Psychotic disorders Flashcards
What is a delusion?
A false unshakeable belief, despite evidence to contrary, not held by others in the same culture and held with intense personal conviction and certainty
What is a hallucination?
A perceptual experience without an object or stimulus, that appears subjectively real but uncontrollable by the patient.
Can be visual/auditory/tactile/olfactrory/gustatory/somatic
What is thought disorder?
An abnormality in the mechanism of thinking such that to the observer the person doesn’t make sense
How long must symptoms be present for before a diagnosis of schizophrenia?
At least 1 month
What are the positive symptoms of schizophrenia?
Hallucinations (especially auditory), delusions, thought disorder
What are the negative symptoms of schizophrenia?
These are late signs. Avolition (lack of motivation) Anhedonia Alogia - poverty of speech Asociality - lack of desire for relationships Affect blunt
What is required for the ICD-10 diagnosis of schizophrenia?
Characterised by fundamental and characteristic disorder of thinking and perception, with affects that are inappropriate or blunted.
Diagnosis of schizophrenia should NOT be made in the presence of extensive depressive or manic symptoms unless schizophrenic symptoms clearly pre-date the affective disturbance. Also should not be diagnosed in presence of overt brain disease (including epilepsy) or
during states of drug intoxication, use of psychoactive substances or withdrawal.
What are 2 subtypes of schizophrenia?
Paranoid and hebephrenic
What are Schneider’s First Rank Symptoms?
3rd person auditory hallucinations, running commentary, thought echo, though insertion, thought withdrawal, thought broadcasting, delusions of passivity (feelings or actions), delusional perception
What is the main neurotransmitter thought to be responsible for psychosis?
Dopamine
Which dopamine pathway is responsible for production of positive symptoms of psychosis?
Increased mesolimbic dopamine activity
Which dopamine pathway is responsible for production of negative symptoms of psychosis?
Decreased mesocortical dopamine activity
Which dopamine pathway is responsible for regulating prolactin?
Tuberoinfundibular pathway
Which dopamine pathway is responsible for modulation of extrapyramidal side effects?
Nigrostriatal pathway
What is the chance of a twin having schizophrenia if the other monozygotic twin has it?
50%
15-20% chance in dizygotic twins
What features are incompatible with a diagnosis of delusional disorder?
Clear and persistent auditory hallucinations (voices)
Delusions of control
Marked blunting of affect
Definite evidence of brain disease
Which delusional disorder is most likely in someone who believes that someone famous/powerful loves them?
DeClarembault’s syndrome
Which delusional disorder is most likely in someone who believes someone known to the subject has been replaced by an imposter?
Capgras syndrome
Which delusional disorder is most likely in someone who believes that their partner is having affair with other despite no evidence?
Othello syndrome
Which delusional disorder is most likely in someone who believes that one person is disguising themselves a multiple people in the subject’s life, often persecuting them?
Fregoli syndrome
Which delusional disorder is most likely in someone who believes they are dead/rotting inside/non-existent?
Cotard’s syndrome
Which delusional disorder is most likely in someone who believes they are infested with parasites?
Ekbom’s syndrome
What is Folie a deux?
Induced delusional disorder. Psychosis is shared by 2 people, delusions usually of a persecutory/hypochondrical nature.
