Schizophrenia and Psychosis Flashcards

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1
Q

Psychosis

A

The inability to distinguish between reality and unreality

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2
Q

Egen Bleuler’s take on Schizophrenia

A

Splitting of usually integrated psychic functions of mental associations, thoughts, emotions not splitting of personalities

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3
Q

Psychotic symptoms

A
  • Negative Symptoms
  • Delusions
  • Hallucinations
  • Disorganized thought
  • Disorganized behaviour
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4
Q

Schizophrenia Spectrum

A

Number, severity and duration of symptoms can vary
- Distinguishes the psychotic disorders form one another
- cognitive deficits also common

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5
Q

Delusions

A
  • False, unshakable beliefs that are held with strong conviction despite contradictory evidence
  • Inappropriately high meaning and attention to irrelevant events
  • Different from self-deceptions (possible, attended to occasionally, acknowledged that could be incorrect)
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6
Q

Hallucinations

A
  • False or inaccurate perceptions that cause one to sense what others do not
  • Auditory verbal hallucinations are most common (70-80% of people with schizophrenia)
  • Visual hallucinations (24-72 with schizophrenia)
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7
Q

Prevalence of types of hallucinations

A

MOST COMMON
Auditory
Visual
Somatic, Tactile
Olfactory, Gustatory
LEAST COMMON

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8
Q

Neuroscience and Hallucinations

A
  • Auditory hallucinations produce signals of sound - brain ‘hears’ them
  • Activity in Broca’s area (production of sounds, including speech)
  • Activity in areas that perceive sound
  • Recognized as sounds coming from within
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9
Q

Formal thought disorder

A

Disorganized thinking
- Not a disorder, thought is in disorder

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10
Q

Loose associations

A

Slipping from one topic to seemingly unrelated topic

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11
Q

Neologisms

A

Made-up words that mean something only to the speaker

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12
Q

Clangs

A

Words associated by sound not content (rhyming)

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13
Q

Disorganized thought and speech

A
  • Formal Thought disorder
  • Loose associations
  • Neologisms
  • Clangs
  • Can be incoherent, speaking in ‘word salad’
  • Men show more language deficits than women
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14
Q

Disorganized Behavior

A
  • Unpredictable, apparently untriggered agitation
  • Difficulty organizing daily routines
  • socially unacceptable behavior
  • Catatonia
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15
Q

Catatonia

A

Noticeable psychomotor dysfunction; decreased or excessive peculiar motor activity
- Negativism: lack of response to instructions
- Mutism: lack of verbal or motor responses
- Catatonic excitement: purposeless excessive motor movement

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16
Q

Negative Symtpoms

A

Loss of certain qualities
- Restricted Affect
- Alogia
- Avolition
- Asociality
More strongly associated with poor outcomes than positive symptoms (more persistent, difficult to treat)

17
Q

Restricted Affect

A

Severe reduction or absence of emotional expression

18
Q

Alogia

A

Reduction of speech

19
Q

Avolition

A

Inability to initiate or persist at common goal-directed activities

20
Q

Asociality

A

Lack of desire to interact with people

21
Q

Cognitive Deficits

A
  • Affecting attention, memory, and processing speed
  • Difficulty paying attention to relevant information and suppressing unwanted or relevant information (poor filtering of stimulation and information) (may contribute to positive symptoms)
  • Commonly experienced before disorder onset
  • Family members commonly experience these symptoms, but to a lesser degree
22
Q

Chrobak et al. eye tracking study

A
  • Participants asked to keep head still and track a moving object back and forth with eyes
  • Patients with schizophrenia scored worse on smooth-pursuit eye movement (may be related to attention problems
23
Q

Diagnosing Schizophrenia

A
  • Two psychotic symptoms must be consistently and acutely present at least 1 month
  • at least one symptom should be hallucinations, delusions, or disorganized speech
  • an acute phase
  • Other symptoms that impair functioning must be present for at least 6 months
24
Q

Acute phase

A

period involving consistent and intense psychotic symptoms

25
Q

Schizophrenia prevalence

A

1% lifetime prevalence in Canada

26
Q

Stages of schizophrenia

A

Premorbid - no or few symptoms
Prodromal - Attenuated symptoms (6 month period, mild psychotic symptoms causing functional decline)
Syndromal - Psychotic symptoms (acute period - 1 month to 1 year)
Chronic or Residual - Psychotic symptoms, negative symptoms, cognitive symptoms, functional disability (Mild symptoms)

27
Q

Schizophrenia onset

A
  • Earlier onset = worse prognosis
  • Not common to emerge before 13 - onset usually after puberty
  • May see cognitive deficits or negative symptoms before
  • Rare to have onset after 40
28
Q

Schizoaffective

A
  • Psychotic symptoms mixed with mood symptoms
  • Major depressive OR manic episodes
  • At least two weeks of hallucinations or delusions without mood symptoms
29
Q

What is the order of functionality impairment of schizophrenia related disorders?

A

MOST IMPAIRMENT
- Schizophrenia
- Schizoaffective
- Brief Psychotic Disorder
- Delusional Disorder
- Schizotypal personality disorder

30
Q

Schizophreniform

A

Only 1-6 months of symptoms
- 2/3/ go on to meet criteria for schizophrenia

31
Q

Brief Psychotic Disorder

A

Sudden onset of symptoms
- Common after major stressor but doesn’t have to happen
Lasts 1-30 days followed by complete remission - Usually only positive symptoms
- Relapse is common

32
Q

Delusional Disorder

A
  • Delusions about real-life occurrences for at least one month
  • no other psychotic symptoms, no other changes in functioning
  • Not a psychotic disorder but puts people at higher risk
33
Q

Heritability of schizophrenia

A

41-87%

34
Q

Biological approach to theories of schizophrenia

A
  • Reduction in gray matter across cortex
  • Reduction in white matter in areas associated with working memory (also seen in family members without schizophrenia
  • Abnormal activity in PFC
  • Enlarged ventricles
  • Prenatal exposures and birth complications
  • Excess dopamine in PFC and limbic system (increased HPA axis activity may cause changes in dopamine production, antipsychotic medication works to block dopamine receptors)
35
Q

Psychosocial Contributors to schizophrenia

A
  • More likely to emerge in chronically stressful circumstances
  • living in populated areas
  • Childhood trauma linked with adulthood psychosis
36
Q

Goldberg and Morrison study on schizophrenia and SES

A
  • Men with schizophrenia end up with lower SES than their fathers
  • Men without schizophrenia end up in similar or higher SES than fathers
  • Social drift as a reuslt