schizophrenia and psychotic disorders Flashcards
Psychosis
severe form of mental illness
lack of insight
represents an inability to distinguish between symptoms of delusion hallucination and disordered thinking from reality
clinical presentation
hallucinations
have the full force and clarity of true perception
no external stimulus, not willed or controlled
delusions
an unshakeable idea of belief which is out of keeping with the person’s social and cultural background held with extraordinary conviction
disorders
schizophrenia delirium severe affective disorders: depressive episode manic episode
schizophrenia
most common cause of psychosis affects 1 per 100 positive symptoms hallucinations delusions disordered thinking negative symptoms apathy lack of interest lack of emotions for more than a month in the absence of organic disorder
diagnosis
1)alienation of thought, thought echo, though insertion or withdrawal, or thought broadcasting
2)Delusions of control, influence or passivity, clearly referred to body or limb movements actions
3)hallucinatory voices giving a running commentary on the patient’s behavior, voices speaking between themselves, other type of voices coming out from part of the body
4) persistent delusions
or
5) persistent hallucinations
6)neologiss, breaks or interpolations in the train or thought, incoherent speech
7) catatonic behavior, such as excitement,
8) negative symptoms
aetiology
biological psychological social factors
biological factors
genetics digeorge syndrome dysbindin Neurochemistry dopamine hypothesis glutamate GABA Serotoninergic transmissions Obstetric complications maternal influenza malnutrition and famine substance misuse
stages of development of delusions
state of fear
delusional idea
social and psychosocial
drift hypothesis
deliriunm
prominent visual experience, hallucinations and illusions
affect of terror
persecutory and evanescent delusions
fluctuating worse at night
affective psychoses
depressive episode delusion of guilt, worhtlessness derogatory auditory halluciantions manic delusions of grandeur, special powers gross overactivity, irritability, behavioral disturbance
treatment for schizophrenia
clozapine
psychotherapy
CBT for psychosis challenge delusional belief
relapse prevention- early warning signs
prognosis
definition
being able to live a meaningful and satisfying life, as defined by each person, in the presence or absence of symptoms
good prognostic factors
absence of family history good premorbid function clear precipitant acute onset mood disturbance prompt treatment motivation
poor prognostic factors
slow insidious onset and prominent negative symptoms are associated with a worse outcome shorter life expectancy suicide risk is 9 times higher substance misuse earlier onset
