psychosis and schizophrenia REVISE

Question 1

relationship between psychosis and schizophrenia?

Answer 1

schizophrenia is a psychotic disorder as has psychotic symptoms

schizophrenia can cause psychosis (collection of positive symptoms of schizophrenia) but has some other symptoms

psychosis is the name of some of the positive symptoms of schizophreia (hallucinations and dellusions)

Question 2

how does the media wrongly view psychosis?

Answer 2

just because someone with psychosis might behave in an anti-soical way, doesn’t mean they have anti-social personailty disorder (media depicts that they do)

Question 3

how does the media wrongly view schizophrenia?

Answer 3

shows schizophrenia as being split personailty disorder but it’s a split between reality and imagination NOT personalities

Question 4

what effect does the incorrect depiction of psychosis and schizophrenia in the media have?

Answer 4

leads to stigma and social isolation for those with the condition

Question 5

what is psychosis?

Answer 5

collection of symptoms involving loss of “shared” sense of reality involving hallucinations and/or delusions

Question 6

what is schizophrenia?

Answer 6

both positive and negative symptoms involving difficulty in understanding difference between reality and imagination

Question 7

why is there a high suicide rate for those with psychosis and schizophrenia?

Answer 7

unable to trust people and voices constantly negative and persecutory

Question 8

are you more prone to commit crime if you have psychosis/schizophreniAa?

Answer 8

yes but when these disorders are combined with alcohol and drug abuse

also, more likely to kill themselves than other people

Question 9

what percentage of people with schizophrenia commit suicide?

Answer 9

10%

Question 10

what are some of the causes of psychosis?

Answer 10

schizophrenia, drug misuse, severe depression, neurological injury, severe stress, lack of sleep

Question 11

positive symptoms of schizophrenia?

Answer 11

delusions
hallucinations
disorganised speech

Question 12

what do positive symptoms of schizophrenia involve?

Answer 12

excess cognition

Question 13

what are delusions?

Answer 13

beliefs that can be seen as a misinterpretation of reality e.g believing they are being spied on

Question 14

what are hallucinations?

Answer 14

vivid visual or auditory experiences distorted from reality and not experienced by others

Question 15

what is disorganised speech?

Answer 15

thoughts and therefore speech becomes disorganised and fragmented, jumping from topic to topic

Question 16

what are the negative symptoms of schizophrenia?

Answer 16

avoltion
alogia
anhedonia
flat affect

Question 17

what do negative symptoms of schizophrenia involve?

Answer 17

deficits in behaviour

Question 18

what is avolition?

Answer 18

loss of energy and interest in usually fun activities

Question 19

what is alogia?

Answer 19

poverty of speech in both quality and quantity

Question 20

what is anhedonia?

Answer 20

lack of feeling of pleasure

Question 21

what is the flat affect?

Answer 21

no outward expression or emotion but probably not actual experience

Question 22

what are the 3 forms of schizophrenia diagnosis?

Answer 22

disorganised
catatonic
paranoid

Question 23

what is the prevalence rate of schizophrenia?

Answer 23

1-2% in UK US and Caribbean

Question 24

what is needed for a disorganised diagnosis of schizophrenia?

Answer 24

content of speech disordered

behaviour disorganised and not congruent with social cues

Question 25

what is needed for a catatonic diagnosis of schizophrenia?

Answer 25

extreme apathy and withdrawal leading to immobility with brief periods of excitement and agitation

Question 26

what is needed for paranoid diagnosis of schizophrenia?

Answer 26

delusions prominent (especially persecutory) and hallucinations

Question 27

when is the typical onset of schizophrenia and psychosis?

Answer 27

adolescence or early adulthood

Question 28

what are some of the most common positive symptoms of schizophrenia?

