Schizophrenia Flashcards
How does the DSM - V define hallucinations?
- perception-like experiences occurring in the absence of an external stimulus
- occurring in absence of hypnogogia and hypnopompic experiences
What percentage of patients with schizophrenia report experiencing hallucinations?
75%
What hallucinations have the highest percentage experienced?
- 60- 70% experience auditorry hallucinations
What are the typically experienced auditory hallucinations?
- running commentary
- criticizing and condemning (persecutory hallucinations)
- command hallucinations (33-74% experience instructions to harm themselves)
What are risk factors for hostility in schizophrenia?
- substance abuse
- non compliance with medications
- younger males with hx of violence
- hx of aggression/violence
Significant part is that because of the delusions cannot be predicted when and where they’ll occur
What is a delusion?
- falsely held belief despite what others believe and despite evidence to the contrary
- beliefs not culturally accepted
How are delusions usually categorised?
- by their content and bizareness
e. g. thought withdrawal, delusion of control, thought insertion, thought broadcasting
What is paranoid/persecutory delusions?
- beliefs others are acting to harm of plot against them
- patient heightened state of threat and hypervigilant to perceived threat
What is a delusion of reference?
- patients believe that personal messages are being conveyed via neutral sources (e.g. coded messages via tv news)
What is a grandiose delusion?
- belief one has special powers, abilities, influence, achievements or another identity that typically relates to power, wealth or fame
- also common in manic episodes
What is a nihilistic delusion?
- belief that one is dead or parts of body no longer exist
What is a somatic delusion?
- false belief that one’s organs are (diseased); infested with insects (parasitosis); anatomy is disfigures (dysmorphobia)
What is the passivity phenomena?
- belief that patient is under the control of another person’s force
What are delusions of guilt?
- cause of significant events (e.g 9/11; aids)
What are jealousy delusions?
- belief that one’s partner has been unfaithful (e.g. evidence via coded messages)
What is an erotomanic delusion?
- false belief that patient’s romantic feelings are reciprocated (often by a famous other)
What is a misidentification delusion?
- belief that someone they know has had their identity tolen
What is thought disorder?
- disturbance in flow and or form of speech
- illogical or disjointed speech
- structure of thoughts (form of speech: incoherent, nonsensical)
How are symptoms categorised in thought disorder
negative: reduced manifestations of thoughts & poverty of speech
positive: circumlocution (goes round and round point); nondirective & verbose (all over the place) derailment (comments slipping from one to next e.g. i payed tennis, going to the court, judge etc); tangential (talking around the point); echolalia; word salad; neologisms (idiosyncratic use of words)
what is disorganised behaviour in schizophrenia?
- grossly disorganised and abnormal motor behaviour
What are some egs of catatonic behaviour?
- extreme negativism (refuses to do what you say)
- immobility (‘waxy flexibility’- move arm and will stay there)
- catatonic excitement: excessive purposeless activity
- peculiar voluntary movements (posture, grimacing)
- echolalia, echopraxia, mutism
What are the subtypes of Schizophrenia?
- schizotypal (pd)–> argued to be precursor
- delusional (erotomania, persecutory, grandiose, jealous)
- brief psychotic disorder (sudden, <1m, return to fning)
- schizophreniform (1-6 m, lack of impaired fning)
- schizoaffective
- substance- induced psychotic
- psychosis due to a medical condition
- catatonia & other unspecified
What is criterion A for Schizophrenia in DSM-V?
A: 2 or more of following for sig portion of time during 1 m period (or less if treat successfully), must have 1,2 or 3:
- hallucinations
- delusions
- disorganised speech
- grossly disorganised or catatonic behaviour
- negative symptoms
What are criterion b, c and d-f of schizophrenia in dsm-v?
B: Significant impact to fn (below baseline)
C: continuous signs present for atleast 6 m (gradual deterioration in fn, must be at least 1 m of psychotic symptoms)
D-F: not better accounted for by dx, substance.medical condition or PDD.
