Week 1: What Is Psychosis?

Question 1

What are the different ways in which individuals can experience psychotic-like experiences?

Answer 1

1) normal psychotic experiences
2) drug-induced
3) psychotic disorders/affective psychotic disorders
4) other disorders

Question 2

Give examples of normal psychotic experiences.

Answer 2

Bereavement, extreme stress,
Lack of sleep, hynopompic and hypnogogic states
Sensory deprivation

Question 3

Give examples of some drugs that can cause psychosis.

Answer 3

Cannabis
Amphetamine
Ketamine

Question 4

Name different types of psychotic disorders (at least 6).

Answer 4

1) Schizophrenia
2) Brief psychotic disorder
3) Schizophreniform
4) Catalonia
5) delusional disorder
6) schizoaffective

Question 5

Describe Malaspina, et al’s. (2013) study into the DSM-5.

Answer 5

• inherited vulnerability to all syndromes
- no distinct etiological entities

• more dimensional approach needed
- Kraepelinian dichotomy may not be appropriate

Question 6

What is the DSM-5 criteria for Schizophrenia?

Answer 6

1a) 3 top symptoms must be had: (duration of 6+ months):

1) delusions
2) hallucinations
3) disorganised speech
4) catatonic behaviour
5) negative symptoms

(For schizophreniform: 2 or more symptoms, for the majority of 1 month)

1b) social/occupational dysfunction:

1c) duration:
• 6+ months of disturbance
- 1 month of primary symptoms

1d) exclusions:
• schizoaffective, MD
• medical condition/drug use
• PDD

Question 7

Name types of negative symptoms.

Answer 7

Alogia

Avolition

Question 8

Name and describe the 5 subtypes of Schizophrenia (DSM-5).

Answer 8

1) disorganised
- thought disorder
2) paranoid
- delusions/hallucinations
3) residual
- + symptoms, low intensity
4) undifferentiated
- symptoms don’t meet diagnostic criteria
5) catatonic
- marked absences

Question 9

What is important to remember about the subtypes of Schizophrenia?

Answer 9

All subtypes have been removed due to poor reliability

Question 10

Describe Heckers, et al’s. (2013) study into the DSM-5.

Answer 10

• greater focus on catatonia and abnormal motor behaviour
• best diagnosis should include all clinical features at the time of the interview
• current diagnosis don’t capture the variability of the spectrum

Question 11

What disorders are time-limited?

Answer 11

Brief psychotic

Schizophreniform

Question 12

What disorders are domain-limited?

Answer 12

Catalonia

Delusional disorder

Question 13

What is the DSM-5 criteria for Bipolar?

Answer 13

• need 2 or more episodes where mood/activity levels are significantly disturbed
• abnormally high or irrational mood lasting 1 week
• 3 or more of:
- lack of sleep, high self-esteem, talkative, distractibility etc.

Question 14

Name and explain the differences between the 2 subtypes of Bipolar.

Answer 14

1) Bipolar-1
• 1 or more manic/mixed episodes

2) Bipolar-2
• 1 or more MDD episodes with at least 1 hypomanic episode
• not psychotic

Question 15

What are the differences between mania and hypomania?

Answer 15

Mania:
• impairment of occupational/social functioning
• hospitalisation
• psychotic

Hypomania is the opposite to all above

Question 16

Name other disorders that aren’t psychotic that can produce psychotic symptoms.

Answer 16

PTSD
OCD
Personality disorders
Psychotic depression

Question 17

What did Kirkbride, et al’s. (2012) study find out regarding the incidence of psychosis in the U.K.?

Answer 17

All psychosis: 32 per 100,00

Schizophrenia: 15 per 100,000

Affective psychosis: 12 per 100,1000

Question 18

What is the lifetime prevalence of psychosis?

Answer 18

3%

30.4 per 1000

Question 19

What is the lifetime prevalence of schizophrenia?

Answer 19

1%

8.7 per 1000

Question 20

What is the prognosis of schizophrenia and bipolar?

Answer 20

S:
45% recover
20% chronic 
30% recurrent 
75% relapse 
1/3 don't respond to treatment 

B:
Good recovery but high relapse

Question 21

Describe Tohen, et al’s. (2003) study into recovery rates in Schizophrenia.

Answer 21

Syndrome recovery: 98% in 2 yrs

Symptomatic recovery: 72% in 2 yrs

Question 22

What do DALYs stand for? (WHO GLOBAL BURDEN OF DISEASE)

Answer 22

Disability adjusted life Years

Question 23

What % of MH cause DALYs?

Answer 23

7.4%

Question 24

What did Whiteford, (2013) report the % of Schizophrenia and BP DALY’s were?

Answer 24

S:
7.4%

B.P:
7.0%

Question 25

Describe Ustin, et al’s. (1999) study.

Answer 25

241 informants from 14 countries

1) quadriplegia
2) dementia
3) active psychosis

Question 26

Describe Kirkbride, et al’s. (2012) study into the economic cost of psychoses.

Answer 26

Non-affective: £8.8 nil
Schizophrenia: £5.25 bill
Total: £12.8 bill

Question 27

What are the suicide rates for Schizophrenia and B.P?

Answer 27

S:
Attempted: 20 - 40%
Completed: 5 - 10%

B.P:
Attempted: 25 - 50%
Completed: 10 - 15%