WEEK 11

Question 1

Psychosis

Answer 1

Psychosis is a state defined by a loss of contact with reality

Question 2

Psychosis: Hallucinations

Answer 2

sensory experiences in the absence of external events

Question 3

Psychosis: Delusions

Answer 3

: irrational/false

belief, confused thinking, changed feelings, changed behaviour

Question 4

Brief Psychotic Disorder

Answer 4

episode lasts for at least 1 day but less than 1 mth

Question 5

Schizophreniform Disorder

Answer 5

episode lasts for at least 1 but < 6 mths

Question 6

Delusional Disorder

Answer 6

the presence of 1 (or more) delusions with a duration of 1 mth or longer
–> folie a deux

Question 7

Schizoaffective Disorder

Answer 7

a major mood episode with concurrent schizophrenia

Question 8

Schizophrenia- prevalence

Answer 8

• approx. 1% population lifetime risk
• present in all countries and cultures
• peak age: late teens, early adulthood
• female: male: 1: 1 (males earlier onset- poorer outcomes)
• personal and financial costs
• life expectancy- less than average (suicide, health behaviours)

Question 9

Early Figures

Answer 9

 Emil Kraepelin (1856-1926)
- distinguished the disorder
from other conditions
- dementia praecox

 Eugen Bleuler (1857-1939)
- introduced the term
schizophrenia
- associative splitting:
‘splitting of the mind’

Question 10

Heterogeneous

Answer 10

a group of separate
disorders that share
common features

the symptoms,
triggers & course of
schizophrenia vary
greatly

Question 11

Positive Symptoms

Answer 11

“pathological
excesses”; bizarre
additions to a person’s behaviour

–> DELUSIONS: faulty
interpretations of
reality; disorders of
thought content

–> HALLUCINATIONS: an experience of a sensory event without any input from the surrounding environment
(can involve any of the senses- most common is auditory) (broca area is activated with hallucinations)

Question 12

Types of delusions

Answer 12

persecution - other people are out to get or
harm you
- being controlled by others
- reference - belief or perception that irrelevant,
unrelated or innocuous phenomena in the world
refer to you directly or have special personal
significance
- grandeur - belief that you are famous or
important
- Capgras syndrome: a familiar person has been
replaced by a double
- Cotard’s syndrome: belief that part of the body
has changed in some impossible way; e.g., you
are dead

motivational view (coping)
or
deficit view (brain dysfunction)

Question 13

Negative Symptoms

Answer 13

“pathological deficits”;

characteristics that are lacking in an individual

Question 14

Negative Symptoms

Avolition

Answer 14

apathy; drained of energy

Question 15

Negative Symptoms

Alogia

Answer 15

poverty of speech

Question 16

Negative Symptoms

Anhedonia

Answer 16

general lack of pleasure

Question 17

Negative Symptoms

Affective flattening

Answer 17

lack of typical emotional responses

Question 18

Negative Symptoms

Social Withdrawal

Answer 18

Social Withdrawal

Question 19

Disorganised Symptoms

Answer 19

disordered thinking & speech (‘formal thought disorder’) e.g., flow & form

• Neologisms: new nonsense words
• perseverations: repetition of key words
• clanging: nonsensical rhyming
• catatonia: wild agitations, immobility

Question 20

Course of Schizophrenia

Answer 20

Premorbid
- risk factors & early indications

Prodromal
- beginning of deterioration; less severe but
unusual behaviours

Onset
- positive, negative & disorganized symptoms

Chronic
- active periods: symptoms are severe
- recovery periods: a return to premorbid or
prodromal levels

Question 21

Diagnosing Schizophrenia

Answer 21

• DSM-5 : diagnosis after overall signs continue for 6 months or more
• During 6 mth period, 2 or more of the following for at least 1 continuous mth.
• -> delusions
• -> hallucinations
• -> disorganised speech
• -> grossly disorganised or catatonic behaviour
• -> negative symptoms

Question 22

Causes

Biological Views

Answer 22

Genetic factors:
- family studies: risk increases with genetic relatedness, parents severity increases likelihood for children, general predisposition (risk for a spectrum of psychotic disorders related to schizophrenia)
- Genes: multiple gene variances combine to produce vulnerability
- diathesis stress relationship: people with a biological predisposition will
develop schizophrenia only if certain kinds of
stressors or events are also present

Question 23

Causes

Neurobiological Views

Answer 23

Neurotransmitters:
- dopamine: while some sites might be overactive others
appear to be less active
- Glutomate also involved

Brain structure:

• dysfunction in frontal lobes
• enlarged ventricles

Viral Problems:
- Brain abnormalities can result from exposure to viruses before birth

Chronic and early use of marijuana

Question 24

Causes

Psychological and Social Views

Answer 24

Stress

• vulnerability
• increase relapse risk

Family
- Expressed emotion (EE): criticism, hostility, emotional
over involvement, relapse

Question 25

Treatment

Biological Interventions

Answer 25

Antipsychotic medications (neuroleptics)

• decrease positive symptoms
• side effects: common and can be permanent
• extrapyramidal symptoms

New antipsychotic drugs (2nd generation)

• more effective that conventional drugs especially for negative symptoms
• few extrapyramidal side effects
• carry a risk of a fatal drop in white blood cells, grogginess, blurred vision, dry mouth

Question 26

Treatment

Psychosocial Interventions

Answer 26

Prodromal and recovery phases:
- early detection and treatment of at- risk individuals

Address social and personal difficulties

• problem solving, coping skills training etc.
• family therapy: communication issues, create better understanding about disorder

Community care:
- short term hospitalisation
- coordinated services: facilities
provide medications, psychotherapy & inpatient emergency care
- Proper care: assists in recovery 

Consumer recovery model

• hope, personal responsibility, respect from community
• new meaning and purpose of life beyond disorder