Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PSYC3018 > Schizophrenia Spectrum & Other Psychotics > Flashcards

Schizophrenia Spectrum & Other Psychotics Flashcards

1
Q

What are the positive symptoms of schizophrenia?

A
  • Observable symptoms
  • Hallucination
  • Delusions
  • Formal thought disorder
  • Behavioural disturbances
    • Disorganised, catatonia, odd movements/behaviours
  • Lack of insight (97%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the negative symptoms of schizophrenia?

A

Affect

  • Social withdrawal (e.g. poor eye contact)
  • Anhedonia
  • Emotional blunting (e.g. talking in monotone)
  • Confusion

Avolition

  • Amotivational
  • Apathy
  • Self-neglect

Alogia

  • Poverty of speech
  • Poverty of content

>> Presence of negative symptoms suggest poorer response to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hallucinations in schizophrenia

A
  • Perception-like experiences that occur in absence of any external stimulus (vivid, clear, & not under voluntary control)
  • Occurs in clear sensorium (hypnogogic & hypnopompic not included)
  • Auditory
  • Visual (not illusion/misperception)
  • Olfactory
  • Gustatory
  • Tactile (e.g. insect crawling)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Auditory hallucinations

A
  • Common: 60-70% of patients
  • Hearing voices:
  • inside head or from external sources
  • own thoughts spoken out loud
  • can be comforting
  • derogatory or insulting
  • third person commentary
  • commands to perform unacceptable behaviours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Aggression in schizophrenia

A
  • Myth: schizophrenics are highly dangerous
  • Reality: not more aggressive than the general population
  • Risk factors:
  • Younger makes
  • Non-adherence with medication
  • Substance use
  • Impulsivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Delusions in Schizophrenia

A
  • False beliefs despite what others believe and despite evidence to contrary
  • Not culturally accepted
  • Categorised according to content and bizarreness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Paranoid or Persecutory delusions

A
  • Most common type
  • Fixed, false belief one is being harmed or persecuted by particular person/group
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Delusions of Reference

A
  • Neutral event interpreted to have personal meaning for individual
  • E.g. TV newsreader sending messages meant specifically for the patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Grandiose Delusions

A
  • False belief that one has special pwers, abilties, influence, achievements or another identity that typically relates to to power, wealth or fame
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Nihilistic Delusions

A
  • Belief that one, bodily part, or would does not exist or has been destroyed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Delusion of Guilt

A
  • personal responsibility for events
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Jealousy Delusions

A
  • Monosymptomatic delusions
  • False belief that romantic partner/spouse is having an affair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Erotomanic Delusions

A
  • False belief that the patient’s romantic feelings are reciprocated
  • Often by a famous other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Misidentification Delusions

A
  • Identity of someone they know has been stolen
  • E.g. imposter has replaced a loved one
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thought disorder in Schizophrenia

A
  • Disturbances in flow and/or form of speech
  • As opposed to content in delusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Negative manifestations of Thought Disorder

A
  • Reduced stream of thoughts and poverty of speech
17
Q

Positive Manifestations of Thought Disorder

A
  • Circumlocution
  • Derailment (comments slipping from one to next)
  • Tangential (irrelevant responses)
  • Echolalia (acute phase)
  • Word salad (Incomprehensible stream of words)
  • Neologisms (idiosyncratic use of words, meanings)
18
Q

Disorganised Behaviour in Schizophrenia

A

Grossly disorganised and abnormal motor behaviour: from child-like silliness to unpredictable agitation

  • Catatonic behaviour
    • Extreme negativism (resistance instructions)
    • Immobility (“waxy flexibility”)
    • Catatonic excitement: Excessive purposeless physical activity
  • Peculiar voluntary movements (posture, repetition, grimacing)
    • Mutism; Echolalia; Echopraxia; Imitating speech, movement
19
Q

Prevalence rates of Schizophrenia

A
  • Lifetime: 1-2%
  • Male to Female ratio: 3:2
20
Q

Age of Schizophrenia Onset

A
  • Late adolescence and early adulthood
  • Tends to be later for women
  • Onset typically preceded by a gradual deterioration in functioning
  • Followed by more acute symptoms
  • Onset can be sudden
  • Coincides with an often stressful time of life, further complicated by impact of schizophrenia
  • Early onset associated with poorer outcomes
21
Q

