Psychotic Disorders Flashcards
What is the definition of psychosis?
Represents an inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality
Lack of insight
Presents in the most severe form of illness (severe depression or mania)
What are illnesses that have psychotic symptoms?
Schizophrenia Delirium Severe affective disorder Depressive episode with psychotic symptoms Manic episode with psychotic symptoms
What is the age of onset for schizophrenia?
15-35 years
What are the symptoms of schizophrenia?
Positive Symptoms
Hallucinations
Delusions
Disordered thinking
auditory hallucinations in the third person and/or voices commenting on the patient’s behaviour
thought withdrawal, insertion and broadcast
primary delusion (arising out of nothing)
delusional perception
somatic passivity and feelings – patients believe that their thoughts, feelings or acts are controlled by others.
Negative Symptoms
Apathy
Lack of interest
Lack of emotions
What is the ICD-10 criteria for schizophrenia?
For more than a month in the absence of organic or affective disorder:
At least one of the following:
a) Alienation of thought as thought echo, thought insertion or withdrawal, or thought broadcasting.
b) Delusions of control, influence or passivity, clearly referred to body or limb movements actions, or sensations; delusional perception.
c) Hallucinatory voices giving a running commentary on the patient’s behaviour, or discussing him between themselves, or other types of hallucinatory voices coming from some part of the body.
d) Persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. being able to control the weather).
And OR at least two of the following:
e) Persistent hallucinations in any modality, when occurring every day for at least one month.
f) Neologisms, breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech.
g) Catatonic behaviour, such as excitement, posturing or waxy flexibility, negativism, mutism and stupor.
h) “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses.
What are the believed precipitants/causes of schizophrenia?
Multi genetics Neurochemistry inc dopamine Obstetric complications Maternal influenza Malnutrition and famine Winter birth Substance misuse Occupation and social class Migration Social Isolation Life Events as Precipitants
What is schizoaffective disorder?
Mix of affective and schizophrenia like features
What are differential diagnoses for schizophrenia?
organic mental disorders (e.g. partial complex epilepsy)
mood (affective) disorders (e.g. mania)
drug psychoses (e.g. amphetamine psychosis)
personality disorders (schizotypal)
What is the management of schizophrenia?
Antipsychotic (neuroleptic) drugs CBT Family education/intervention Cognitive remediation Social skills training
