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*Psychiatry > Schizophrenia and Psychotic Disorders > Flashcards

Schizophrenia and Psychotic Disorders Flashcards

1
Q

What is psychosis?

A

Severe forms of mental illness
Lack of insight
Inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

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2
Q

What is the clinical presentation of psychosis?

A

Hallucinations - full clarity with no external stimulus
Delusional beliefs
5 senses

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3
Q

What is a delusion?

A

Unshakeable idea or belief which doesn’t match the person’s social and cultural background; it is held with EXTRAORDINARY conviction

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4
Q

Give 2 examples of delusions?

A

Paranoid (persecutory)
Grandiose
Hypochondriacal
Self referential

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5
Q

What psychiatric conditions may present with psychotic symptoms?

A

Schizophrenia
Delirium
Severe affective disorder

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6
Q

What is schizophrenia?

A

Mental illness affecting thinking, emotion and behaviour

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7
Q

How common is schizophrenia?

A

1:100
M=F
15-35y/o

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8
Q

How does schizophrenia present?

A 
Positive symptoms:
- Hallucinations
- Delusions
- Disordered thinking
Negative symptoms:
- Apathy
- Lack of interest, emotions
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9
Q

How is schizophrenia diagnosed?

A 
>1 month, in absence of organic/affective disease:
At least 1 of:
a) Alienation of thought
b) Delusions of control or passivity
c) Hallucinations 
d) Persistent delusions
and/or 2 of:
e) Persistent hallucinations
f) Neologisms
g) Catatonic behaviour
h) Negative symptoms
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10
Q

What is alienation of thought in reference to schizophrenia?

A 
Thought echo
Insertions
Withdrawal 
Blocking
Broadcasting (thoughts not in their own control)
Knight's Move
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11
Q

What is passivity in reference to schizophrenia?

A

The belief that something else is controlling ones actions/sensations

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12
Q

What are hallucinations in reference to schizophrenia?

A

Voices giving running commentary

Discussing patient

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13
Q

What are persistent delusions in reference to schizophrenia?

A

Delusions that are culturally inappropriate or completely impossible

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14
Q

What are persistent hallucinations in reference to schizophrenia?

A

Any modality

Every day for at least 1 month

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15
Q

What are neologisms in reference to schizophrenia?

A

Breaks/interpolations in train of thought leading to incoherent speech

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16
Q

What is catatonic behaviour in reference to schizophrenia?

A 
Excitement
Posturing
Waxy flexibility
Negativism
Mutism
Stupor
17
Q

What are negative symptoms in reference to schizophrenia?

A

Apathy
Paucity of speech
Blunting/incongruity of emotional responses

18
Q

What are the causes of psychosis?

A

Factors among:

  • Biological
  • Psychological
  • Social
  • Evolutionary theories

(could be predisposing, precipitating or perpetuating)

19
Q

What are the biological factors of schizophrenia?

A 
Genetics (Twin studies, neuregulin, dysbinding, Di George Syndrome)
Neurochemistry (Glutamate, Gaba)
Obstetric complications
Maternal Flu
Malnutrition
Winter birth
Substance misuse
20
Q

What are the social/psychosocial factors of schizophrenia?

A

Occupation and social class
Migration
Social isolation
Life events

21
Q

What is the differential diagnosis of schizophrenia?

A

Delirium
Acute organic brain syndrome
Affective psychoses

22
Q

How does delirium/acute organic brain syndrome psychoses differ from schizophrenia?

A 
Caused by organic disease 
Prominent visual hallucinations/illusions
Terror effect
Persecutory delusions
Worse at night - fluctuates
23
Q

How does a Depressive episode with psychosic symptoms differ from schizophrenia?

A

Delusions of guilt, worthlessness, persecution

Derogatory auditory hallucinations

24
Q

How does a Manic episode with psychosic symptoms differ from schizophrenia?

A

Delusions of grandeur, special powers
Messianic roles
Overactivity, irritability

25
Q

What therapy is indicated in treatment resistant schizophrenia with aggression/hostility?

A

Clozapine

26
Q

How is schizophrenia managed?

A

Early intervention
Assertive community treatment
Antipsychotics
Psychotherapy

27
Q

How are psychotherapies used for schizophrenia?

A

Psychosis - CBT
Cognitive remediations
Family intervention
Social skills training

28
Q

How is a Schizophrenia “recovery” diagnosed?

A

Being able to live a meaningful and satisfying life, with or without symptoms

29
Q

What is the prognosis of schizoophrenia?

A

80% after first episode

Up to 50% have moderate recovery

30
Q

What are the good prognostic factors for schizophrenia?

A 
Absense of +ve FH
Good premorbid function
Clear precipitant
Acute onset 
Mood disturbance 
Prompt treatment 
Maintenance of initiative
31
Q

What are the poor prognostic factors for schizophrenia?

A

Slow, insidious onset
Severe negative symptoms
Systemic disease
Starting in childhood

32
Q

Outline Conrad’s stages of development of delusions?

A

State of fear
Delusional idea appears
Make sense of experience by altering view of the world
Breakdown leading to disorder

*Psychiatry (18 decks)

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