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Psychiatry > Schizophrenia and psychotic disorders > Flashcards

Schizophrenia and psychotic disorders Flashcards

1
Q

What is psychosis?

A

Inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

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2
Q

What are the 5 special senses?

A 
Auditory
Visual
Tactile
Olfactory
Gustatory
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3
Q

What are some examples of delusional beliefs?

A

Grandiose
Paranoid (correctly persecutory)
Hypochondriacal
Self referential

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4
Q

Which conditions may present with psychotic symptoms?

A

Schizophrenia
Delirium
Severe affective disorders like depression or mania with psychosis

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5
Q

What is the most common cause of psychosis?

A

Schizophrenia

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6
Q

When is the mean onset of schizophrenia?

A

Males 28

Females 32

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7
Q

What are some symptoms of schizophrenia?

A 
Hallucinations
Delusions
Disordered thinking
Apathy
Lack of interest
Lack of emotions
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8
Q

How is schizophrenia diagnosed?

A

At least one of the following for more than a month and in the absence of organic or affective disorder

-Alienation of thought
-Delusions of control/influence/passivity
-Hallucinatory voices giving running commentary
-Persistent delusions
and/or at least 2 of:
-Persistent hallucinations
-Neologisms/breaks in train in thought leading to inchorence
-Catatonia
-Negative symptoms

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9
Q

How can schizophrenia be inherited genetically?

A

Affected parents increase risk
Neuregulin (chromosome 8p)
Dysbindin (chromosome 6p)
DiGeroge syndrome

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10
Q

What is the dopamine hypothesis for schizophrenia?

A

Mesolimbic hyperdopaminergia and mesocortical hypodopaminergia are risk factors

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11
Q

What are some neurotransmitters associated with schizophrenia?

A

Glutamate
GABA
Noradrenaline

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12
Q

What are some neuro signs of schizophrenia?

A 
Reduced frontal lobe performance
Eye tracking abnormalities (saccadic)
EEG abnormalities
Reduced brain volume
Ventricular enlargement
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13
Q

What are some other biological risk factors in schizophrenia?

A 
Obstetric complications
Maternal influenza
Malnutrition and famine
Winter birth
Substance misuse
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14
Q

What are the stages of developing a delusion identified by Conrad (1958)?

A

State of fear
The delusional idea appears
Effort to make sense of the experience by altering one’s view of the world
Final breakdown, as thought disorder and behavioural symptoms emerge

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15
Q

What are some social and psychosocial risk factors for schizophrenia?

A 
Occupation/class
Migration
Social isolation 
Stress
Traumatic life events
Cannabis use
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16
Q

What is the drift hypothesis?

A

Clinical features of psychotic disorders contribute to a gradual downward socioeconomic trajectory for the affected individual

17
Q

How does delirium present?

A 
May follow brain or systemic disease
Prominent visual hallucination/illusion
Affect of terror
Persecutory and evanescent delusion
Worse at night
18
Q

How may a depressive episode with psychosis present?

A

Delusions of guilt, worthlessness and persecution

Derogatory auditory hallucinations

19
Q

How may a manic episode with psychotic symptoms present?

A

Delusions of grandeur; special powers or messianic roles

Gross overactivity, irritability and behavioural disturbance i.e. Manic excitement

20
Q

What sets schizoaffective disorder apart from schizophrenia?

A

Affective symptoms as well as classic schizophrenia symptoms

21
Q

What are some factors indicative of good prognosis in schizoprhrenia?

A 
Absence of family history
Good premorbid function - stable personality, stable relationships
Clear precipitant
Acute onset
Mood disturbance
Prompt treatment
Maintenance of initiative, motivation
22
Q

What are some factors indicative of poor prognosis in schizophrenia?

A

Slow insidious onset
Prominent negative symptoms
Substance misuse
Childhood onset

23
Q

Does chronic schizophrenia have any more severe symptoms than first onset?

A

Poorer cognition

24
Q

How is schizophrenia usually treated?

A 
Atypical antipsychotics (olanzapine, quetiapine)
CBT
25
Q

Differential diagnosis of schizophrenia?

A

Drugs (Increasing dopaminergic tones in mesolimbic and mesocortical pathways)
Psychotic depression

26
Q

What is the difference between delusional perceptions and referential ideas?

A

DP: Thinking true events are related to you and purposed towards you where there is no real or justifiable link, completely incomprehensible (bike outside means I’m the king)
RI: Bit more of an understandable idea but still random (bike outside means I’m being followed)

27
Q

What is schizophrenia?

A

Fundamental and characteristic distortions of thinking and perception
Inappropriate or blunted affect

28
Q

What is the pathology of schizophrenia?

A

Neurotransmitters affected

Hyperactivity of dopaminergic transmission at D” receptor

29
Q

What are some psychological treatment options for schizophrenia?

A

Psycho-education and support for patient, family, carers
CBT
Family interventions
Art therapy

Psychiatry (18 decks)

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