Define psychosis
a form of severe mental disturbance where the individual loses touch with reality
Schneider 1st Rank symptoms
ABCD:
- Auditory hallucinations
- Broadcasting of thoughts
- Controlled thoughts (delusions of control)
- Delusional perception
Positive/hard symptoms
- Hallucinations
- Delusions
- Bizarre behaviour
- Flight of ideas
Negative/soft symptoms
- Lack of facial expression (flat effect)
- Lack of pleasure (anhedonia)
- Lack of drive & energy (apathy)
- Lack of interest (avolitional)
- Lack of speech (alogia)
Types of delusional disorder
- Erotomania (stalkers)– believe that ppl are in love with them
- Paranoia
- Persecutory – usually comes from govt. or ppl with power
- Grandiose – believe that they are powerful
- Somatic – believe that they have alot of medical problems
- Morbid jealousy
Desc of schizoaffective disorder
- Major depressive episode + type A symptoms
- Delusions or hallucinations occur for at least 2 weeks
- The disturbance is NOT due to the direct physiologic effects of a substance eg. illicit drugs
Factors of schrizophrenia
1) Genetic
Eg. Unrelated: 0.86% chance
Children of 2 affected parents: 46.3%
2) Environmental
- Maternal viral infection / malnutrition
- Obstetric issues (using recreational drugs)
- Substance use especially cannabis
- Poverty
3) Brain structure & chemistry
- Associated with some imbalance of certain chemical sy
What can very high dose of Amphetamine cause?
- paranoia
- delusions
- auditory hallucinations
What block D2 receptors & alleviate positive/hard symptoms?
Phenothiazines (incl. chlorpromazine) & all other typical neuroleptics
Examples of 1st gen antipsychotics
Thorazine, Fluanxol & Haloperidol
Functions of 1st gen antipsychotics
- Effectively control +ve symptoms
- Primarily block dopamine receptors
Side effects of 1st gen antipsychotics
- Dry mouth
- Blurred vision
- Constipation
- Rigidity
- Tremors
- Restlessness
- Drowsiness
- Dizziness
Usually disappear a few weeks after patient starts treatment
Late-appearing side effect of 1st gen antipsychotics
Tardive dyskinesia
Examples of 2nd gen antipsychotics
- Abilify (aripiprazole)
- Risperdal (risperidone)
- Zyprexa (olanzapine)
- Seroquel (quetiapine)
- Clozaril (clozapine)
Functions of 2nd gen antipsychotics
- 1st line treatment
- excellent at reducing -ve symptoms
Side effects of 2nd gen antipsychotics
- weight gain
- drowsiness
Electroconvulsive Therapy (ECT) desciption
- Usually for treatment resistant
- Effective for acute schizophrenia, mania & depression
- Safe
- Administered under a light general anesthesia
Desired outcomes of treatment of schrizophrenia
- ↓ frequency of hallucinations & delusions
- Ability to recognise hallucinations or delusional thoughts
- More logical & reality-based thought processes
- Improved ability to concentrate
- Improved ability to interact with others
- Appropriate mood
Overall aim in managing schizophrenic patients
SAFETY in ALL settings (home; hospital/ community)
___ in every 100 people suffer from schizophrenia
1
____ out of 4 cases begins between ages ___ and ___ years.
3;
ages 17-25
Only 1 criterion A symptom is required for the diagnostic criteria if:
- Delusions are bizarre
- Hallucinations consist of a voice keeping up a running commentary on the person’s behaviour or
thoughts - 2 or more voices conversing with each other.
Difference btw +ve and -ve symptoms
- positive symptoms are often episodic, with rapid onset and remission
- while negative symptoms typically are stable and enduring phenomena
Explain the theory of dopamine hypothesis
Argues that the unusual behaviour and experiences associated with schizophrenia (sometimes extended to psychosis in general) can be fully or largely explained by changes in dopamine function in the brain.
