WEEK 4 Flashcards
1
Q
PSYCHOSIS
A
- Refers to symptoms in which there is a misinterpretation and misapprehension of the nature of reality
- For example disturbances in perception (hallucinations) disturbances of belief and interpretation of the environment (delusions) and disorganised speech patterns (thought disorder)
- The person experiences impairment across a range of essential areas of functioning: cognitive, emotional, social and communicative responses and interpretation of reality
2
Q
PSYCHOTIC DISORDERS
A
- Psychosis is a feature of a number of disorders, to a greater or lesser extent: schizophrenia, bipolar disorder, depression, delirium and dementia
- People subjected to trauma, severe stress, sleep deprivation and other adversities can also experience brief psychotic episodes.
- Psychosis may also be drug induced
3
Q
PSYCHOSIS: PREVALENCE AND CAUSE
A
- Usually emerge during adolescence and early adulthood
- In any given 12 month period, 1 in 200 Australians will experience a psychotic illness
- Some people experience brief forms of psychosis, some experience a few episodes and some experience psychosis associated with a longer-term illness (e.g. schizophrenia)
4
Q
CHARACTERISTICS OF PSYCHOTIC DISORDERS
A
- Symptoms of psychotic disorders can be categorised into positive or negative symptoms
- Positive→ Delusions, hallucinations, disorganised thinking, grossly disorganised motor behaviour
- Negative→ Diminished emotional expression- affective flattening/blunting, avolition, alogia (poverty of speech) and andhoneia
5
Q
SYMPTOMS OF PSYCHOSIS
A
- Hallucinations→ False sensory perception that occurs in absence of external or objective stimuli (occurs in any othe 5 senses→ auditory, gustatory, olfactory, somatic, tactile, visual)
- Delusion→ False belief firmly held despite objective evidence to the contrary, and despite others from the same culture not sharing the belief (bizzare, jealous, grandiose, erotomania, thought insertion)
- Thought disorder→ Thought processes become disordered, continuity of thoughts and info processing is disrupted, results in illogical and confused thinking and speech
- Disorganised behaviour (bizarre or unusual) - appearance (deterioration), repetitive behaviour, apraxia, echopraxia, agitation/aggression
- Secondary features may also occur (changed feelings/emotions) - feel strange, cut off from the world, mood swings, dampened emotions)
- Sleep disturbances
- Social withdrawal
- Anxiety and/or Depression
- Impairments in role functioning
6
Q
CONTRIBUTORS TO PSYCHOSIS
A
- Likely caused by factors creating vulnerability to experiencing symptoms→ genetic, environmental and biological factors
- Aetiology→ resulting from the impact of stress and other risk factors upon a biological predisposition (‘stress vulnerability’ interaction)
- The risk factors that predispose someone to mental illness can be mitigated by protective factors
7
Q
FIRST EPISODE PSYCHOSIS
Stages/phases of psychotic episodes
A
- Phase 1→ Prodrome
- Phase 2→ Acute
- Phase 3→ Recovery
- Continuing care
8
Q
PRE- PSYCHOTIC OR PRODROMAL PHASE (SOMETHING ISN’T RIGHT)
A
- Occurs in the months prior to the active/acute phase, and is a fluctuating and fluid process, symptoms gradually appearing and changing over time
- Changes in affect such as anxiety, irritability or depression
- Changes in cognition such as difficulties with concentration or memory
- Changes in thought content- preoccupation with new ideas often of an unusual nature
- Social withdrawal and avoidance of social interaction
- A general loss of interest and a depressed mood
- Avoidance of work or studies
9
Q
ACUTE PHASE
A
- This is the phase when psychotic symptoms develop (Hallucinations, delusions, thought disorders)
- Disorganised thinking
Speech may be disjointed - Disorganised or odd behaviours
- Strong affect- distress, anxiety, depression, fear
Sleep disturbance and other physical symptoms - Loss of motivation and withdrawal- the ‘negative’ symptoms
10
Q
RECOVERY PHASE
A
- In the recovery phase, treatment begins and active phase symptoms diminish
- Majority of people make a complete recovery
- May be some impairment in role functioning
- “Negative” symptoms may be ongoing- amotivation, blunted affect
- Each relapse represents potential risk for developing more enduring mental health problems
11
Q
CONTINUING CARE
A
- Gradual recovery is the norm
- Approximately 85% of people with a first episode of psychosis will achieve remission of positive symptoms within 12 months → 25% of young people will never experience another psychotic episode
- Mental disorder and treatment is stigmatised, important that the first episode of care is managed carefully to minimise trauma
- Trauma related to mental health care affects future engagement with mental health services and continuity of care
12
Q
HEARING VOICES- A FEW FACTS
A
- 70-90% of people who do hear voices do so following traumatic events
- Voices can be male, female, without gender, child, adult, human or non-human
- People may hear one voice or many. Some people report hearing hundreds of voices, although in almost all reported cases, one dominates above the others
- Brain imaging has confirmed that voice hearers do experience a sound as if a real person was talking to them
- Voice hearing is often seen as a prime symptom of psychosis, however many people who do hear voices find them helpful or benevolent
13
Q
POSSIBLE QUESTIONS TO ASSESS FOR PSYCHOTIC SYMPTOMS
A
- Have you had any trouble with your thought processes lately (Do they seem speeded up or confused) → Checking for thought disorder
- Have you been concerned about any unusual events recently, or thought that there were strange things were happening around you, or to you? → Checking for delusions
- Have you been feeling as if something bad is happening to you, or that people have turned against you in some way? → Checking for delusions
- Have you experienced any strange or unpleasant experiences involving your senses, for example hearing things or seeing things that others could not? → Checking for hallucinations
14
Q
WHAT IS SCHIZOPHRENIA
A
- Complex disorder of brain function with wide variation in symptoms and signs, and a highly variable course of illness
- Characterised by distortions in thinking, perception, expression of emotions and relationships with others
- ‘Disturbance involving the most basic functions that give the normal person a feeling of individuality, uniqueness and self-direction’
- Some recover, however for many it is a prolonged illness which can involve years of distressing symptoms
15
Q
SCHIZOPHRENIA CRITERIA: A
A
- Include at least 2 of the following (and at least one must be from the first three symptoms) present for a significant portion of time during a 1-month period
- Delusions
- Hallucinations
- Disorganised speech
- Grossly disorganised or catatonic behaviour
- Negative symptoms
