Psychosis Flashcards
Psychosis:
any disorder so severe that the victim loses contact with reality
– Schizophrenia
– Bipolar disorder (previously known as manic- depressive illness)
– Dissociative identity disorder (split-personality)
– Schizoaffective disorders
– Persistent delusional disorders
Symptoms (positive and negative) of schizophrenia
– Pervasive thought disturbance – Difficulty in ignoring irrelevant stimuli (external or internal) – Cognitivedeficits – Withdrawal from personal contact – Delusions – Hallucinations – Emotionaldisorder – Behavioural disruption
• Cognitive deficits (Executive function) of schizophrenia
– Sustained attention
– Planning
– Verbal and visuo-spatial working memory – Language skills
– Explicit learning and memory – Perceptual / motor processing
• Delusions:
– Ideas of reference / changes in salience
– Delusional system
Hallucinations:
– Auditory hallucinations
Behavioural disruption
– Catatonic
– Disorganised
• Is Schizophrenia a unitary disorder?
– Subtypes?
- Catatonic
- Disorganised(Hebephrenic) • Paranoid
- Simple
- Undifferentiated
- Residual
risk factors for schizophrenia
– Genetics
– Physiological
– Anatomical
– Psychosocial
• Dopamine hypothesis
– Classical antipsychotics – Overstimulation
Dopamine-serotonin interaction hypothesis
– Atypical antipsychotics
- Acetylcholine?
- Glutamate?
- GABA?
Schizophrenia – psychosocial
- Social class
- Minority position
- Urban environment
- Family environment
- Cannabis use?
Schizophrenia - treatment
• Early intervention tends to result in better long-term outcomes
• Drug therapies
– Classical antipsychotics
– Atypical antipsychotics
• Side effects
Psychological interventions
– Family intervention
– Cognitive Behaviour Therapy – Social-skills training
treatment after first episode
– Oral antipsychotic medication in conjunction with psychological intervention (family intervention and individual CBT)
Continuing treatment and care (psychosis services or specialist community-based team)
– Offer CBT to assist in promoting recovery (particularly if persistent symptoms or in remission)
– Offer family intervention
– Consider offering depot or long-acting antipsychotic medication if the patient would prefer it after an acute episode or to avoid covert non-adherence as a clinical priority
– Monitor physical health regularly, particularly in relation to potential side effects of medication, but also overall physical health.
