Psychosis and Schizophrenia Flashcards
What is psychosis
Psychosis - presence of hallucinations or delusions
Describes symptoms, not a diagnosis
Name some causes of psychosis
Delirium caused by infection
Delirium tremens
Acute drug/alcohol intoxication - drug induced psychosis
Post-ictal psychosis
Hyperthyroidism
Encephalitis
Hypercalcaemia
Cerebral lupus
Iatrogenic causes - steroids, L-DOPA
What is affective psychosis
Affective psychosis - psychotic experiences are normally congruent (coincide) with mood
What is schizophrenia
Long term mental health condition characterised by a range of psychological symptoms
Name some symptoms of schizophrenia
Auditory hallucinations - thought echo or running commentary
Passivitiy experiences - believes action or feeling is caused by external force
Thought withdrawal - thoughts being taken out of mind
Thought broadcast - thoughts are being made known to others
Thought insertion - thoughts implanted by others
Delusional perceptions - attributes new meaning to normally percieved object
Somatic allocation - mimics feeling from inside body
Patients with schizophrenia often have symptoms which are classed in positive and negative. Name some positive and negative symptoms of schizophrenia
Positive symptoms - delusions, hallucinations, thought disorder, lack of insight (symptoms are added)
Negative symptoms - underactivity, low motivation, social withdrawal, emotional flattening, self-neglect (symptoms are taken away)
Dysfunction of which two pathways are thought to be the cause schizophrenia and which symptoms do they cause, positive or negative
Mesolimbic pathway - positive symptoms, e.g. delusions, hallucinations, thought disorder
Mesocortical pathway - negative symptoms, e.g. underactivity, low motivation, social withdrawal, self-neglect
Describe the route of the mesolimbic pathway and what happens to it in schizophrenia
From ventral tegmental area to the limbic strucutres and the nucleus accumbens
Thought to be overactive in schizophrenia
Describe the route of the mesocortical pathway and what happens to it in schizophrenia
From ventral tegmental area to the frontal cortex and cingulate cortex
Thought to be underactive in schizophrenia
What brain changes are seen in schizophrenia
Enlarged ventricles
Reduced hippocampal formation
Reduced amygdala
Reduced parahippocampal gyrus
Reduced prefrontal cortex
What is anti-NMDA encephalitis and what is it treated with
Anti-NMDA encephalitis is an autoimmune condition where there is sudden onset of psychiatric symptoms
Antibodies bind to NMDA receptor causing it to become internalised leading to hypoperfusion
Treated with corticosteroids and IV Ig
What is the treatment for schizophrenia and how does the medication work
Typical antipsychotics - block D2 receptors in all CNS dopaminergic pathways. Mainly affects mesolimbic and mesocortical pathways
Atypical antipsychotics - low affinity for D2 receptors. Milder side effects as dissociates rapidly from D2 receptors
What type of symptoms are seen as a side effect of psychotic drug use
Usually have parkinsoniam symptoms due to lower dopamine levels
What are the symptoms of catatonia
Supor/mutism
Excitement
Posturing
Negativism
Rigidity
Waxy flexibility
Command automatism
