paranoid personality disorder
Sensitive Unforgiving Suspicious Possessive and jealous Excessive self- importance Conspiracy theories Tenacious sense of rights
What does ALL ALONE stand for in regard to schizoid personality disorder
Anhedonia Limited Emotional range Little sexual interest Apparent indifference to praise or criticism Lack of close relationships one-player games Normal social conventions ignored Excessive fantasy world
What does FIGHTS stand for in regards to dissocial personality disorder
Forms but cant maintain relationships Irresponsible Guiltless Heartless Temper easily lost Someone else's fault
What are the two types of Emotionally unstable personality disorder
Borderline type
Impulsive type
What does SCARS stand for in relation to borderline type EUPD
Self imagine unclear Chronic "empty feelings" Abandonment fears Relationships are intense and unstable Suicide attempts and self harm
What does LOSE IT stand for in regards to impulsive type EUPD
Lacks impulse control Outbursts or threats of violence Sensitivity of being criticised Emotional instability Inability to plan ahead Thoughtless of consequences
What does ACTORS stand for in regards to Histrionic personality disorder?
Attention seeking Concerned with own appearance Theatrical Open to suggestion Racy or seductive Shallow affect
What does DETAILED stand for in regards to Anankastic personality disorder
Doubtful Excessive detail Tasks not completed Adheres to rules Inflexible Likes own way Excludes pleasure and relationships Dominated by intrusive thoughts
Name 4 core features of dependence syndrome
Primacy
Continued use despite negative consequences
Loss of control of consumption
Narrowing of repertoire
rapid reinstatement of dependant use after abstinence
Tolerance and withdrawal
What is an early indicator of autism in children
Stacking toys
What is the name of the stimulant medication used for ADHD
Methylphenidate (stimulants)
-Ritalin, Converta
Atomoxetine (non stimulant)
What are the psychological and social treatments for ADHD
Psychological
-Parenting course
Social
-Liaison with education
What is the name of the guidelines and competency regarding capacity in under 16s
Gillick competency
and
Fraser guidelines
What is Conner’s rating scales
Observer rated questionnaire for ADHD
What number IQ is considered sub average intellectual functioning
<70
