Psychosis Flashcards
What are the three main types of symptoms related to schizophrenia spectrum disorders?
Positive symptoms
Negative symptoms
Disorganized symptoms
Presence of psychotic symptoms
Positive symptoms
Between 50-70% of people with schizophrenia experience —, —, or —
Hallucinations, delusions, or both
Delusions are deemed —- if they are clearly implausible, not understandable, and not derived from ordinary life experiences
bizarre
Delusions involving someone/something/a group being “out to get you”
Persecutory delusions
Belief in extreme positive qualities assigned to the self; often religion-based
Delusions of grandeur
Connections being made between references that aren’t grounded in reality
Delusions of reference
“Invasion of the brain,” thoughts coming from elsewhere
Delusions of thought insertion
The belief something is wrong with your body in the absence of evidence
Somatic delusions
Belief that someone, not associated with you (often celebrities or people with power), are in love with with you
Erotomanic delusions
Belief that you or some part of you is dead
Cotard’s delusion
Belief that you or someone you love have been “swapped” with an identical double
Capgras syndrome
What type of hallucination is most common?
Auditory
What’s the difference between an intrusive thought and an auditory hallucination?
Intrusive thoughts come from the self; an auditory hallucination comes from “someone else”
What are the four types of hallucinations?
Auditory hallucinations are the most common
Tactile hallucinations
Scent-based hallucinations
Visual hallucination
Hallucinations that happen as you fall asleep
Hypnagogic hallucinations
Delusions that happen as you are waking up
Hympnopomic hallucinations
Absence or insufficiency of normal behaviour
Negative symptoms
What are five common negative symptoms associated with schizophrenia?
Avolition/apathy
Alogia
Anhedonia
Asociality
Affective flattening
What are the three common disorganized symtoms associated with schizophrenia?
Disorganized speech
Disorganized movement
Inappropriate affect
What are four characteristics of disorganized speech associated with schizophrenia?
Thinking process is difficult to follow
Topics are loosely connected
Circumstantial: an inability to differentiate the essential from the unessential when speaking
Tangential thinking: going on various unrelated tangents unrelated to the topic at hand
No psychomotor activity; not actively relating to environment
Stupor
Repetitive, abnormally frequent, non-goal-directed movements
Stereotypy
Limbs will stay wherever they are moved
Catalepsy
Describe the DSM-5 criteria (A-F, summarized) for schizophrenia
A. Presence of psychotic symptoms
B. Lower levels of functioning
C. Continuous signs of the disturbance persist for at least 6 months.
D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out
E. Not substance-related
F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month
Lifetime rate worldwide for schizophrenia is approximately – of the population
1%
What is the relationship between schizophrenia and life expectancy?
About 10 years lower on average, high suicide rate
What are the three phases of psychosis?
- Prodrome
- Acute psychotic episode
- Recovery
Which four factors differentiate between disorders on the schizophrenia spectrum?
Symptom type and severity
Symptom duration
Cause of symptoms
Co-morbidity with other disorders
What is the essential feature of schizotypal personality disorder?
A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior
Summarize the criteria (A-C) for Brief Psychotic Disorder
A. Presence of psychotic symptoms
B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning.
C. Not better explained by another condition, substance, or diagnosis
Describe criteria (A-D) for schizophreniform disorder
A. Presence of psychotic symptoms
B. An episode of the disorder lasts at least 1 month but less than 6 months.
C. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out
D. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Describe criteria (A-D) for delusional disorder
A. The presence of one (or more) delusions with a duration of 1 month or longer.
Criterion A for schizophrenia has never been met.
B. Apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd.
C. If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods.
D. The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or obsessive-compulsive disorder.
What are the 7 types of delusional disorders?
Erotomanic
Grandiose
Jealous
Persecutory
Somatic
Mixed
Unspecified
Describe the crietria (A-C) for Substance/Medication-induced Psychotic Disorder
A. Presence of delusions or Hallucinations.
B. There is evidence from the history, physical examination, or laboratory findings of both 1) The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication 2) The involved substance/medication is capable of producing the symptoms in Criterion A.
C. The disturbance is not better explained by another psychotic disorder
Describe the criteria (A-C) for Psychotic Disorder due to Another Medical Condition
A. Presence of delusions or hallucinations.
B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.
C. The disturbance is not better explained by another mental disorder.
Describe the criteria (A-D) for schizoaffective disorder
A. An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with Criterion A of schizophrenia.
B. Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.
C. Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.
D. The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Which four speculative hypotheses for the causes of psychosis were discussed?
Cat poop (toxoplasma gondii)
Fingerprint ridges
Eye-tracking differences
Living in cities
What are the four key risk factors for developing schizophrenia?
Genes (family history)
Dopamine disregulation
Stress
Lack of social support
You are most likely to develop schizophrenia if…
You have a monozygotic twin who has schizophrenia
Describe the evidence for dopamine’s role in psychosis
Most anti-psychotic medications work by blocking dopamine in the brain
The negative side effects of anti-psychotic drugs are similar to Parkinson’s (which is caused by insufficient dopamine)
Drugs that treat Parkinson’s increase dopamine levels, which can cause psychosis
Amphetamines (e.g. crystal meth) and related drugs that work on dopamine (e.g. cannabis, cocaine) can lead to psychosis
Describe the evidence for dopamine’s role in psychosis
Many people with schizophrenia do not benefit from anti-psychotic medications that influence dopamine
Anti-psychotic medications block dopamine quickly, but changes in symptoms are not seen for days or weeks
Anti-psychotic medications are only somewhat helpful for negative symptoms
Clozapine is an extremely effective medication for schizophrenia, but only acts weakly on dopamine
Before the 1980s, what was the most common treatment for schizophrenia?
Psychoanalytic treatments
What are the frontline treatments for psychosis?
Medications
What are the most commonly prescribed anti-psychotic medications?
Second-generation anti-psychotics
