Psychosis and schizophrenia Flashcards
Suggest a definition for psychosis and state whether or not they have insight
‘Experiencing a reality that is different to everyone else, it is not true’
In psychosis, they do NOT have insight
List 4 symptoms for psychosis
- Hallucinations
- Delusions
- Formal thought disorder
- Passivity phenomena / fragmentation of the boundaries of ‘self’
Outline the 5 senses that can be involved in hallucinations
- Auditory = most common, especially in psychosis
- Visual - more likely to be delirium or LB dementia
- Olfactory - frontal lobe pathology
- Gustatory
- Tactile
Suggest the difference between hallucinations and pseudohallucinations
Hallucinations:
- Clear, sharp image
- Colourful
- 3D/rotates
Pseudohallucinations:
- Fuzzy/blurred image
- Grey
- ‘Flat’
Pseudohallucinations are not true hallucinations
State the definition of delusion
- A fixed, firmly held belief that is (usually false), cannot be reasoned away despite evidence to the contrary
- Also out of keeping with a person’s sociocultural norms
State some different types of delusions
- Persecution
- Reference
- Control
- Thought possession
- Grandeur
- Poverty
- Guilt
- Nihilism
Briefly explain the following types of delusions:
- Persecution
- Reference
- Control
- Thought possession
- Grandeur
- Poverty
- Guilt
- Nihilism
Persecution - someone is out to get them
Reference - something did happen, but they’re drawing inappropriate meaning from it
Control - ‘made to do things’
Thought possession - everyone else knows their thoughts
Grandeur - they are more superior/important than other people
Poverty - they have no money/possessions
Guilt - they’ve committed an unforgivable sin
Nihilism - belief that something or someone no longer exists
Outline passivity phenomena
Feel that some aspect of themselves is under the control of others
Caninclude thought disorders e.g. broadcast, insertion and withdrawal
Suggest the types of delusions and hallucinations that occur in the following presentations:
- Schizophrenic
- Manic
- Depression
Schizophrenic:
- Persecutory delusions
- 3rd person hallucinations
Manic:
- Grandiose delusions
- 2nd person hallucinations
Depression:
- Guilt delusions
- Poverty delusions
- Nihilistic delusions
- 2nd person hallucinations
State the rough prevalence of schizophrenia in the UK
Approximately 0.7% of population currently
Lifetime prevalence of 1.5%
Rarely begins before 10 years old
Briefly explain the dopamine hypothesis for schizophrenia
States that schizophrenia is secondary to over-activity of mesolimbic dopamine pathways in the brain
Supported by the fact that antipsychotics work by blocking dopamine (D2) receptors
Further supported by notion that Parkinson drugs and Amphetamines activate the pathway leading to psychotic symptoms
State the major classifications of schizophrenia
- Paranoid (positive symptoms dominate)
- Post-schizophrenic depression (depression with schizophrenic illness in the past 12 months)
- Hebephrenic (thought disorganisation predominates)
- Catatonic
Others:
- Simple
- Undifferentiated
- Residual
List some positive features of schizophrenia (acute syndrome)
‘Additional’ features:
- 3rd person auditory hallucinations
- Delusions
- Thought disorders e.g. thought echo, broadcast, insertion, removal
- Passivisity
List some negative features of schizophrenia (chronic syndrome)
Hint: lots of ‘A’s
‘Withdrawn’ features - difficult to differentiate from depression:
- Anhedonia
- Asocial behaviour
- Affect blunted
- Attention (cognitive) deficits
- Avolition (low motivation motivation)
- Alogia (poverty of speech)
List some of Schneider’s first rank symptoms for schizophrenia (4 key ones)
One or more of these symptoms present indicates schizophrenia (alternative to ICD-10)
- Third person auditory hallucinations (usually running commentary)
- Thought interference = insertion, withdrawal or broadcast
- Passivity phenomenon
- Delusional perception (new delusion in response to a real perception without any logical sense e.g. the traffic light turned red so I am the chosen one)
