Schizophrenia and Psychotic Disorders Flashcards
What is psychosis?
Represents an inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality.
Severe forms of mental illness.
How does psychosis present?
Hallucincations - have fun force and clarity of true perception. Located in external space with no external stimulus and they are not willed or controlled.
Can affect 5 special senses -auditory, visual, tactile, olfactory, gustatory.
What is a delusion?
An unshakeable idea or belief which is not out of keeping with the person’s social and cultural background, it is held with extraordinary conviction.
What are some types of delusional belief?
Grandiose
Paranoid
Hypochondriacal
Self referential
What illness are likely to have psychotic symptoms?
Schizophrenia
Delirium
Severe affective disorders e.g. depressive episode with psychotic symptoms.
What is schizophrenia?
Severe mental illness affecting thinking, emotion and behaviour.
Most common cause of psychosis. M=F
Age of onset 15-35 years.
What are the symptoms of Schizophrenia?
Positive:
Hallucinations
Delusions
Disordered thinking
Negative:
Apathy
Lack of interest
Lack of emotions
How does ICD-10 classify Schizophrenia?
For >1month in the absence of organic or affective disorder at leat 1 of the following:
Alienation of thought as thought echo, thought insertion to withdrawal or thought broadcasting.
Delusions of control, influence or passivity, clearly referred to the body or limb movement actions or sensations, delusional perception.
Hallucinatory voices giving a running commentary on the patients behaviour or discussing them between themselves, or other types of hallucinatiory voices coming from some part of body.
Persistent delusions of other kinds that are culturally inappropriate and completely impossible e.g. being able to control the weather.
And/or at least 2 of the following:
Persistent hallucinations in any modality occurring every day.
Neologisms, breaks or interpolations in the train of thought resulting in incoherent or irrelevant speech.
Catatonic behaviour such as excitement, posturing or waxy flexibility, negativism, mutism and stupor.
Negative symptoms such as marked apathy, paucity of speech and blunting or incongruity of emotional responses.
What needs to be considered in the aetiology of psychosis?
Biological factors
Psychological factors
Social factors
Evolutionary theories
What are some biological factors that may affect Schizophrenia?
Genetics Neurochemistry - dopamine hypothesis, glutamate, GABA and serotoninergic transmission. Obstetric complications Maternal influenza Winter birth Substance misuse
What are some psychological theories of psychosis?
Jung’s concept of Collective unconsciousness (memory traces from man’s ancestral past)
Conrad using Gestalt psychology to identify stages in development of delusions.
What are some social and psychosocial factors affecting schizophrenia?
Occupation Social class Migration Social isolation Life events
What is Delirium or Acute Organic Brain Syndrome?
Consequent upon brain or systemic disease.
Prominent visual experience, hallucinations and illusions.
Affect of terror.
Delusions are persecutory and evanescent.
Fluctuating worse at night.
What are the symptoms of a depressive affective psychosis?
Depressive episode with: Delusions of guilt, worthlessness and persecution.
Derogatory auditory hallucinations.
What are the symptoms of a manic affective psychosis?
Manic episode with:
Delusions of grandeur, special powers or messianic roles.
Gross overactivity, irritability and behavioural disturbance, manic excitement.
