Psychotic experience as a continuum, Topic 2: Predicting the transition to psychosis, Topic 3: Intervention and treatment in prodromal and first episode psychosis Flashcards
What does it mean to be 100% Penetrant
Disorders that are caused by one gene.
Why cannot most disorders be entirely dichotomous in nature?
Because the aetiology is multifacturial - such as in psychiatric disorders.
What are some of the ways the psychosis phenotype can be expressed when it is at a level below it’s clinical manifestation?
Psychosis proneness
psychotic experiences
schizotypy
or at-risk mental states
In Paul Mehl’s model what describes the genetic predisposition to schizophrenia?
Schizotaxia.
What was the outcome of Paul Meehl’s gene theory of schizophrenia for psychiatry?
What are the 5 stages in Meehl’s original quasi dimensional model of schizophrenia?
van Os 2000 interviewed 7075 people on the lifetime presence of delusions or hallucinations.
Wha were the results for the 4 categories
True hallucinations
clinically relevant hallucinations
true delusions
clinically relevant
What were the results of this study?
Median prevalence rate, Median incidence rate, Transitory psychotic experiences that disappear over time
What were the results of this study?
%’s
Psychotic experiences,
Psychotic symptoms,
Psychotic disorder
Name the 11 psychotic like experiences
Name come of the 17 psychotic experiences assessment tools
What are the environmental exposures (sensitisation) that would potentially result in someone moving from T0 to T2
What was the risk of conversion to a clinical psychotic outcome between individuals with and without PLE.
People with PLE were about three times more likely to convert to clinical psychotic outcome over those with no PLE, but the transition risk was still really low.
What is the DSM-5 diagnostic definition for the newly added
Attenuated Psychosis Syndrome? (used in the US)
[Still a bit different from psychometric definition given by CAARMS given for clinical high risk.]
What are the diagnostic differences
No GRD or BLIP subgroup inclusion. Only at attenuated symptoms.
Distress and disability are key requirements needed in DSM-5 APS, but are not strictly needed to meet a clinical High Risk State. They are not strictly needed in other available psychometric instruments used to define individuals at clinical high risk for psychosis.
Distress and disability are required on the CAARMS and measured on the SOFAS.
What is the conceptual difference between them?
It is seen as either a risk factor, or a disorder. A disorder has symptoms at baseline, a risk factor doesn’t, so treatment would be different.
What did the meta analysis find?
What is validity and reliability within CAARMS?
What is needed, and why, to achieve a satisfactory reliability on the use of the CAARMS?
How many people who meet the CAARMS intake criteria or similar psychometric tools for clinical high risk will develop psychosis within 2 years? And is it comparable to other approaches in clinical medicine?
30%.
yes it is the same for transition rates from pre diabetes to diabetes.
Is there any meta analytic evidence suggesting that individuals who meet the genetic risk and deterioration syndrome subgroup have increased risk of developing psychosis compared to controls? And how does that compare to BLIP
What are BLIPS and BIPS
short-lived psychotic episodes. two different definitions.
CAARMS: less than 7 days, resolving without psychotic medication
BLIPS (Brief Limited Intermittent Psychotic Symptoms): These are short-lived psychotic episodes. They are characterized by their brief duration, limited impact on overall functioning, and intermittent occurrence. BLIPS can include symptoms like hallucinations or delusions but are transient and not as pervasive as in full-blown psychotic disorders like schizophrenia.
In the US:
BIPS (Brief Intermittent Psychotic Symptoms): This term is similar to BLIPS and refers to brief and intermittent episodes of psychotic symptoms. The difference in terminology usually depends on the specific research or clinical context, but both BLIPS and BIPS indicate a similar pattern of short-lived, non-continuous psychotic experiences.
Which one is DSM-5 and which one is ICD-10?
What two diagnosis tools for short-lived psychotic episodes have a strong overlap?
BLIPS and ICD-10’s F23
Which diagnostic tool for brief psychotic episodes most accurately predicts relapse?
What are Affective Psychoses as per the DSM-5
What are some schizophrenia and related psychoses under the DSM-5?
What are some schizophrenia and related psychoses under the ICD-10?
What are Affective Psychoses as per the ICD-10?
What are the advantages and disadvantages of Categories in diagnosis?
What are the advantages and disadvantages of continua theories?
What is the problem with the ‘symptom’?
What is the CAARMS?
What is CAPE?
What does Parnas say needs to be a part of early diagnostic assessment of attenuated psychotic symptoms?
What are the main points about the continuum model of psychosis and its clinical utility?
What’s the difference between Prodromal and clinical high risk?
What percentage of people meeting high or ultra-high risk states achieve symptomatic remission? OASIS
20%
What percentage of people meeting high or ultra-high risk states will develop psychosis will develop
Non-psychotic comorbid disorders
Persistent high or
ultra-high risk state? at OASIS
-
-
-
for individuals meeting clinical high-risk state for psychosis
What is the % transition risk from at-risk group to outcome in psychosis?
What is the risk of developing psychosis after treatment after one year of CBT vs counselling?
What is NNT? and in high risk of psychosis patients + 1 year of CBT, what is the NNT?
What’s the correlation between untreated psychosis and outcome?
