Psychiatry Flashcards
what are the 3 symptom clusters in PTSD
1) intrusive and vivid re-experiencing of the event
2) avoidance of reminders of the event
3) physiological reactivity
what do NICE guidlines recommend for the treatment of PTSD
trauma focused CBT (can be brief if offered within 1 month) or eye movement desensitisation and reprocessing ( if > 3 months)
what is DBT
dialectical behaviour therapy
works on the theory of emotional dysregulation
what is ACT
acceptance and commitment therapy
developed by steven hayes, encourages patients to accept and embrace their private events
what is CAT
cognitive analytic behaviour
exposure therapy relies on which psychological principle
classical conditioning
what is the difference between obsession and compulsion
obsession are recurrent, persistent and distressing ideas whereas compulsions are repetitive and intentional behaviours which are carried out to try and neutralise the obsession
what is the risk of schizophrenia in the general population
1%
10% if first degree relative
40-65% if monozygotic twin
what are the schneiderian first rank symptoms
primary delusions delusion of control 3rd person auditory hallucinations somatic hallucinations delusions of thought
list some examples of 3rd person auditory hallucinations
thought echo
voices arguing or discussing the pt
voices commenting on actions
list some examples of delusion of thought control
thought insertion
thought withdrawal
thought broadcast
what are the exclusion criteria in the ICD-10 diagnostic criteria for schizophrenia
mood disorders
schizoaffective disorder
overt brain disease
drug intoxication/withdrawal
what are the inclusion criteria for the ICD-10 diagnostic criteria for schizophrenia
at least one of the first rank symptoms plus at least two of:
- persistent daily hallucinations
- thought disorder
- catatonic behaviour
- negatice symptoms
- persistent behavioural change
all for at least 1 month
what are the subtypes of schizophrenia?
paranoid - prominent hallucinations and delusions - most common type
catatonic- dominated by psychomotor disturbances
hebephrenic - disorganised
residual - chronic with predominantly negative symptoms for at least a year - the transition between acute and chronic
simple
post schizophrenic depression
undifferentiated
what is an illusion
a false perception associated with a sensory stimulus
can occur in normal people and in drug abuse
what is a hallucination
a false perception in the absence of a sensory stimulus
what is a pseudohallucination
a hallucination which has an “as if” quality to it or the patient perceives it as seeing it through the minds eye.
Has multiple meanings
in which syndromes do you get auditory hallucinations
schizophrenia (3rd person)
also found in affective psychoses
alcoholic hallucinatory states (usually 2nd person)
what is the difference between a primary and a secondary delusion
primary is a true delusion
secondary is understandable in terms of the mood state or hallucination (eg guilt in depression)
what are the four types of primary delusion
autochtonous - sudden onset, self referent
delusional perception - 2 stages normal perception becomes invested with transformed meaning
delusional memory
delusional atmosphere
what is capgras
a delusional misidentification syndrome where the patient believes that someone closely related has been replaced by an imposter
what is fregolis
the belief that unfamiliar people are familiar people in disguise
what is the characteristic formal thought disorder in mania
the flight of ideas
which blood abnormality can occur with clozapine
agranulocytosis and therefore requires weekly monitoring
