Schizophrenia & Psychotic Disorders

Question 1

How is psychosis defined?

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

How does psychosis present?

Answer 2

Hallucinations:
- Have the full force and clarity of true perception
- located in external space
- no external stimulus
- not willed or controlled

5 special senses (auditory or visual. tactile, olfactory and gustatory)

Question 3

What are delusional beliefs and what are some examples?

Answer 3

“ a delusion is an unshakeable idea or belief which is out of keeping with the person’s social and cultural background; it is held with extraordinary conviction.”

Examples:
grandiose
paranoid (correctly persecutory)
hypochondriacal
Self referential-all things are related to you, placement of object, people laughing associated with you

Question 4

What illnesses display psychotic symptoms?

Answer 4

Schizophrenia
Delirium
Severe affective disorder
- Depressive episode with psychotic symptoms
- Manic episode with psychotic symptoms

Question 5

What is the most common cause of psychosis?

Answer 5

Schizophrenia
(Affects males & females equally)

Question 6

What are the positive symptoms of schizophrenia?

Answer 6

• Hallucinations
• Delusions
• Disordered thinking

Question 7

What are the negative symptoms of schizophrenia

Answer 7

• Apathy
• Lack of interest
• Lack of emotions

Having more negative symptoms means your prognosis is poorer

Question 8

How is schizophrenia diagnosed?

Answer 8

> 1 month in the absence of organic or affective disorder:

At least one of the following:

a) Alienation of thought thoughts echo, thought insertion or withdrawal, or thought broadcasting.

b) Delusions of control, influence or passivity, clearly referred to body or limb movements actions, or sensations; delusional perception.

c) Hallucinatory voices giving a running commentary on the patient’s behaviour, or discussing him between themselves, or other types of hallucinatory voices coming from some part of the body.

d) Persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. being able to control the weather).

Question 9

What is an example of thought insertion?

Answer 9

Alien thought-aware its not coming from within

Question 10

What is delusions of control?

Answer 10

Believe under influence of others control or an objects control

Question 11

What is passivity?

Answer 11

Limbs and body are moving and you are not responsible for it

Question 12

What is a delusional perception (almost exclusively seen in schizophrenia)?

Answer 12

Delusion of a real perception

Question 13

Is there a genetic component in schizophrenia?

Answer 13

50% concordance in MZ twins

Roughly 10% risk if one parent affected; 40% if two parents; 10% on sibling; 110% for DZ twins).

Question 14

How does a depressive episode with psychotic symptoms present?

Answer 14

• Delusions of guilt, worthlessness & persecution
• Derogatory auditory hallucinations

Question 15

How does a manic episode with psychotic symptoms present?

Answer 15

Delusions of grandeur; special powers or messianic roles

Gross overactivity, irritability and behavioural disturbance: Manic excitement