Schizophrenia Flashcards
Define positive symptoms
Active presence of abnormal phenomena
List some positive symptoms
Hallucinations, delusions, thought disorder
Define negative symptoms
Deficits in normal behaviour
List some negative symptoms
- less speech
- less interest or motivation
- less emotional expression
- less feeling or interest
- blunted affect
- avolition
- alogia
- anhedonia
- sociality
Which type of symptoms respond better to intensive psychosocial treatment?
Negative
What are delusions
False beliefs which are a misrepresentation of reality; held in a fixed way; typically personal
List common forms of delusion
- persecutory
- referential
- grandiose
- somatic
- delusions of control
- thought insertion
- thought broadcasting
Persecutory delusions
Person/group/system is trying to harm you
Referential delusions
Certain gestures/comments/environmental cues are directed at you e.g. radio is sending you a message
Grandiose delusions
Belief that one has special powers or abilities, special significance, or has been given a special mission
Somatic delusions
Clearly unrealistic, often bizarre belief about one’s own body e.g. rats have eaten internal organs
Delusions of control
Belief that one is controlled by mysterious external forces
Thought insertion
Belief that someone is putting thoughts into one’s head
Thought broadcasting
Belief that others can hear one’s thoughts
What are hallucinations?
Experiences that are interpreted as perceptions, but without the external stimulus
Characteristics of voices/auditory hallucinations
- voices distinct from one’s own
- can be multiple different voices
- majority are negative voices
List some disorders of thought and language
- confused thinking -unusual and idiosyncratic
- disorganised or incoherent speech - derailment, associations
- difficulty concentrating
Neologisms
Use of made up words that have little or no meaning to others
Loose associations or derailment
Drifts off on a train of associations evoked by an idea of the past
Perseveration
Inappropriate but persistent repetition of the same words or train of thought
Clanging
Stringing together of words or sounds on the basis of rhyming
Blocking
Train of thought interrupted by silence before idea is completed then thought being conveyed cannot be recalled
Blunted affect or affective flattening
Emotions seem dampened, person’s emotional expression is reduced
Avolition
Difficulty getting motivated and initiating goal directed action
Alogia
Reduced speech output
Anhedonia
Decreased ability to experience pleasure or remember previously pleasurable events
Asociality
Refers to lack of interest in social interactions
List some differential diagnoses for schizophrenia
- attenuated psychotic syndrome
- brief psychotic disorder
- schizophreniform psychosis
- substance induced psychosis
- organic psychosis
- schizoaffective disorder
Attenuated psychotic syndrome
Possibly prodromal for schizophrenia
Brief psychotic disorder
Symptoms similar but last less than one month
Schizophreniform psychosis
Symptoms similar but last between 1-6 months
Substance induced psychosis
On withdrawal of substance, symptoms should resolve
Organic psychosis
Need to investigate head injuries, look at concussive and impaired symptoms
Schizoaffective disorder
Presence of psychotic symptoms within a mood episode and outside a mood episode (2 or more weeks)
What are the phases of a psychotic episode
- prodromal
- active or acute
- residual
- remission or recovery
Prodromal
The lead up to something; onset; early signs; some changes in perceptions
Active or acute
Floridly psychotic, exhibiting clear psychotic symptoms
Residual
Acute symptoms have resolve but still some signs of disorder or negative symptoms remain
Remission or recovery
No psychotic symptoms remain
What percentage of schizophrenics are employed?
10-20%
When is typical onset?
Between 16-28
What percentage of the global population is affected?
About 1%
What is the percentage risk for genetic predisposition?
75%
What are some other factors that can combine to cause schizophrenia?
- pre pregnancy factors
- pregnancy stress
- social stress
- environmental stress
- neurobiology (dopamine hypothesis)
What is the risk for an adopted child of mother with psychotic disorder?
22%
Which endophenotypes can be used to identify schizophrenia early?
- saccadic eye movement
- social cognition
- cognitive deficits
What are endophenotypes?
Biological markers
Stress-diathesis
Underlying vulnerabilities to schizophrenia can be impacted by stress and hence it could emerge
Definition of psychosis
When perceptions and sensations lose touch with reality around you
Contributions of John Haslam
- looked at schizophrenia from a scientific level
- believed they could be helped
Contributions of Philippe Pinel
- took over management of Bicetre asylum
- released prisoners from their chains
- gradually discharged people
- improved nutrition
- stopped blood letting
- forbade harsh treatment
Contributions of Emil Kraepelin
- distinguished between schizophrenia and mood disorders
- first to characterise dementia praecox (schizophrenia)
Contributions of Eugene Bleuler
- introduced the term schizophrenia (split brain)
- saw schizophrenia as splitting between emotional and intellectual functions
Two or more of the following:
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganised or catatonic behaviour
- Negative symptoms
Benefits of effective psychoeducation
- reduce number of relapses/episodes
- reduce the need for hospitalisation
- improve adherence with pharmacological and psychological treatment
What is the modern recovery oriented approach
Personal recovery is about being able to create and live a meaningful life in a community of choice, with or without mental issues
Which type of treatment works best for positive symptoms?
Anti-psychotic medications
List 4 examples of inappropriate affect and disorganised behaviour
- extremely active/excited or lethargic
- catatonic behaviour
- unusual behaviour based on hallucinations and delusions
- inappropriate affect
Prevalence of schizophrenia
0.2 - 1.5%
