Psychosis and Schizophrenia Flashcards
Define psychosis
An individual experiencing a reality different to everyone else
How can a psychotic episodes onset present?
Sudden or gradually
How long can a psychotic episode last for?
Days to months
What level of insight do psychotic patients have during a psychotic episode?
Typically none - don’t realise they are psychotic
To whom do psychotic patients often present first?
Police, family or friends
Rarely to a psychiatrist or other physician
When assessing a potentially psychotic patient, what is it important to assess?
If they are really psychotic
In which way they are psychotic and what symptoms they have
How does the mind process sensory inputs?
Senses data (e.g. chemicals, light, pressure)
Interprets this as an object or thing
Brain processes this to give the object meaning
What are the symptoms of psychosis?
Hallucinations
Delusions
Formal thought disorder
Fragmentation of the boundaries of the self
Define hallucination
The perception of an object in the absence of an external stimulus
What modalities can a hallucination occur in?
Any of the 5 sensory modalities
What is the most common form of hallucination in psychosis?
Auditory
What point of view can an auditory hallucination bee perceived in?
2nd or 3rd person
What condition is more likely to present with visual hallucinations?
Delirium
What does an olfactory hallucination suggest?
Possible frontal lobe pathology
Is a patient claiming to hear voices in their head experiencing psychosis?
No - they have insight so is likely a pseudohallucination
Define a delusion
A fixed, firmly held belief that is (usually) false, that cannot be reasoned away, is held despite evidence to the contrary and is out of keeping with a person’s sociocultural norms
What types of delusions are there?
Persecutory
Grandiose
Reference
Erotomanic
Hypochondriacal
Define formal thought disorder
A problem of speech (and the flow of thought) which means that each sentence (or phrase or word) does not follow on from the next
How does formal thought disorder differ from flight of ideas?
Flight of ideas typically has connections between each idea, formal though disorder does not
What are disorders of the self?
Difficulties understanding:
The self vs others
The self through time
The unity of experience
The self as agent
What do disorders of the self result in?
The inability of the patient to distinguish between himself and the world
What presentations do disorders of the self result in?
Thought broadcast
Passivity phenomena
Thought insertion
What type of delusions do people with schizophrenia typically present with?
Persecutory
Define schizophrenia
A disorder characterised by psychotic episodes and negative symptoms
What are some negative symptoms of schizophrenia?
Flat affect
Ambivalence
Loosening of associations
Amotivation or apathy
What are some positive symptoms of schizophrenia?
Hearing one’s own thoughts aloud
Hears third person voices
Hears running commentary
Believing sensations in the body are caused by outside sources
Thought broadcasting
Thought withdrawal, insertion and other thought influences
Delusions
What are some different types of thought interference?
Thought broadcast
Thought withdrawal
Thought insertion
Thought echo
What is thought broadcast?
When a patient believes that their thoughts are being broadcast from their head to be heard by other people
What is thought withdrawal?
When a patient believe thoughts are being taken from their heads, not necessarily for listening to (as in thought broadcast)
What is thought insertion?
When a patient believes that thoughts that are not their own are being placed in their head
What is thought echo?
When a patient can hear their own thoughts spoken aloud as an auditory hallucination
How must a true auditory hallucination be uncovered?
By asking the patient if they hear the voice in their head (not a hallucination) or as a true voice (hallucination)
What is passivity?
When a person believes that their actions are being controlled by somebody else
What are the first rank symptoms of schizophrenia?
Thought echo
Voices speaking to each other (with replies) about the patient
Running commentary auditory hallucination
Tactile hallucinations (believes physical sensation within body caused by outside force)
Thought broadcast
Other influences on thought
Passivity
Delusions
