Week 1: What Is Psychosis? Flashcards
What are the different ways in which individuals can experience psychotic-like experiences?
1) normal psychotic experiences
2) drug-induced
3) psychotic disorders/affective psychotic disorders
4) other disorders
Give examples of normal psychotic experiences.
Bereavement, extreme stress,
Lack of sleep, hynopompic and hypnogogic states
Sensory deprivation
Give examples of some drugs that can cause psychosis.
Cannabis
Amphetamine
Ketamine
Name different types of psychotic disorders (at least 6).
1) Schizophrenia
2) Brief psychotic disorder
3) Schizophreniform
4) Catalonia
5) delusional disorder
6) schizoaffective
Describe Malaspina, et al’s. (2013) study into the DSM-5.
• inherited vulnerability to all syndromes
- no distinct etiological entities
• more dimensional approach needed
- Kraepelinian dichotomy may not be appropriate
What is the DSM-5 criteria for Schizophrenia?
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
Name types of negative symptoms.
Alogia
Avolition
Name and describe the 5 subtypes of Schizophrenia (DSM-5).
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
What is important to remember about the subtypes of Schizophrenia?
All subtypes have been removed due to poor reliability
Describe Heckers, et al’s. (2013) study into the DSM-5.
- 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
What disorders are time-limited?
Brief psychotic
Schizophreniform
What disorders are domain-limited?
Catalonia
Delusional disorder
What is the DSM-5 criteria for Bipolar?
• 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.
Name and explain the differences between the 2 subtypes of Bipolar.
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
What are the differences between mania and hypomania?
Mania:
• impairment of occupational/social functioning
• hospitalisation
• psychotic
Hypomania is the opposite to all above
Name other disorders that aren’t psychotic that can produce psychotic symptoms.
PTSD
OCD
Personality disorders
Psychotic depression
What did Kirkbride, et al’s. (2012) study find out regarding the incidence of psychosis in the U.K.?
All psychosis: 32 per 100,00
Schizophrenia: 15 per 100,000
Affective psychosis: 12 per 100,1000
What is the lifetime prevalence of psychosis?
3%
30.4 per 1000
What is the lifetime prevalence of schizophrenia?
1%
8.7 per 1000
What is the prognosis of schizophrenia and bipolar?
S: 45% recover 20% chronic 30% recurrent 75% relapse 1/3 don't respond to treatment
B:
Good recovery but high relapse
Describe Tohen, et al’s. (2003) study into recovery rates in Schizophrenia.
Syndrome recovery: 98% in 2 yrs
Symptomatic recovery: 72% in 2 yrs
What do DALYs stand for? (WHO GLOBAL BURDEN OF DISEASE)
Disability adjusted life Years
What % of MH cause DALYs?
7.4%
What did Whiteford, (2013) report the % of Schizophrenia and BP DALY’s were?
S:
7.4%
B.P:
7.0%
Describe Ustin, et al’s. (1999) study.
241 informants from 14 countries
1) quadriplegia
2) dementia
3) active psychosis
Describe Kirkbride, et al’s. (2012) study into the economic cost of psychoses.
Non-affective: £8.8 nil
Schizophrenia: £5.25 bill
Total: £12.8 bill
What are the suicide rates for Schizophrenia and B.P?
S:
Attempted: 20 - 40%
Completed: 5 - 10%
B.P:
Attempted: 25 - 50%
Completed: 10 - 15%
