Psychosis and Schizophrenia Flashcards
What is psychosis?
Individual experiencing a different reality to everyone else
What constitutes a psychotic episode?
Sudden or gradual onset
Can last days, weeks, or months
Individual does not (usually) realise they are psychotic
What are the symptoms of psychosis?
Hallucinations
Delusions
Formal thought disorder
Fragmentation of the boundaries of self
What is a hallucination?
Perception of an object in the absence of an external stimulus
5 modalities (senses)
Auditory is the most common in psychosis
Olfactory indicates possible frontal lobe pathology
What is the difference between hallucinations and pseudohallucinations?
hallucinations = false sensory perception in the absence of an external stimulus
pseudohallucinations = special forms of imagination or representations with individual aware that they are hallucinating e.g. hearing voices in your head
What are delusions?
Fixed, firmly held belief (usually false)
Cannot be reasoned away
Held despite evidence to contrary
Out of keeping with normal sociocultural norms
e.g. persecutory, grandiose, reference, erotomanic, hypochrondriacal
What is a formal thought disorder?
A problem of speech > lack of flow (phrases or words)
What is a disorder of the self?
Individual cannot distinguish between themselves and the world
i.e. self vs other, self over time, unity of experience, self as agent
inc thought broadcast, passivity phenomena, thought insertion
What are some functional causes of psychosis?
Delerium
Dementia
Infection
Endocrine
Temporal lobe epilepsy
What are the types of functional psychosis?
Schizophrenic (bizarre, persecutory, 3rd person)
Manic (grandiose, 2nd person)
Depressive (guilt, poverty, nihilism, 2nd person)
What is schizophrenia?
Disorder characterised by psychotic episodes (+ve symptoms) and negative symptoms
+/- symptoms = something added / taken away from normal experience
What are the negative symptoms of schizophrenia?
Autism (self-absorbed / in own world)
Flat affect / incongruous
Ambivalence
Loosening of associations
Amotivation or apathy
What are Schneider’s First-Rank symptoms?
Hearing one’s own thoughts spoken out loud
Hallucinatory voices in the form of statement and reply (voices speaking about them in 3rd person)
Hallucinatory voices in form of running commentary
Physical hallucinations (sensations in body are produced by outside forces)
Thought broadcasting
Thought withdrawal / insertion
Influence of others on feelings / drive / volition of common events
Delusional perception
What is the aetiology and epidemiology of psychosis and schizophrenia?
1% prevalence
Higher in afro-carribean UK migrants
Increased mortality 10-20 years
? Role of family, upbringing, obstetrics, elicit drugs, genetics
What is the management of schizophrenia?
Oral antipsychotics
CBT (offered to all patients)
Close attention: CV RF modification (high smoking rates and antipsychotic medication ^ risk)
