Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CP2 Psychiatry > Psychosis and Schizophrenia > Flashcards

Psychosis and Schizophrenia Flashcards

1
Q

Define Psychosis

A

Mismatch between representation of reality in individual’s mind and representation supported by objective evidence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Classify psychosis

A

Perception and thought

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Delusion

A

Unshakeable belief (fixed form belief), derived by erroneous inference, out of keeping with social or cultural beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Themes of delusion

A

Persecution, infidelity, erotomania, grandiosity, ill-health, guilt, nihilistic, poverty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of psychosis

A
  • Delusions
  • Hallucinations
  • Formal thought disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define hallucination

A

Hallucination is a percept without object i.e. a sensory experience without an external stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Types of hallucination

A

Any sensory modality

  • Auditory (hearing)
  • Visual (vision)]
  • Tactile (Touch)
  • Olfactory (smell)
  • Gustatory (Taste)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Formal Thought disorder

A

A pattern of disordered language that reflects disordered thought form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examples of formal thought disorder

A
  • Loosening of association (derailment)
  • Flight of ideas
  • Circumstantial thoughts
  • Tangential thoughts
  • Thought block
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Most common form of hallucinations within schizophrenia and psychosis

A

Auditory hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What % of the population are estimated to be experiencing hearing voices?

A

5-28%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List positive symptoms of schizophrenia

A
  • Thought disorder
  • Disorganised behaviour
  • Delusions
  • Hallucinations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List negative symptoms of schizophrenia

A
  • Social withdrawal
  • reduced attention
  • Blunted affect
  • Avolition
  • Poverty of speech
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Scheider’s First Rank Symptoms

A 
ABCD 
Auditory Hallucinations
Broadcasting of thought
Controlled thought (delusions of control)
Delusional Perception

(Thought echo, third persona auditory hallucination, delusional perception, made volition, somatic passivity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical features of Schizophrenia

A 
Reality distortion (Positive)
Disorganisation (Positive)
Psychomotor poverty (negative)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Characteristic reality distortions of schizophrenia

A

Third person auditory hallucinations

Alien influence over thought

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Organic causes of psychosis

A
  • Delirium
  • medication-induced (corticosteroids, stimulants, dopamine agonists)
  • Endocrine disorders (Cushing’s, hypothyroidism, hyperthyroidism)
  • Neurological disorder (temporal lobe epilepsy, MS, movement disorders, Wilson’s disease, Huntington’s disease)
  • Systemic diseases (porphyria, SLE)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Schizophrenic cause of psychosis presentation

A
  • Symptoms present for longer than 28 days
  • First rank symptoms present OR persistent hallucinations and delusions
  • Negative and cognitive symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Other psychiatric causes of psychosis

A
  • Schizoaffective disorder (mix of first rank symptoms and mood symptoms)
  • Delusional disorder (non-first rank delusional belief with minimal hallucination)
  • Schizotypal disorder
  • Acute and transient psychotic disorder (symptoms <28 days)
  • Mood disorder (Mania, severe depression)
  • Substance misuse (alcohol withdrawal, intoxication with stimulants, cannabis)
20
Q

Epidemiology of schizophrenia

A
  • 1/100 lifetime risk
  • M=F
  • Very rare <14y/o
  • Rare 14-16 y/o
  • Peak incidence = 23y/o male; 26 y/o female (second peak between 30-40)
  • Urban > rural
  • Lower social class
21
Q

Biological aetiology of schizophrenia

A
  • Genetic - family history (possible multiple genes)
  • Obstetric complication (increased risk)
  • Dopamine theory
  • Neurodevelopmental theory
22
Q

Risk of schizophrenia increases by __ if ___ has schizophrenia

A 
46% - Identical twin 
40% - Both parents
15% - One sibling/fraternal twin
15% - One parent
6% - One grandparents
1% - No relatives
23
Q

Psychological aetiology of schizophrenia

A

Cognitive errors - jumping to conclusions (especially in delusions and paranoia)
Premorbid personality - schizotypal disorder

24
Q

Social aetiology of schizophrenia

A

Urban living (x2/3)
Migration (x3)
Life events (incl. physical + sexual abuse)
Ethnicity (x4 in Afro-Carribeans in UK; higher incidence in South Asians)

25
Q

Prodrome

A

The period of time where the individual is gradually developing symptoms but has not yet met the criteria for diagnosis

26
Q

Prodromal symptoms

A

Non-specific negative symptoms
Emotion distress/agitation without reason
Transient psychotic symptoms

27
Q

What is the average DUP?

