Schizophrenia and Psychotic Disorders Flashcards
Pychosis?
Lack of insight.
Inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality
->seen in the most severe forms of mental illness
What are hallucinations?
Involved in the five senses e.g. seeing things, hearing things, smelling things
Have the full force and clarity of true perception but there are no external stimuli
What is meant by a delusion?
An unshakeable idea or belief which is out of keeping of a person’s social or cultural background.
It is held with extraordinary conviction and the patient cannot be convinced otherwise.
What are some of the categories of delusion?
Grandiose
Paranoia
Hypochondrial
Self referential
Grandiose?
The patient believing they are the best at something e.g. cleverest, most attractive, etc.
Paranoia delusions?
Idea that someone is out to get you or is against you in some way.
Hypochondriacal?
Believing you are ill when you are not.
Self refrnetial?
Believing things refer to you in some way
e.g. a stabbing in London happened because you went to work this morning
Which illnesses have psychotic symptoms?
Schizophrenia
Delirium
Severe affective disorder e.g. depressive episode with psychotic symptoms or manic episode with psychotic symptoms
What is the most common cause of psychosis?
Schizophrenia
Epidemiology for schizophrenia?
1 in100
Men = Women
Age of onset 15-35
Positive and negative symptoms of schizophrenia?
Positive symptoms:
Hallucinations
Delusions
Disordered thinking
Negative symtpoms:
Apathy
Lack of interest
Lack of emotion
->diagnosis made if at least two symptoms for at least a month.
In an exam question, if they have schizophrenia symptoms for two weeks, they CANNOT have schizophrenia
What is meant by disordered thinking?
Flow of thoughts is disrupted.
May go off on tangents
What is meant by schizo fasia or word salad?
Patient does not have structure of speech and cannot put more than 2 or three coherent words together to make sense.
->very hard for actors to reproduce.
If seen this, very likely patient has schizophrenia
Catatonia?
Psychomotor
Two types- restless, agitated or non-moving, mute
->not just seen in schizophrenia
Which drugs make the symptoms of catatonia disappear for a short spell?
Benzodiazepines
Schizoaffective disorder?
A patient that meets all the criteria for schizophrenia
AND
the criteria for either a depressive disorder or a manic episode
AT THE SAME TIME
Summarise the diagnostic criteria of schizophrenia.
One month, in the absence of organic or affective disorder. Two of the following:
Alienation of thought- thought echoing, thought insertion, broadcasting of though
Delusions
Hallucinations
Breaks or interpolations in the train of thought, resulting in incoherence irrelevant speech
Catatonic behaviour
Apathy, blunting of emotional response
What are some of the biological factors which can increase risks of developing schitzophrenia?
Genetics
Obstetric complications *
Maternal influenza
Malnutrition and famine
Winter birth
Substance misuse
-> * this is why we ask about any birth complications in personal history during psychiatric history taking
What are some of the social and psychosocial factors that may increase risks of developing schitzophrenia?
Migration
Occupation and social class
Social isolation
Severe life events
What is the main difference between delirium hallucinations and schizophrenic hallucinations?
In delirium, they tend to occur at night and tend to be visual hallucinations
Auditory hallucination is more common in schizophrenia
What would be the likely symptoms of depressive episode with psychotic symptoms?
Delusions of guilt, worthlessness
Derogatory auditory hallucinations
Feeling although you are already dead or rotting
What would be the likely symptoms of manic episode with psychotic symptoms?
Delusions of grandeur- special powers or messianic roles
Gross overactivity, irritability, behavioural disturbances, manic excitement
Summarise treatment for schizophrenia.
Get family involved
Antipsychotic meds
CBT for psychosis
Family therapies potentially
