Psych - Psychosis Flashcards
What contributes to madness?
- Psychosis
- Personality disorder
- Dementia
- Encephalopathy/ brain injury
- Delirium
What contributes to psychosis?
- Schizophrenia
- Drugs, metabolism, endocrine, infection
- Mania, depression, psychotic disorders
What are the 2 defining features fo psychosis?
Hallucinations Delusions
What is reality failure?
Group of pathologies which disrupt the process of receiving and interpreting reality.
How do we perceive reality?
Through consciousness - the content of consciousness is screened via attention - both active and passive.
What are auditory verbal hallucinations?
Thoughts or internal monologues experienced as external or 3rd person
How common are auditory verbal hallucinations?
Affect around 5% of the healthy population however are common with psychosis
How can auditory verbal hallucinations cause mental disorders?
These combined with emotional state, poor coping, past/family history of psychosis and cognitive difficulties can lead to the formation of mental disorders
What are delusions?
Fixed, false, unshakeable beliefs out of cultural context
Why do we get delusions?
They are our bodies response to perplexity. Our brain cannot interpret and organise sensory input, so rather than breaking down, it will create confabulations or delusions to bridge the gap between sensory input and our cognition
In what demographic do we see a greater prevalence of delusions?
We often see more delusions in populations which have historically been controlled or persecuted. With these people, we see more persecutory delusions, such as accusing your neighbours of trying to kill you.
What is meant by the positive or negative symptoms of schizophrenia?
Positive symptoms mean that they are added onto the normal human experience. Negative symptoms on the other hand are the result of aspects of the normal human experience being taken away from us.
What are the positive symptoms of schizophrenia?
We have hallucinations which are extremely common and can be very real for people with schizophrenia. We also have delusions which can be grandiose or persecutory, or delusions of control/interference.
What are the negative symptoms of schizophrenia?
Anhedonia Apathy Social withdrawal Blunted mood
What are the disorganised symptoms of schizophrenia?
Formal thought disorder Aimlessly wandering/ abnormal behaviour Inappropriate affect e.g. violence Disorganised speech or behaviour
What is perplexity?
This is a disruption of language and meaning whereby normal experiences appear aberrantly salient. Also, with perplexity there is always the sense that something strange is going on
What is the disruption of the sense of self?
Your thoughts and experiences lose their ownership ie you no longer see them as your own thoughts, as the ‘other’ invades your world.
Describe the genetic component of schizophrenia
There is a significant genetic component to SCZ. Heritability = 80% Single parent heritability is 10% but both parents having SCZ = 50%. MZ twin heritability = 40%. There are over 200 genes affecting SCZ as well as environmental influences
What is the role of dopamine?
NT involved in the reward pathway - we get reward for spotting errors (salience)
What is salience?
Term that refers to anything that is different or noticeable compared to our surroundings
What are the causes of psychosis?
Genetic component (SCZ) Childhood adversity or abuse Recreational drugs Neurodevelopment e.g. premature birth or hypoxia/infection Life stressors
How does adversity/abuse contribute to psychosis?
We get a sensitised striata dopaminergic pathway
How do recreational drugs contribute to psychosis?
Account for 25% of psychosis - an earlier age of smoking cannabis and a stronger strain of cannabis is associated with an increased psychosis risk
What treatments are available for psychosis?
Antipsychotics Psychological therapy Social therapy
What antipsychotics are available?
Antidopaminergic Serotonergic Cholinergic Typical/atypical
What psychological therapy is available?
CBT (psychosis) Avatar therapy - gives a sense of agency over the auditory verbal hallucinations
What social support is available?
Supportive environment provided Benefits Budgeting/ employment support
What is the neuroanatomy of the dopamine pathways?
We have 4 pathways: striatum, cortical, livic and pituitary
What are some of the potential side effects of antipsychotics?
Neurological e.g. movement problems Prolactin Metabolic e.g. weight gain Muscarinic Haematological e.g. neutropenia Cardiac e.g. arrhythmia Sedation
What is the link between mental illness and violence?
Most patients are more likely to be victims than aggressors except for schizophrenia patients. When untreated their risk of violence increases by 2-4, however with alcohol violence of normal people, the risk increases by 10-20.
What is the pathophysiology of schizophrenia?
Dopamine 2 receptors are heavily involved and we get the disorganisation of the default mode network. This creates stimulus independent thought and self regulation. In SCZ, we can see through PET scans that there is an excess of striatal dopamine, especially in response to stress, causing symptoms of schizophrenia.