Course of Schizophrenia

A
  • Highly variable
  • >1 episodes with periods of normal (or near normal) functioning between episodes
    • 66% difficulty with at least one daily living activity
  • Most remain chronically unwell with a deteriorating course
    • 50% classified as unable to work
    • <25% engaged in employment
    • Social isolation, homelessness, low income & poor health
  • Chronic condition without full recovery
22
Q

Affect in Schizophrenia

A

Anxiety & perplexity

  • Often frightened, perplexed & confused over emerging symptoms
  • Irritability
  • 30% of patients attempt suicide
  • 5-10% complete suicide
23
Q

Course of Schizophrenia (phases)

A

Prodromal phase

  • Median length for symptoms to develop is 2 years but highly variable

Acute phase

  • Typically 1 year between onset of active symptoms & treatment
  • Response to treatment related to duration of untreated psychosis

Early recovery phase

Late recovery phase

  • reintegration
  • 80-90% relapse within 2-5 years of treatment
24
Q

Good Prognostic Factors

A
  • Good premorbid functioning
  • Acute onset
  • Later age of onset (females)
  • Precipitating event (e.g. drug-induced psychosis)
  • Low substance use
  • Brief duration of active phase
  • Absence of structural brain abnormalities
  • No family history of schizophrenia
25
Q

Bad Prognostic Factors

A
  • Poor premorbid
  • Slow insidious onset
  • Prominent negative symptoms
  • Duration of untreated psychosis
  • Slower or less complete recovery
  • Lower socioeconomic class
  • Migrant status
  • Social support network
26
Q

Medication

A
  • Primary intervention
  • 60% of clients with positive symptoms respond
  • 10-20% do not show symptom improvement in response to medication
  • Relapse rates high wit 40% relapsing within one year
27
Q

Side effects of neuroleptics

A
  • Sedation
  • Extrapyramidal side effects
    • Symptoms resembling Parkinson’s Disease
    • Tardive dyskinesia (abnormal movements, facial grimacing, lip smacking)
    • Finger tremors, shuffling gait, drooling, chewing, twisted posture
  • Side effects often treated with anti-Parkinson drug
  • Weight gain, diabetes, heart disease
  • Clozapine additional side effects
    • Blood abnormalities
    • Reduced white blood count
28
Q

Psychological interventions for Schizophrenia

A

Designed to target specific deficits or objectives

  • Social skills training for interpersonal deficits
  • Medication compliance
  • Managing delusions/hallucinations
  • Reduction of stresses
29
Q

CBT for Schizophrenia

A

Help patients to:

  • Notice early signs of relapse
  • Understand relationship between thoughts, feelings & behaviours
  • Challenge beliefs about not being able to manage one’s thoughts & behaviours
  • Learn strategies to cope with symptoms & stressors
  • Evaluate evidence supporting delusional beliefs vs. alternative beliefs
30
Q

How effective is CBT in treating Schizophrenia?

A

Better outcome overall

  • Reduce relapse, hospitalisation, positive & negative outcomes
  • Improve social functioning
  • Gains maintained at 2-year follow-up
  • Also shown to reduce numbers who go on to develop psychosis in UHR groups
31
Q

Family Therapy

A
  • Developed in response to higher relapse rates for patients from families high in Expressed Emotion (EE)
  • Provide:
    • Education about schizophrenia and its treatments
    • Realistic goal setting skills
    • Communications training (empathic not critical)
    • Problem solving skills
    • Promote social support
  • Shown to reduce relapse & enhance family support
32
Q

Psychosis subtypes

A

› Schizotypal (Personality) Disorders

› Brief Psychotic Disorder (sudden, <1mth, return to functioning)

› Schizophreniform (>1mth<6mths & individual has recovered;

bipolar & depressive disorder ruled out; provisional diagnosis)

› Schizoaffective (mood disorder criteria present)

› Substance-induced psychotic

› Psychosis due to a medical condition

› Catatonia & other unspecified (exclude neurodevelopmental or

medical condition)

› Schizophrenia

PSYC3018 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions