Schizophrenia and Psychotic Disorders

Question 1

Describe modern use of term psychosis

Answer 1

Severe forms of mental illness

Lack of insight

represents an inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

Question 2

What is the clinical presentation of psychosis?

Answer 2

Hallucination

• full force and clarity of true perception
• located in external space
• no external stimulus
• not willed or controlled

5 special senses

• auditor or visual
• tactile
• olfactory and gustatory

Question 3

Describe delusional beliefs

Answer 3

an unshakeable idea or belief which is out of keeping with person’s social and cultural background; extraordinary conviction

Examples; grandiose, paranoid, hypochondrial, self-referential

Question 4

What illnesses can have psychotic symptoms?

Answer 4

Schizophrenia
Delirium
Severe affective disorder; depressive episode with psychotic symptoms/manic episodes with psychotic symptoms

Question 5

What does schizophrenia affect?

Answer 5

Thinking
Emotion
Behaviour

Most common cause of psychosis

• 1 per 100 population
• males and females equally
• age of onset 15-35 years

Question 6

What are positive symptoms of schizophrenia?

Answer 6

Hallucinations
Delusions
Disordered thinking

Question 7

What are negative symptoms of schizophrenia?

Answer 7

apathy
lack of interest
lack of emotions

Question 8

What are considerations in the aetiology of psychosis?

Answer 8

Biological factors
Social factors
Psychological factors
Evolutionary theories

Each of these can be possible predisposing, precipitating or perpetuating factor

Question 9

What are differentials for psychotic illness?

Answer 9

• delirium or acute organic brain syndrome

Question 10

Describe depressive episode with psychotic symptoms

Answer 10

Delusions of guilt, worthlessness and persecution

Derogatory auditory hallucinations

Question 11

Describe manic episode with psychotic symptoms

Answer 11

Delusions of grandeur, special powers or messianic roles

Gross overactivity, irritability and behavioural disturbance: manic excitement

Question 12

What are positive prognostic factors in psychotic illness?

Answer 12

• absence of FHx
• good premorbid function; stable personality and relationships
• clear precipitant
• acute onset
• mood disturbance
• prompt treatment
• maintenance of initiative, motivation

Question 13

What are first rank symptoms of schizophrenia?

Answer 13

Auditory hallucinations
Thought insertion
Thought broadcast
Thought removal 
Delusional perception