SCHIZOPHRENIA Flashcards

1
Q

neurosis is less severe=

A

anxiety and mood disorder

-symptoms of stress but not a radical loss of touch with reality

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2
Q

psychosis is more severe=

A

a loss of contact with reality

*can be psychotic but also experience symptoms of neurosis

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3
Q

History

A

Dementia Praecox- Biological = Kraepelin, 1893

Schizophrenia- Freudian = Eugene Bleuler, 1911

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4
Q

Epidemiology

A
  • 0.7% of people
  • higher prevalence un inner cities/ lower socioeconomic
  • 20% of psychiatric hospitals
  • 20% attempted suicide admissions
  • 2/3 of ‘insanity pleas’ in legal cases
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5
Q

Onset

A
  • usually between late teens and mid 30s
  • only if symptoms persist for 6 months
  • three episodes: prodromal, active and residual
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6
Q

DSM-5

A

NO LONGER SUBTYPES

2 or more for at least a month/signs of disturbance for 6 months or more:

  1. delusions (+)
  2. hallucinations(+)
  3. disorganised speech(+)
  4. disorganised behaviour
  5. negative symptoms
  • diminished level of functioning in work, relationships or self care

Positive symptoms (also includes motor and thought disturbances)= generally more responsive t treatment than negative symptoms

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7
Q

Thought broadcasting

A

one’s own thoughts are being broadcast or transmitted to others

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8
Q

Thought withdrawal

A

ones thoughts are being removed from ones own mind

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9
Q

Delusions of grandeur

A

one is famous or powerful person from past or present

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10
Q

Delusions of control

A

some external force is trying to take control of one’s thoughts

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11
Q

Delusions of reference

A

all happenings revolve around oneself/ centre of attention

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12
Q

Delusions of persecution

A

one is the target of others’ mistreatment, evolution plots, murderous intent

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13
Q

Delusions of jealousy

A

that everyone is jealous of them

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14
Q

Hallucinations- sensory perception is not perceived by others

A
  • auditory= sounds and voices outside
  • visual= clear or vague
  • tactile- tingling, burning, electric shock
  • somatic-insects crawling under skin
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15
Q

Disorganised thinking and speech

A

Illogical, disconnected thought and speech patterns

-thought alienation
derailment 
neologisms 
-perseveration 
-clang and rhyming 
-word salad
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16
Q

loose associations (cognitive slippage)

A

repeatedly shifting from topics without apparent or logical connection

17
Q

neologisms

A

new, seemingly meaningless words formed by combining words

18
Q

disorganised motor disturbances

A

extreme activity levels, peculiar body movements or postures, strange gestures and grimaces

19
Q

Negative symptoms examples

A
  • flat affect- show no emotion at all
  • anhedonia- lack of pleasure or enjoyment
  • alogia- reduction in amount and meaningful content of speech
  • avolition- feeling drained of energy and unable to initiate course of action
  • inability to engage in routine or goal-directed activities
  • inability to feel pleasure; lack of interest or enjoyment in activities or relationships
20
Q

The prodromal phase

A
  • changed occur in weeks, months, years before
  • irritability
  • fragmentary psychotic symptoms
  • avoidance of work and social functioning
  • “attenuated general functioning”
21
Q

The active phase

A
  • “Florid” psychotic symptoms (distortions in thinking, delusions, hallucinations(
  • anxiety, depressions and fear
  • difficult to distinguish between manic episode
  • dangerous with presence of paranoid elements
22
Q

The residual phase

A
  • symptoms ease a bit
  • same symptoms may persist

*not a DSM term

23
Q

Schizoaffective disorders

A
  • presence of schizophrenia and bipolar

* some clinicians think schizophrenia is a group of disorders- different symptoms = different treatments

24
Q

Genetics

A
  • 80% heritability (17% fraternal-prenatal and 48% identical twins)
  • adoption studies
  • epigenetics- changing of expression of genes to be coded
  • mutations are rare
25
Q

The dopamine hypothesis

A

excessive levels of dopamine or sensitivity to dopamine (uptake)

*antipsychotic drugs lower dopamine amounts

26
Q

Enlarged ventricles

A
  • CT scene and MRI
  • deteriorations or atrophy of brain- increased blood flow
  • increased compared to twin or sibling
27
Q

substance abuse

A
  • biological vulnerability
  • may not be first exposure, may be fourth or fifth
  • ecstatcy, alcohol, cocaine, marijuana, crystal meth
28
Q

Stress

A

of life events and trauma -in combination with biological vulnerability

  • hallucinations often be meaningfullly linked to earlier trauma or stress
  • high rates of reports of child abuse and trauma (childhood risk factors)
29
Q

Smoking

A
  • correlation

- cigarettes used a a from of self-medication, not that cigarettes trigger psychosis

30
Q

Social causation hypothesis

A

different standards of healthcare, poorer living conditions which increase stress

31
Q

Social drift hypothesis

A

clinical features of psychotic disorder contribute to gradual downward socioeconomic trajectory

32
Q

Conventional antipsychotic drugs

A
  • reduce positive symptoms of schizophrenia in around 65% of cases
  • unwanted Parkinson’s disease side effects:muscle tremors, muscle rigidity, taking, shuffling feet, lack of facial expression
33
Q

Atypical antipsychotic drugs

A
  • act of both dopamine and serotonin systems
  • more effective: help 85% of schizophrenics
  • help negative and positive symptoms

*major danger in side-effects e.e.g agranulocytosis

34
Q

Group Therapy

A

Hearing Voices Network

-bring people who suffer from hallucinations together to talk about their experiences and to find their voices

35
Q

Prognosis

A
  • after 5 years, one quarter recover completely
  • gradually improves, only deterioration in 10%
  • better prognosis for this diagnosed in adulthood than childhood
  • 20% of people attempt suicide
36
Q

Recurrence

A
  • 20%have only one episode
  • 35% go on to have several episodes with no impairment between
  • about 10% have multiple episode with a static level of functional and personality impairment. between
  • 35% have multiple episodes with increasing levels of impairment
37
Q

Subclinical symptoms

A

Experiences associated with schizophrenia- such as paranoid delusional thinking and auditory hallucinations- are observes in an attenuated for in 5-8& of healthy people.

38
Q

Unusual belief in the general population

A
  • 45% beloved in telepathy
  • 45% believed in the ability to predict the future
  • 31% believed in ghosts
  • 21% said there had been ties over the past year when they’d felt that people were against them
  • 9% said they had believed that they thoughts were being controlled or interfered with by some outside force or person
  • 1.5% said there had been ties when they’d felt people were plotting to cause them serious harm.