Psychosis and Schizophrenia Flashcards
define psychosis
mental disorder in which the thoughts, affective response or ability to recognise reality, and the ability to communicate and relate to others are sufficiently impaired to interfere grossly with reality
what are the classic characteristics of psychosis
hallucinations
delusions
disorder of the form of thought
lack of insight
inability to distinguish between subjective experience and reality
is harmful to individuals functioning and interpersonal relationships
what can psychosis occur in
organic conditions: delirium, dementia, brain injury, stroke
substance use: acute intoxication, withdrawal, delirium tremens
manic depressive psychosis: unipolar depression, bipolar depression
(schizoaffective disorder)
dementia praecox: shizophrenia
what is schizoaffective disorder
when someone has symptoms of both schizophrenia and mood disorder (BPAD, depression)
what are types of psychotic experiences
hallucinations
ideas of reference (thinking things have strong personal significance)
delusions
formal thought disorder (disorganised thoughts as evidenced by disorganised speech)
thought interference
passivity phenomena
loss of insight
what causes hallucinations
aberrent brain processing making you perceive things without stimulus
what is a hallucinations
a perception which occurs in the absence of an external stimulus
what are the qualities of a hallucination
is experienced as originating in real space (not in thoughts)
has same qualities as normal perception (vivid, solid, compelling)
not subject to conscious manipulation
can occur in any sensory modality: visual, auditory, olfactory, gustatory, tactile, hapatic
when only are hallucinations significant
only when in the context of other relevant symptoms
what are ideas of reference
innocuous or coincidental events will be ascribed significant meaning by the person:
messages in newspaper about them, news reports commenting on their life/ talking directly to them, knowing peoples conversations/ social media postings are about them, believing a radio station is broadcasting songs in a way to tell you something, seeing meaning in other peoples gestures
what are self referential experiences
the belief that external events are related to oneself
what are the qualities of self referential experiences
can vary in intensity from a brief thought to frequent and intrusive thoughts to delusional intensity
e.g.
the feeling that others are speaking about me/ laughing at me
the belief that TV or the radio are transmitting messaged aimed at me
the belief that i am the second coming of christ (grandiosity)
persecutory - other people to blame
paranoia- self referential
what is a delusion
a fixed, falsely held belief
what are the qualities of a delusion
held with unshakable conviction
impervious to logical argument/ evidence to the contrary
held outwith the usual social, cultural, religious and educational background of the patient
may be bizarre or imposisble
what is a primary delusion
arrives fully formed in the consciousness without need for explanation
what are the types of delusion
Paranoid
Persecutory
Grandiose
Religious
Misidentification- people replaced by imposters (e.g. FBI agents)/ thinking different people are the same person
Guilt
Sin
Poverty
Nihilistic (that you have lost everything are bankrupt is no point. Capgrass- think you are dead)
Of Love/ erotomanic/ De cleramabult- thinking you are in love/ someone in public eye has fallen in love with you
Jealousy- Othello syndrome. This can lead to homicide so red flag
Of reference
what are secondary delusions
often attempts to explain anomalous experiences e.g. hallucinations, passivity experiences, depression
what determines the content of a delusion
is culturally defined- persecutor is often recognisable to society/ culture as a danger/ threat
how must thought disorders be inferred
from patterns in speech-cannot be directly observed
what are types of thought disorder
neologisms- make up new words and expect you to know what they mean
circumstantiality (talk around question then make point)/ tangentiality (will talk around point then go off on tangent and not make point)
clanging and punning
loosening of associations/ knights move thinking (sequence of unrelated/ loosely related ideas)
verbigeration/ word salad
what are the types of thought interference
thought insertion (thoughts put into head) thought withdrawal (thoughts taken out) thought broadcasting (everyone can see them) thought blocking (cant think for a while)
what are the types of passivity
volition- made action
affect- made feelings
impulse- made urges
somatic- influence on the body
what questions can you use to carefully challenge someones beliefs
What would you say if someone said to you that [these beliefs] are not true?”
“Can you just explain to me how this is possible?”
“I just want to check that I am understanding this correctly, I don’t want to misunderstand you, I think what you are saying is that ……
what condition does 3rd person auditory hallucinations suggest
schizophrenia
what conditions can you get formal thought disorder
schizophrenia
mania
dementia/ delirium
