Psychosis and schizophrenia Flashcards
What is psychosis
an acute mental health state, resulting in disrupted thoughts and perceptions and loss of contact with reality
Give 5 differentials for psychosis
- schizophrenia
- drug and alcohol abuse - cannabis, amphetamines
- steroid induced psychosis
- neurological disorders - Parkinson’s, Huntington’s
- bipolar disorder
- puerperal psychosis
Give 4 features of psychosis
- hallucinations
- delusional
- thought disorganisation - clanging, word salad
- agitation
- self-harm
Define a delusion
Fixed, strange or irrational belief, which is firmly held, and out of context for the individuals cultural background.
State and describe 3 different types of delusion
- Delusions of grandeur – exaggerated ideas of importance – e.g. belief they are an important historical figure
- Paranoia – e.g. belief in a plot against them
- Somatic – belief that they have a terrible incurable illness
What is a hallucination
A sensory perception – which can be auditory, visual, touch or smell based – without an obvious real-world stimulus
* e.g. hearing voices, seeing figures which aren’t present
What is schizophrenia
chronic mental health disorder characterised by psychosis and Impairment of perception and thinking
Give 3 RFs for schizophrenia
- FHx - strongest
- substance misuse - cannabis, amphetamines
- traumatic childhood events
Describe the prodrome period that may precede ‘true’ schizophrenic symptoms
- loss of interest
- social withdrawal
- depression
- anxiety
classified if symptoms last over 6 months
What are the most common type of auditory hallucination in schizophrenia
third person
may be single/ multiple voices
What are Schneider’s First Rank Symptoms of Schizophrenia
- auditory hallucinations - mc
- thought disorders (withdrawal, insertion and broadcasting)
- delusional perception
- passivity phenomenon
What is a delusional perception
occurs when the patient experiences an ordinary and unremarkable perception that triggers a sudden, often self-related delusion
What is Passivity phenomena
- believe their bodily sensations being controlled by external influence
- actions/impulses/feelings - experiences which are imposed on the individual or influenced by others
Apart from the first rank symptoms, give some other features of schizophrenia
- impaired insight
- negative symptoms
- thought form - word salad, neologism, circumstantiality
- catatonia
Give 4 negative symptoms of schizophrenia
- Affective flattening (incongruity/blunting of affect) - minimal emotional reaction
- Alogia - reduced speech
- anhedonia - lack on interest in activities
- avolition - lack of motivation in life
How is schizophrenia diagnosed
DSM-5/ ICD-11
* 2 or more of the following present for at least one month, for most days and have some level of disturbance for 6m
- Hallucinations
- Delusions
- Disorganised thinking
- Negative symptoms
- Grossly disorganised or catatonic behaviour
How is schizophrenia managed
- psychological therapies - CBT, early intervention, family therapy
- social support
- 1st line: oral atypical antipsychotics
- 2nd: switch to another antipsychotic
- if 2 other antipsychotics have not been effective consider clozapine
Why are atypical antipsychotics recommended over typical ones in the treatment of schizophrenia
significant reduction in extrapyramidal side-effects.
How may antipsychotics be administered if there’s a compliance issue
depot every 2-4 weeks
Name 2 antipsychotics that can be given via depot in the treatment of schizophrenia
- aripiprazole
- risperidone
Non-auditory hallucination can occur in schizophrenia but are most common in which type of conditions
organic conditions
Give 5 factors associated with poor prognosis of schizophrenia
- strong family history
- gradual onset
- low IQ
- prodromal phase of social withdrawal
- lack of obvious precipitant
What is schizoaffective disorder
combines the symptoms of schizophrenia with bipolar disorder. Patients have psychosis and symptoms of depression and mania
What is a pseudohallucination
false sensory perception in the absence of external stimuli when the affected is aware that they are hallucinating
