TASK 8 - SCHIZOPHRENIA (PSYCHOSIS) Flashcards
schizophrenia
= disorganised thinking/speaking, loss of touch with reality
- positive symptoms: add something
- negative symptoms: remove something
- psychosis = when not able to tell the difference between what’s real + what isn’t
- prodromal (= before acute phase)
- residual (= after acute phase) symptoms
- -> mostly negative with milder forms of positive symptoms
positive symptoms
- delusions
= ideas that they believe are true but are highly unlikely/impossible
- preoccupied with them, attempt to convince others
- highly resistant to compelling arguments that contradict their delusions
delusions
- types
- persecutory delusions = false belief they/or loved ones are being watched/ tormented, conspired against
- delusions of reference = belief random events/comments by others are directed at them
- grandiose delusions = false belief that they are a special being or possess special powers
- delusions of being controlled = beliefs that one’s thoughts, behaviours are being imposed/controlled by an external force
- -> thought broadcasting = belief that one’s thoughts are being broadcast from one’s mind for other to hear
- -> thought insertion = belief that another person is inserting thoughts into one’s head
- -> thought withdrawal = belief that thoughts are being removed from one’s head by another person/object - delusion of guilt or sin = false belief that that one has committed a terrible act
- somatic delusion = false belief that one’s appearance is diseased
- types are the same for all cultures –>differ in content
positive symptoms
- hallucinations
= unreal perceptual experiences
- tend to be very frequent, persistent, complex, sometimes bizarre + often entwined with delusions
- not simply caused by sleep deprivation/stress/ drugs
- auditory, visual, tactile (outside), somatic (inside)
- types are the same for all cultures –> differ in content
are auditory verbal hallucinations the same in healthy + psychotic people?
can’t answer the question
x differences: negative emotional valence of content, higher frequency, lower degree of control
x later age of onset in patient group: healthy: 12 = maximal synaptic density vs. psychos: 21 = synaptic pruning
√ similarities: perceived location (inside vs. outside), number of voices, loudness, personification, attribution
positive symptoms
- disorganised thought/speech
- formal thought disorder = disorganised thinking in people with schizophrenia
- loose association/derailment = slip from one topic to another seemingly unrelated one with little coherent transition
- word salad = totally incoherent
- neologism = make up words
- clangs = make associations btw words based on their sounds rather than content
- men: more severe deficits –> possibly because language is controlled less bilaterally
positive symptoms
- disorganised/catatonic behaviour
= unpredictable + apparently untriggered agitation
- catatonia = unresponsiveness to environment
- -> negativism = lack of response to instructions
- -> mutism = complete lack of verbal/motor responses
- -> catatonic excitement = purposeless + excessive motor activity for no apparent reason
negative symptoms
- restricted affect
= severe reduction/ absence of emotional expression
- anhedonia = loss of the ability to experience pleasure
BUT seems like they experience intense emotions but can’t show them
negative symptoms
- avolition/asociality
- avolition = inability to initiate/ persist at common goal-directed activities (at work/school/home)
- asociality: only diagnosed when individual has access to a welcoming family/friends but shows no interest in socialising with them
cognitive deficits
- trouble focusing + maintaining attention and deficits in WM
- can’t distinguish relevant from irrelevant –> can’t ignore irrelevant –> contributes to symptoms (delusions/ hallucinations = try to make sense of all the thoughts)
- early marker of risk rather than a consequence –> relatives have the same problems to a lesser degree
DSM-5
A.
2 OR MORE of the following, each present for a significant portion of time during a 1-MONTH PERIOD (or less if successfully treated). At least one of these must be 1,2 or 3:
- delusions
- hallucinations
- disorganised speech
- grossly disorganised/ catatonic behaviour
- negative symptoms
DSM-5
B.
for significant portion of the time since onset, the level of functioning in the major areas is markedly below the level achieved before
- impairment
DSM-5
C.
continuous signs of disturbance persist for AT LEAST 6 MONTHS
- 6-month period must include AT LEAST 1 MONTH of symptoms meeting criterion A + may include periods of prodromal/ residual symptoms
- during these prodromal/residual periods, the signs of disturbance may be manifested by only negative symptoms or by 2 or more symptoms listed in criterion A present in attenuated form
- duration
DSM-5
D.
schizoaffective + depressive or bipolar disorder with psychotic features have been ruled out because either
(1) no major depressive/manic episode occurred concurrently with active symptoms or
(2) mood episodes that have occurred during active phase were present only for a minority of the time
- depressive exclusion
DSM-5
E.
not because of substance/ other medical condition
- medical exclusion
