Schizophrenia and psychotic disorders Flashcards
Neurosis
disease of nerves
Psychosis
inability to distinguish between symptoms of delusion, hallucinations and disordered thinking from reality
Historical thoughts about psychosis
good and evil - demonic - witchcraft - TV and radio interference - FBI - aliens
Psychotic hallucinations
full force and clarity of true perception
external space and no external stimulus
not willed or controlled
5 special senses
auditory, visual, gustatory, tactile, olfactory
Delusion
unshakeable idea or belief which is out of keeping with the persons social and cultural background –> held with extraordinary conviction
Types of delusions
grandiose, paranoid, hypochondriacal, self referential
illnesses with psychotic symptoms
schizophrenia - without moo disorder
delirium
severe affective disorder - depressive or manic
What is schizophrenia?
A severe mental illness affecting thinking, emotion and behaviour
Epidemiology of schizophrenia
most common cause of psychosis
M=F
15-35
1 in 100 people
Positive symptoms of schizophrenia
hallucinations
delusions
disordered thinking
Negative symptoms of schizophrenia
apathy
lack of interest
lack of emotions
How long do the symptoms of schizophrenia need to last and in absence of what?
more than a month
organic or affective disorder
schizophrenia: ICD-10
4 criteria you need 1 of
alienation of thought - echo, insertion, withdrawal, broadcasting
passivity - limb movement
hallucinatory
persistent delusions - completely impossible
Schizophrenia ICD-10
4 criteria you need at least 2 of
persistent hallucinations
breaks or interpolations in the train of thought
catatonic behaviour eg wavy flexibility, stupor
negative symptoms eg apathy
List some types of schizophrenia listed in ICD-10
Paranoid
catatonic
simple
broad aetiology of schizophrenia
biopsychosocial
evolutionary theories
Biological factors of schizophrenia
genetics eg neuregulin, dysbindin neurochemistry eg dopamine obstetric complications maternal influenza malnutrition and famine winter birth substance misuse
Psychological theories of schizophrenia
Jungs - collective unconscious
conrad - development of delusion
Harland - migrants
psychosocial factors of schizophrenia
occupation and social class
migration
social isolation
life events
psychosis and families
schizophrenogenic mother
high EE families
delirium
brain or systemic disease affect of terror worse at night persecutory delusions visual experience
affective psychoses
depressive - guilt, worthlessness, persecution, auditory hallucinations
manic - grandeur, special powers, overactivity, irritable
Broad treatment of schizophrenia
CBT
family therapy
anti-psychotics
clozapine if treatment resistant - blood dyscriasis
Recovery
Being able to live a meaningful and satisfying life, as defined by each person in the presence or absence of symptoms
% recovery after first episode of psychosis
80
Good prognostic factors
absence of FH good premorbid function clear precipitant acute onset prompt treatment mood disturbance
Poor prognostic factors
slow, insidious onset negative symptoms CVD, smoking, resp, cancer suicide and violence starts in childhood