Answer 28

``` lack of insight (97%) due to not trusting people so not trusting diagnosis auditory hallucinations (74%) ```

Question 29

why may schizophrenia be triggered by an excess of dopamine in the brain?

Answer 29

when drugs increasing dopamine levels were given to Parkinson's sufferers, their symptoms lessened (disease associated with reduced dopamine levels) but they began to experience hallucinations suggesting some symptoms are due to high levels of dopamine ALSO schizophrenia symtpms themelves reduce once given neuroleptics to reduce dopamine levels

Question 30

difference in brain systems of those with schizophrenia?

Answer 30

excess activity in the substantia nigra (produces dopamine) decreased activity in the prefrontal cortex (decision making and social behaviour) and diminished connectivity between them (communication out of sync)

Question 31

relationship between level of connectivity between the substantia nigra and the striatum and psychosis levels?

Answer 31

the higher the level of disconnectivity, the higher the level of psychosis seen in schizophrenic patients

Question 32

genetic cause of schizophrenia

Answer 32

MZ 42% and DZ 9% (Gottesman and Shields) and negative symtpoms more genetically linked than positive BUT COULD BE DUE TO SHARED SOCIAL ENVIRONMENT however, greater risk of having schizophrenia if genetic mother schizophrenic even when raised in another environment (Heston)

Question 33

what is the lifetime risk of having sz if first degree relative has it?

Answer 33

6.5%

Question 34

what is the lifetime risk of having sz if MZ twin has it?

Answer 34

40%

Question 35

early cause of schizophrenia being brain injury in pregnancy

Answer 35

Helsinki found offspring were more likely to develop schizophrenia if there was a flu epidemic in 2nd trimester BUT FAILED TO CONFIRM THIS FINDING MORE RECENTLY

Question 36

what are some psychological stress factors triggering the onset of schizophrenia?

Answer 36

social factors stressful life events family environment

Question 37

social factors as a cause for sz

Answer 37

likelihood of schizophrenia highest in low socio-economic groups (due to poor housing and environmental hazards not due to the disorder lowering their social class) BUT ABLE TO REDUCE LIKELIHOOD THROUGH BUFFERS E.G EDUCATION AND SOCIAL SUPPORT

Question 38

stressful life events as a cause for schizophrenia

Answer 38

such as beareavement, job loss and divorce

Question 39

family environment as a cause of schizophrenia

Answer 39

high levels of expressed emotion not so much a cause of schizophrenia but may trigger relapse and maintain disorder (58% in high EE group relapsed) high levels of EE include critical comments and confronting the patient

Question 40

reduction in number of cases of schizophrenia if no one smoked cannabis?

Answer 40

8-24% in different countries issue as USA making steps towards legalising and therefore inrceasing consumption of cannabis

Question 41

social stress as a cause of sz

Answer 41

racism 5% prevalence for young black men in south london (Institute of Psychiatry) deduced racism was the cause as risk not elevated by genetic (2% in carribean), drug use or misdiagnosis risk greatest in migrants when they form a small proportion of their local community rates high in children of migrants but not reflected in increased rates from their country (implicating social factors) (Picchioni and Murray)

Question 42

summary of causes for schizophrenia

Answer 42

bio-psycho-social condition with one or more factors being influential ``` family genetic vulnerabillity socio-economic status social stressors bereavement ```

Question 43

early ineffective and damaging treatments for schizophrenia?

Answer 43

psychosurgery (surgical procedures carried out on brain to remove disorder) ECT

Question 44

what is the function of neuroleptics/antipsychotics?

Answer 44

block dopamine receptors so dopamine unable to bind to receptors therefore reduces positive symptoms by reducing levels of dopamine in the brain

Question 45

issue with neuroleptics/antipsychotics?

Answer 45

negative symptoms still remain as not caused by high but low levels of dopamine side effects of parkinsons from sexual dysfunction to tardive dyskinesia and NMS so discontinue use some symptoms are still drug resistant

Question 46

what does family therapy involve?

Answer 46

aims to prevent relapse by educating and changing patterns in the family enivronment from confrontative to collaborative and constructive e.g don't shout or stand over them reduce stress = reduce relapse

Question 47

effectiveness of family therapy?

Answer 47

out of 18 receiving family therapy so EE lowered, only 2 relapsed compared to 9 of control group not receiving changes to EE levels (Falloon et al.)

Question 48

what are the psychological interventions for sz?

Answer 48

family therapy social skills training psychoeducation

Question 49

what does social skills training consist of?

Answer 49

aims to develop social and daily living skills role playing in groups and real social situations to learn and reacquire unknown social skills

Question 50

what do cognitive therapies involve?

Answer 50

investigate content of beliefs and sources of voices and challenge them with evidence and learning to manage and answer voices (CBT) normalise certain cognitive functions such as memory and attention which are deficient in sufferers (cognitive remediation and cognitive enhancement therapies)

Question 51

what is the ABC model?

Answer 51

used in CBT A - activating event e.g voices B - beliefs e.g voices control me C - consequences e.g behaviour

Question 52

effectiveness of CBT in treating schizophrenia?

Answer 52

modest efficacy in reducing symptoms and improving subjective quality of life BUT MINIMAL EFFICACY IN REDUCING RELAPSE (Penn et al.)

Question 53

long term outcome for those with schizophrenia?

Answer 53

30% independent and working full time (schizoaffective disorder potentially not full sz) 50% relatively independent but continuing with medication 20% long term structured care

Question 54

when is a better outcome expected for those with schizophrenia?

Answer 54

known trauma that triggered the first episode onset of schizophrenia after 20 onset sudden rather than gradual good social functioning before onset

Question 55

what percentage of sufferes after their first episode will never have another?

Answer 55

less than 20% | Picchioni and Murray

Question 56

what is the relationship between causes of psychosis and the type of the psychosic experience they'll have?

Answer 56

if cause was bi-polar, delusions likely to involve agrandising themselves if cause schizophrenia or depression, may develop persecutory delusions

Question 57

why are antipsychotics also referred to as neuroleptics?

Answer 57

cause side-effects similar to that of a neurological disease

Question 58

what does psychoeducation treatment involve?

Answer 58

teaching them about symptoms and biological and psychological triggers for symptoms