A

DUP = duration of untreated psychosis

over a year

28
Q

Aims of management

A

Establish a diagnosis

Manage condition

29
Q

Management if:
Urgent/immediate concerns regarding risk s because of patient’s psychotic symptoms
BUT risks can be adequately managed in community with intensive input

A

Crisis Resolution and Home Treatment (CRHT) Team

30
Q

Management if:
Urgent/immediate concerns regarding risk s because of patient’s psychotic symptoms
BUT risks cannot be adequately managed in community with intensive input and patient is willing to come to hospital

A

Informal Admission to a psychiatric ward

31
Q

Management if:
Urgent/immediate concerns regarding risk s because of patient’s psychotic symptoms
BUT risks cannot be adequately managed in community with intensive input and patient is NOT willing to come to hospital

A

Mental Health Act (MHA) assessment to determine if patient needs detaining

32
Q

Management if:

NO urgent/immediate concerns regarding risks and patient is aged 18-35 and first episode

A

Early Intervention in Psychosis Team (EIP)

33
Q

Management if:
NO urgent/immediate concerns regarding risks and patient is NOT aged 18-35 and NOT first episode but has Established psychotic illness and needs a period of intensive psychiatric rehabilitation to improve functioning

A

Community Rehabilitation Service

34
Q

List first generation (typical) anti-psychotics

A 
Chlorpromazine
Haloperidol
Zuclopenthixol
Flupentixol
Fluphenazine
35
Q

List second generation (atypicals) anti-psychotics

A 
Olanzapine
Risperidone
Quetiapine
Aripiprazole
Clozapine for treatment resistant schizophrenia
36
Q

Common reasons for non-compliance in treatment of schizophrenia

A 
Lack of insight
Side effects
Delusions about medication/prescriber
Patient feels better when ill
Remission from symptoms and no longer thinks medication is required
37
Q

Standardised mortality rate in schizophrenia

A

nearly 5x higher

38
Q

What physical diseases are schizophrenics at increased risk of? What are contributing factors?

A

Cardiovascular disease, diabetes, stroke

CF: poor diet, reduced physical activity, smoking, not engaging with physical health monitoring, antipsychotics increase the risk of metabolic syndrome

39
Q

Physical health monitoring in schizophrenia - Baseline measurements and every year

A

Smoking and drinking status
Personal/family history of diabetes/coronary heart disease
BP, BMI
blood for FBC, RFT, LFT, glucose and lipid
ECG

40
Q

What is TRS? How do you diagnose TRS?

A

Treatment resistant schizophrenia

TRS = lack of response to adequate doses of 2 antipsychotics. Before diagnosis, review diagnosis, rule out co-morbid substance misuse, ensure dose, duration and compliance with previous treatment

41
Q

Psychological Treatment - NICE GUidelines

A

Cognitive Behavioural Therapy - recent NICE guidelines CG178 have stated that everyone with psychosis/ schizophrenia should be offered CBTp (cognitive behavioural therapy for psychosis).

Family Intervention Therapy (FIT) - NICE CG178 also made recommendations on the provision of family intervention therapy to family members and the service user where appropriate, and offering carers education and support programmes.

42
Q

Other psychological therapies

A 
PSYCHOEDUCATION
-relapse signature/early -relapse signs
-Crisis plans
-relapse prevention
-WRAP (wellness, Recovery and Action Plans)
COPING STRATEGIES
MAASTRICHT INTERVIEW (voice hearers)
CONCORDANCE THERAPY
43
Q

Social management of schizophrenia

A
  • Daytime activities/ occupation/ employment/ education/ leisure hobbies
  • Family
  • Accommodation
  • Benefits
  • Relationships
  • Cultural needs
  • Safeguarding
44
Q

Follow-up considerations for schizophrenia

A
  • Monitor mental state
  • Monitor treatment effectiveness and S/E
  • Monitor risk
  • Monitor support system
  • Further psychoeducation
45
Q

Carer’s needs (Expressed Emotion)

A

Carer’s emotional reaction to the individual with schizophrenia: 3 different domains:

  • criticism
  • hostility
  • over-involvement

CP2 Psychiatry (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions