Schizophrenia Flashcards

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1
Q

What is schizophrenia categorised by?

A

Major disturbances in thought, emotion and behaviour.

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2
Q

Who does schizophrenia affect?

A

The incidence of schizophrenia is the same across the world. 1:100 or 1%.
It appears to strike men and women equally.
The average age of onset is 15-30.

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3
Q

Schizophrenia appears to strike men and women equally. What does this suggest about it’s cause?

A

This suggests the cause of schizophrenia is not due to sex chromosomes or upbringing (dependent on gender)

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4
Q

What are the symptoms of schizophrenia?

A

There are no essential common symptoms. One schizophrenic patient differs from another far more than any one depressed patient differs from another depressed person.

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5
Q

The symptoms are divided into two groups. What are those groups?

A

Positive symptoms (Type I) and negative symptoms (Type II)

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6
Q

How are the positive symptoms classified? (What are positive symptoms?)

A

“Symptoms that non-schizophrenic people don’t have, but schizophrenic people do”.
Excesses which are rare in normal everyday experiences.
Associated with abnormalities in the lambic system.
Initially the most dramatic and disturbing symptoms, but generally respond well to drug treatment.

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7
Q

What are the positive symptoms of schizophrenia?

A

Hallucinations
Delusions
Disorganised speech and/or thoughts
Disorganised behaviour

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8
Q

What are hallucinations?

A

Sensing something that isn’t there or doesn’t exist.

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9
Q

What are auditory hallucinations?

A

(The most common form or hallucinations in schizophrenics)

Hearing voices which are not there

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10
Q

What are visual hallucinations?

A

(Second most common)

Seeing things which are not there

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11
Q

Name some less common hallucinations

A

Taste (gustatory)
Smell (olfactory)
Touch (tactile)
Lilliputian (size)

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12
Q

What is a delusion?

A

A false belief, which is experienced without any evidence to support it. Usually a belief in something absurd or untrue which cannot be overcome by reason.

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13
Q

What is a delusion of persecution?

A

A false belief that others are plotting against or trying to harm them (paranoid)

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14
Q

What are delusions of grandeur?

A

A false belief that one has a power (e.g. flight) or is a famous person (e.g. Jesus Christ)

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15
Q

What is disorganised speech and/or thoughts?

A

Problems with the organisation of ideas and speaking - this is linked to ‘thought disturbances’ where the person may appear incoherent

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16
Q

What is disorganised behaviour?

A

Unpredictable behaviour e.g. problems organising daily routine, wild excited behaviour (catatonic excitement) or immobility (catatonic stupor)

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17
Q

How are negative symptoms of schizophrenia classified?

A

“Something non-schizophrenics have, but schizophrenics don’t”
Behavioural defects which are less dramatic and can be experienced in every day life.
Associated with abnormalities in the frontal lobes/enlarged ventricles.
Can cause serious long term consequences for the schizophrenic sufferer
More difficult to treat as less responsive to drug treatment

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18
Q

What are the negative symptoms of schizophrenia?

A

Avolition
Flat affect
Absence of social functions

19
Q

What is avolition?

A
General loss of energy resulting in:-
Lack of goal-directed behaviour;
Inability to complete tasks;
General loss of interest in life;
Social isolation and withdrawal
20
Q

What is the flat affect?

A

Absence of emotion and appearing lifeless. This may include staring vacantly and not making eye contact and speaking in a flat, toneless voice.

21
Q

What is absence of social functions?

A

Poor social skills and limited social interactions leading to social isolation and withdrawal

22
Q

What did Wing (1992) argue for the distinction of?

A

Primary and secondary impairments

23
Q

What are primary impairments?

A
Intrinsic to the disorder
Hallucinations 
Delusions
Thought disorders
Apathy
Emotional blunting
24
Q

What are secondary impairments?

A

Result from the primary impairments
Social- isolation or withdrawal
Psychological- depression/anxiety, addiction

25
Q

What is required for a diagnosis?

A

Two or more symptoms of; delusions, hallucinations, disorganised speech, disorganised behaviour or negative symptoms; each present for at least one month
Social/occupational dysfunction since the onset of symptoms
Duration of at least 6 MONTHS of symptoms

26
Q

How long do the symptoms/dysfunction have to be present for a diagnosis?

