Psychosis + Schizophrenia Flashcards
What are the key features of psychosis?
Inability to distinguish between subjective experience and reality
Characterised by lack of insight
Harmful to functioning and relationships
Give some examples of psychotic experiences
Hallucinations Ideas of reference Delusions Formal thought disorder Thought interference Passivity phenomena
What are the features of a hallucination?
Perception occurring in the absence of an external stimulus
Originating in real space
Not subject to conscious manipulation
Can occur in any sensory modality
What are ideas of reference?
Coincidental events are ascribed significant meaning
e.g. news is talking about them, song is trying to tell them something
What are self-referential experiences?
Belief that external events are related to oneself
What is a delusion?
A fixed, falsely held belief
Held with unshakable conviction
Outwith the usual social, cultural and educational background of the patient
Give some examples of thought disorder
Neologisms (new words) Circumstantiality Clanging + punning Loosening of associations Knights move thinking Verbigeration/word salad
(inferred from patterns of speech)
Give some examples of thought interference
Thought insertion
Thought withdrawal
Thought broadcasting
Thought blocking
What is passivity phenomena and name some different types?
Made to do things by an external agency
- volition –> made actions
- affect –> made feelings
- impulse –> made urges
- somatic –> influence on body
What is the differential diagnosis for psychosis?
Organic conditions: - delirium, dementia, brain injury, stroke etc Substance use: - acute intoxication, withdrawal, delirium tremens Unipolar depression Bipolar disorder Schizophrenia + other paranoid illnesses Schizoaffective disorder
What are the core (First Rank) symptoms of schizophrenia?
Delusions
Auditory hallucinations
Thought interference
- withdrawal, insertion, broadcasting, passivity of thought
Passivity phenomena
- affect, impulse, volition, somatic passivity
What are the negative syndromes/symptoms of schizophrenia?
Reduced amount of speech Reduced motivation/drive Reduced interest/pleasure Reduced social interaction Blunting of affect
What is the usual age of onset for schizophrenia?
Men 15-25
Women 25-35
What are the risk factors for schizophrenia?
Genetics Birth complications - prematurity, foetal distress, hypoxia, 2nd trimester virus, malnutrition Drug use --> cannabis, cocaine, amphetamines Urban dwelling Social deprivation Enlarged ventricles, thinner cortices Altered dopamine signalling Childhood viral CNS infection
What is the rate of completed suicide in schizophrenia patients?
10-15%
–> medical, psychological and social follow up ESSENTIAL
