Week 7 - Psychosis and Biploar Flashcards
What are some different types of delusions?
- PERSECUTORY (E.G. Russians are trying to poison me with radioactive particles)
- RELIGIOUS
- GRANDIOSE e.g. I am the queen of the universe
- SOMATIC e.g. my insides have been overtaken by worms
- CONTROL e.g. my private thoughts are being transmitted to others
- REFERENCE e.g. that billboard is a message for me
What is the CBT theory of delusions?
• Could delusions be rational attempts to explain anomalous perceptual experiences or culturally unacceptable explanations of life events?
• Results of rapid, overconfident reasoning style:
―More likely to jump to conclusions (cognitive distortion)
• Thus, clients may benefit from learning how to evaluate competing hypotheses
(that is, cognitive distortions that may have occurred from anaomolous perceptual experiences or culturally unacceptable explanations of life events)
What are hallucinations?
Hallucinations are sensory experiences that feel real but without any stimulation of the sense
―Not illusions
Could consider them as misattributed internal mental events (e.g., verbal thoughts, inner speech)
What are different types of hallucinations?
- AUDITORY
- OLFACTORY (smell)
- GUSTATORY (strong tastes)
- VISUAL
- SOMATIC (feels like spiders crawling on us)
What are some examples of disorganised speech and behaviour in psychosis/schizophrenia?
- de-railed, tangential, illogical speech
- inappropriate or bizarre behaviour:
- socially inappropriate
- stupor (daze)
- mutism
- rigidity/posturing
- repetitive behaviour
What is the DSM-5 criteria for schizophrenia?
A.Two of the five symptoms AND at least one symptom must be one of the first three (delusions, hallucinations, disorganized speech):
1) Delusions (false beliefs held despite evidence to contrary)
2) Hallucinations (in any of 5 senses but auditory more common)
3) Disorganized speech (jump from topic to topic, new words, strange grammar)
4) Disorganized or catatonic behaviour (inapprop behaviour - agitation, talking to self, aimless wandering, child like silliness)
5) Negative symptoms (loss of motivation, anhedonia, alogia - reduced speech, affective flattening)
B. Social/Occupational Dysfunction
C. Duration: continuous signs for at least six months.
What is the prevalence, course and sex differences in Australia?
- 4 in 1000
- 55% multiple eps with good/partial recovery, 39% unremitting continuous course
- 1 in 7 attain nearly complete recovery
- roughly equal between men and women (later course in females); prognosis generally worse for men; women peak in symptom severity during menstruation
Discuss comorbidity and mortality in schizophrenia.
- highly comorbid with other mental health issues (substance abuse- particularly tobacco and cannabis use, anxiety, depression)
- reduced life expectancy (18.7 years for men, 16.3 yrs for women)
What risk factors increase the likelihood of suicide for individuals with schizophrenia?
- high IQ
- men who have had an earlier onset
- higher in single, unemployed men
- paranoia
- severe chronic illness in past 5 years
- previous suicide attempts
- depression
- insight
- substance abuse
What are some pervasive and cognitive deficits known ijn schizophrenia?
- reduced executive functioning (i.e. poorer decision making)
- less likely to recognise own thoughts as their own)
- deficits in learning, memory and attention
What are some of the social cognitive deficits seen in schizophrenia?
- poorer theory of mind
- poor emotion recognition (particularly with faces)
- attributional style (more inaccurate in attributing cause for an outcome)
SOCIAL COGNITION AND COGNITION AND PREDICTORS OF OUTCOME
What are some risk factors for psychosis?
- TRAUMA (childhood adversities increase risk of psychosis both physical and sexual; 2.5 more likely in migrants)
- SOCIAL DEFEAT (trauma, migration, discrimination, bullying, isolation, poor social support, low SES)
- BIRTH COMPLICATIONS
- PATERNAL AGE
- URBAN RISK (pollution, maternal stress)
- DRUG-USE (cannabis in particular)
What does the onset of psychosis typically look like?
- onset usually preceded by period of non-psychotic symptoms (PRODROMAL)
- usually begins early adulthood, late adolescence
- episodic in nature and triggered by stressor “stress-vulnerability” hypothesis
- the longer psychosis goes unnoticed and untreated, the more severe repercussions for relapse and recovery
What is the DSM-5 criteria for a manic episode?
A: Distinct period of elevated, expansive or irritable mood + increased goal directed activity for at least 1 week (most of the day, nearly everyday)
B: 3 + symptoms (4 if irritable mood only) [noticeable change]
• Inflated self esteem or grandiosity
• Decreased need for sleep
• More talkative than usual or pressure to keep talking
• Flight of ideas ‘racing thoughts’
• Distractibility
• Increase in goal directed activity or psychomotor agitation
• Excessive involvement in activities with a high potential for painful
consequences (buying sprees, sexual
indiscretions or foolish investments)
C: CAUSES MARKED IMPAIRMENT
D: Not due to a substance or medial condition
What is the DSM-5 criteria for a hypomanic episode?
A: Distinct period of elevated, expansive or irritable mood + increased goal directed activity for at least 4 days (most of the day, nearly everyday)
B: 3 + symptoms (4 if irritable mood only) [noticeable change]
• Inflated self esteem or grandiosity
• Decreased need for sleep
• More talkative than usual or pressure to keep talking
• Flight of ideas ‘racing thoughts’
• Distractibility
• Increase in goal directed activity or psychomotor agitation
• Excessive involvement in activities with a high potential for painful
consequences (buying sprees, sexual indiscretions or foolish investments)
C & D: Uncharacteristic and observable
E: DOESN’T CAUSE MARKED IMPAIRMENT
F: Not due to a substance or medial condition