A

At least six months, with at least one month of symptoms

27
Q

What are the sub-types of schizophrenia outlined in the DSM IV?

A
Paranoid 
Catatonic
Disorganised
Undifferentiated 
Residual
28
Q

What are the symptoms of paranoid schizophrenia?

A

Delusions
Auditory hallucinations
NO disorganised speech or catatonic behaviour
Cognitive and emotional responses not affected

29
Q

What are the symptoms of catatonic schizophrenia?

A

Major disturbances in motor activity

30
Q

What are he symptoms of disorganised schizophrenia?

A
Disorganised, unintelligent speech
Bizarre behaviour 
Flat affect 
Social withdrawal 
Loss of interest in every day life
31
Q

What are the symptoms of undifferentiated schizophrenia?

A

CANNOT BE CLASSIFIED INTO ANY OTHER CATEGORY

Symptoms may be a MIXTURE from the other types

32
Q

What are the symptoms of residual schizophrenia?

A

Individuals who have once suffered from extreme and major symptoms but now display few/mild symptoms

33
Q

Schizophrenia is a psychosis. What is a psychosis?

A

Loosing touch with reality in some way.

34
Q

What are the problems associated with catatonic classification of schizophrenia?

A

The CATATONIC type is RARE and may be due to certain types of DRUGS used to treat the disorder.
Some claim that it is NOT A TRUE CATEGORY of schizophrenia and should be DROPPED from classification.

35
Q

What are the problems associated with the undifferentiated category?

A

The UNDIFFERENTIATED category is said to be TOO VAGUE and ILL-defined.
Many clinicians believe it is OVERUSED and there is CONFUSION between it and OTHER psychotic DISORDERS in the DSM.

36
Q

What are the problems associated with diagnosis of schizophrenia?

A

Diagnosing schizophrenia ACCURATELY and with RELIABILITY is NOT STRAIGHT FORWARD.
The criteria for diagnosis do not specify a precise set of symptoms, but indicate that some of each category need to be present.
This LACK of PRECISION means that MISDIAGNOSIS MAY HAPPEN.

37
Q

Suggest three ways in which misdiagnosis may occur

A

Ethnic bias
Cultural differences
Symptoms OVERLAPPING with different disorders

38
Q

Misdiagnosis may occur due to ethnic bias. Explain this

A

Research by Goater et al (1999) has shown that certain ethnic groups may be diagnosed with schizophrenia more often than other groups (racist overtone)

39
Q

Outline Goater et al’s 1999 study in which they investigated different rate of diagnosis of schizophrenia in ethnic groups in London

A

People from different ethnic groups were followed for 5 YEARS in LONDON to see how many from each group were DIAGNOSED with schizophrenia

40
Q

What were the results of Goater et al’s 1999 study?

A

People from BLACK ETHNIC MINORITY groups were found to be MORE LIKELY to be DETAINED by police, taken to HOSPITAL by police and given EMERGENCY INJECTIONS.
They were also MORE LIKELY to be DIAGNOSED as SCHIZOPHRENIC

41
Q

What did Goater et al conclude from their 1999 study?

A

MISDIAGNOSIS of schizophrenia is MORE LIKELY to occur amongst BLACK MINORITY ethnic groups

(However, this could be due to a genetic link)

42
Q

Why might cultural differences lead to a misdiagnosis?

A

The RELIABILITY of diagnosis may be challenged by the finding that there is MASSIVE VARIATION between COUNTRIES

43
Q

Outline Copeland et al’s 1971 study

A

Copeland et al (1971) gave a DESCRIPTION of a PATIENT to 134 US and 194 BRITISH PSYCHIATRISTS.

69% of the US psychiatrists DIAGNOSED

ONLY 2% of the BRITISH psychiatrists DIAGNOSED

44
Q

Why might overlapping of symptoms with different disorders lead to a misdiagnosis of schizophrenia?

A

It is DIFFICULT to DISTINGUISH between schizophrenia and other disorders such as MANIC DEPRESSION as SOME of he SYMPTOMS, such as DELUSIONS, OVERLAP.

This could lead to the problem of psychiatrists DIAGNOSING the WRONG DISORDER and wider issues of INCORRECT TREATMENT PROGRAMMES