Psychosis Flashcards
Delusions
False or erroneous beliefs, misinterpretation of perceptions or experiences
Ideas of Reference
describe the phenomenon of an individual’s experiencing innocuous events or mere coincidences and believing they have strong personal significance
Paranoid Delusions
is the fixed, false belief that one is being harmed or persecuted by a particular person or group of people.
Cotard Delusion
false belief that one does not exist or has died
Thought Insertion
idea that another thinks through the mind of the person (another person)
Thought Broadcasting
is the belief that others can hear or are aware of an individual’s thoughts
Hallucinations
- perception-like experiences that occur without an external stimulus
- auditory (most common), visual, olfactory, gustatory, and tactile
- perceived as distinct from the person’s own thoughts
Positive Symptoms
- Hallucinations
- Delusions
- Disorganized Thinking
- Grossly Disorganized Behavior
Negative Symptoms
- Negligible response to conventional antipsychotics
- Eye contact is decreased
- Grooming and hygiene is decline
- Affective responses become flat
- Thought blocking
- Inattentiveness
- Avolition
- Expressive gestures decrease
- Time – increases the number of negative symptoms
- Recreational interests diminish; relationships decrease
- A’s absence/lack of certain features (5 A’s)
- Content of speech diminishes (poverty of thought)
- Knowledge – cognitive deficits decrease
Negative Symptoms also include a lack of the 5 A’s
aPathy/avolition aLogia Affective flattening aNhedonia aTtentional impairment
Brain feature of psychotic disorder
larger than normal lateral ventricles
Genetics of Psychotic disorder
- Monozygotic twins to develop schizophrenia is between 30-50%.
- Dizygotic twins to develop schizophrenia is about 15%.
- Siblings who are not twins is also about 15%.
Environment and psychotic disorder
- family stress, poor social interactions, infections or viruses at an early age, or trauma at an early age.
- season of birth has been linked to the incidence of schizophrenia, including late winter/early spring in some locations
The “dopamine theory of schizophrenia” states that schizophrenia is caused by
an overactive dopamine system in the brain
-Drugs that block dopamine reduce schizophrenic symptoms
The best drugs to treat schizophrenia
resemble dopamine and completely block dopamine receptors
High doses of amphetamines cause
schizophrenic-like symptoms in a disorder called “amphetamine psychosis.” Amphetamine psychosis is a model for schizophrenia because drugs that block amphetamine psychosis also reduce schizophrenic symptoms. **Amphetamines also make the symptoms of schizophrenia worse.
Children at risk for schizophrenia may have brain wave patterns similar to
adults with schizophrenia.
-These abnormal brain wave patterns in children can be reduced by drugs that block dopamine receptors
Other weird things that are linked to psychotic disorders
- hypoxia
- greater paternal age
- stress, infection, malnutrition, maternal diabetes, and other medical conditions
-However, the vast majority of offspring with these risk factors do not develop schizophrenia
Brief Psychotic Disorder Diagnostic Criteria
Presence of 1+ of the following symptoms (1 must be 1 of the first 3 listed)
- Delusions.
- Hallucinations.
- Disorganized speech (e.g., frequent derailment or incoherence)
- Grossly disorganized or catatonic behavior
- Duration of an episode of the disturbance is at least 1 day but less than 1 month
- 2x more common in females
Schizophreniform Disorder Diagnostic Criteria
2+ of the following, for significant portion of time for at least 1-month but less than 6 months:
- At least 1 of these must be 1, 2 or 3:
1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment or incoherence).
4. Grossly disorganized or catatonic behavior.
5. Negative symptoms (i.e., diminished emotional expression or avolition)
About 1/3 of people with Schizophreniform Disorder usually recover within
6 months
- schizophreniform disorder is their final diagnosis
- The majority of the remaining 2/3 of individuals will eventually receive a diagnosis of schizophrenia or schizoaffective disorder
Schizophrenia Diagnostic Criteria
- 2+ of the following, each present for a significant portion of time during a 1-month period
- At least one of these must be (1), (2), or (3):
- Delusions.
- Hallucinations.
- Disorganized speech (e.g., frequent derailment or incoherence).
- Grossly disorganized or catatonic behavior.
- Negative symptoms (i.e., diminished emotional expression or avolition)
- Level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset
- Continuous signs of the disturbance persist for at least 6 months*
Schizoaffective Disorder
- An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with schizophrenia symptoms
- Delusions or hallucinations for 2+ weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.
- patient meets criteria for a major mood episode for total duration of illness
- The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
2 types of Schizoaffective Disorder
- Bipolar type: manic episodes and major depressive episodes
- Depressive type: only major depressive episodes
