Schizophrenia & Psychosis# Flashcards
Define Psychosis
An inability to distinguish symptoms of delusion, hallucination or disordered thinking from reality
Define a delusion?
An unshakeable belief which is outside of their social & cultural background and held with extraordinary conviction
Come in many types e.g. grandiose, paranoid, hyperchondiacal etc
What leads to psychosis?
Biological factors e.g. Genetics, neurochemistry & complications as a foetus/birthing
Psychological factors e.g. Stress & fear
Social problems e.g. migration, isolation, major events or substance misuse
Who gets Schizophrenia?
Onsets mostly 15-35 yrs and affects both genders equally
Hits a surprisingly high 1 in 100 people
What’s the difference between +ve and -ve symptoms of schizophrenia?
+ve add something to the patient’s mind e.g. a hallucination, delusion or disordered thinking
-ve take something away e.g. apathy, anhedonia or lack of/incongruity of emotional affects & reactions
Before diagnosing schizophrenia, what other psychotic illnesses should be ruled out first?
Transient psychosis - often caused by substance abuse
Affective psychoses (Depressive or Manic Episode with Psychotic Symptoms)
Delirium
Other physical problem e.g. brain tumour
A psychotic patient is suffering from prominent visual hallucinations, is oft terrified, has persecutory and fleeting delusions all of which worsens at night. Is this schizophrenia?
Not likely, it sounds like a patient suffering from delirium.
The fear affect, evanescent delusions and worsening at night is all indicative
What pattern would the symptoms follow in a depressive psychosis?
Delusions are likely to be very -ve e.g. of guilt, worthlessness or persecution
Hallucinations are often derogatory voices
LOW MOOD
How would a manic psychoses present?
Delusions of grandeur, special powers or a messianic role
ELEVATED MOOD
How do we manage schizophrenia?
Early Intervention Services
Antipsychotics
Psychological Interventions
Perinatal Care
What are Early Intervention Services
Early services provided by a clinician in partnership with other professions e.g. social work to address social issues surrounding the patient including:;
- Housing
- Problems at work or with benefits
- Social skills training
- Substance abuse
- Support for families/carers
What psychological interventions are common in schizophrenia?
CBTp
Family therapy
Cognitive Remediation
Social skills training
What do we mean by perinatal care with schizophrenic patients?
A lot of anti-psychotics are teratogenic so you must counsel on this and help them if they wish to become pregnant
Also there is a high risk of relapse in the post-partum which patient’s must be counselled on and prepared for
What are some good prognostic factors?
Absence of FH Acute onset No -ve symptoms Female Late Onset Supportive Home & good Premorbid function A clear Precipitant
What are some bad prognostic factors?
Insidious onset
Starts in childhood
-ve symptoms
