Schizophrenia and Psychotic Disorders Flashcards
Psychosis definition?
An inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality
Lack of insght
Clinical presentation of psychosis?
Hallucinations
Delusional beliefs
Definition of delusion?
An unshakeable idea or belief which is out of keeping with the person’s social and cultural background
Examples of delusion?
Grandiose
Paranoid (persecutory)
Hypochondrial
Self referential
Most common cause of psychosis?
Schizophrenia
Epidemiology of schizophrenia?
1 per 100 population
M:F equal
Age of onset 15-35
Positive symptoms of schizophrenia?
Hallucinations
Delusions
Disordered thinking
Negative symptoms of schizophrenia?
Apathy
Lack of interest
Lack of emotions
For diagnosis of schizophrenia, at least one of…?
TAPP Thought disorder Auditory hallucinations Passivity phenomenon Delusional 'P'erceptions
For diagnosis of schizophrenia, and/or at least two of…?
Persistent hallucinations
Breaks or interpolations in the train of thought
Catatonic behaviour
“Negative” symptoms
Potential biological factors implicated in schizophrenia?
Obstetric complications
Maternal influenza
Winter birth
Substance misuse
Potential social and psychosocial factors implicated in schizophrenia?
Occupation and social class
Migration
Social isolation
Life events as precipitants
Differential diagnosis for schizophrenia?
Delirium or acute organic brain syndrome
Depressive episode with psychotic symptoms
Manic episode with psychotic symptoms
Schizoaffective disorder
Delirium?
Prominent visual experience, hallucination and illusions
Affect of terror
Persecutory delusions
Fluctuating, worse at night
Depressive episode with psychotic symptoms?
Delusions of guilt, worthlessness and perception
Derogatory auditory hallucinations
Manic episode with psychotic symptoms?
Delusions of grandeur, special powers or messianic roles
Gross overactivity, irritability and behavioural excitement
Management of schizophrenia?
Treat early Antipsychotic Clozapine in treatment resistance CBT Family intervention
Prognosis and recovery figures in schizophrenia?
80% after a first episode
Up to 50% have a moderate recovery
Small group with chronic symptoms and little recovery
Good prognostic factors for schizophrenia?
Prompt treatment Acute onset Absence of family history Clear precipitant Good premorbid function Mood disturbance Maintenance of initiative, motivation
Poor prognostic factors for schizophrenia?
Slow, insidious onset
Childhood onset
Prominent negative symptoms
1.6x higher mortality
9x suicide risk
Shorter life expectancy
