Psychosis and Schizophrenia Flashcards
What is a psychotic episode?
When an individual experiences a different reality to the rest of the world/people around you
How long can a psychotic episode last?
Anything from days to months
How do psychotic episodes begin?
Can begin quickly or gradually
Do patients have insight in a psychotic episode?
No
How do pts experiencing a psychotic episode present?
Usually via the police, a CPN/other community MH professional, or by concerned family member
Basically not usually via the GP
What 4 key things are part of a psychotic episode?
Hallucinations
Delusions
Formal Thought Disorder
Disorders of self
What is it important to find out with a psychotic patient?
If the cause is organic or functional
What organic problems can cause a psychotic episode?
Dementia Delerium Infections Endocrine disturbance Temperal lobe epileps
Define schizophrenia
Disorder/group of disorders characterised by psychotic epiodes (positive symptoms) and negative symptoms
What are the 3 types of functioning psychosis?
Schizophrenic
Manic
Depressive
What are the three patterns to psychotic episodes that a person can experience?
- One off
- Recurrent episodes with normal periods in between
- Episode(s) -> personality changes and recurrent episodes
What is the prevalence of schizophrenia?
1% of general population
Which demographic groups is schizophrenia more common in?
Afro-caribbean
Identical twins
Users of illicit drugs
What essentially is a psychosis?
Experiencing a different reality to everyone else, and unaware that what they are experiencing is abnormal.
Define a delusion
Fixed firmly held belief in things which are not true, and go against the persons own (usual) beliefs
What kinds of delusions can a person experience?
Guilt, erotomanic, grandiose, persecutory, hypochondriacal, and delusions of reference
Define a delusion of guilt.
Patient feels great amounts of guilt at minor things they may have done
Define a erotomanic delusion
Belief that people are in love with you
Define a grandiose delusion
Belief that you are a very importnt/famous person e.g. royalty or Christ
Define a persecutory delusion
The belief that people are persecuting you/out to get you
Define a hypochondriacal delusion
The belief that they have a terrible illness
Define a delusion of reference
Believing that every day events have some massive significance, blowing coincidences out of proportion
Define a hallucination
Perception in the absence of external stimulus
What are the most commonly experienced hallucinations?
Auditory and tactile
What is thought broadcasting?
Thinking that everyone can hear your thoughts
What is thought insertion?
Thinking that other people’s thoughts are becoming implanted in your brain, thoughts/dreams are not your own
What kind of symptoms will pts with schizophrenia experience?
Positive and negative symptoms, occuring sometimes at the same time and sometimes not
What are the positive symptoms of schizophrenia?
Delusions, hallucinations, formal thought disorder, disorders of self (thought insertion/withdrawal)
What are the negative symtpoms of schizophrenia?
Lack of will and interest
Social isolation
Living in their own world
How long must a pt have had symptoms to diagnose schizophrenia? How many symptoms?
1 month/28 days
One or more clear cut, or 2+ mild positive symptoms, or one or more with a negative symptom
What should all schizophrenia pts have done?
A risk assessment. Stupid question really, should do a risk assessment in all psych patients.
If a pt is low risk, where should we refer them?
Psychosis service
Who starts antipsychotic treatment in schizophrenics?
Consultant psychiatrist
What is first line for treatment of achizophrenia?
Try on a course of oral antipsychotics and offer CBT
How do antipsychotics work?
Block function of dopamine receptors, as well as other receptors
What are the 2 types of antipsychotic?
Typical and atypical/1st gen and 2nd gen
What are the typical antipsychotics?
Haloperidol
Chlorpromazine
Piperazine
