What is the definition of psychosis?
“Psychosis represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality.” = lacking insight
“Psychosis represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality.”
What are hallucinations?
Hallucinations
- Have the full force and clarity of true perception
- located in external space
- no external stimulus
- not willed or controlled
5 special senses
- auditory or visual
- tactile
- olfactory and gustatory
“Psychosis represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality.”
What are delusions?
“ a delusion is an unshakeable idea or belief which is out of keeping with the person’s social and cultural background; it is held with extraordinary conviction.”
Examples
- grandiose
- paranoid (correctly persecutory)
- hypochondriacal
- self referential
May be more helpful not to consider psychosis as a major classification but consider the illnesses that may have psychotic symptoms
Give some examples
- Schizophrenia
- Delirium
- Severe affective disorder
- Depressive episode with psychotic symptoms
- Manic episode with psychotic symptoms
What does schizophrenia affect?
A severe mental illness affecting
- Thinking
- Emotion
- Behaviour
Most common cause of psychosis
- Affects 1 per 100 population
- Males and females equally
- Age of onset 15-35 years
Psychosis represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality.
Schizophrenia is the most common cause of psychosis.
What are the positive symptoms?
- Hallucinations
- Delusions
- Disordered thinking
Psychosis represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality.
Schizophrenia is the most common cause of psychosis.
What are the positive symptoms?
- Hallucinations
- Delusions
- Disordered thinking
Psychosis represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality.
Schizophrenia is the most common cause of psychosis.
What are the negative symptoms?
- Apathy
- Lack of interest
- Lack of emotions
Psychosis represents an inability to distinguish between symptoms of hallucination, delusion and disordered thinking from reality.
Schizophrenia is the most common cause of psychosis.
What are the negative symptoms?
- Apathy
- Lack of interest
- Lack of emotions
According to the ICD-10, what are the criteria to diagnose schizophrenia?
For more then a month in absence of organic or affective disorder:
At least one of the following:
a) Alienation of thought as thought echo, thought insertion or withdrawal, or thought to broadcast.
b) Delusions of control, influence or passivity, clearly referred to body or limb movements
actions, or sensations; delusional perception.
c) Hallucinatory voices giving a running commentary on the patient’s behaviour, or discussing him between themselves, or other types of hallucinatory voices coming from some part of the body.
d) Persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. beingable to control the weather).
And OR at least two of the following:
e) Persistent hallucinations in any modality, when occurring every day for at least one month.
f) Neologisms, breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech.
g) Catatonic behaviour, such as excitement, posturing or waxy flexibility, negativism, mutism and stupor.
h) “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses.
According to the ICD-10, what are the criteria to diagnose schizophrenia?
For more then a month in absence of organic or affective disorder:
At least one of the following:
a) Alienation of thought as thought echo, thought insertion or withdrawal, or thought to broadcast.
b) Delusions of control, influence or passivity, clearly referred to body or limb movements
actions, or sensations; delusional perception.
c) Hallucinatory voices giving a running commentary on the patient’s behaviour, or discussing him between themselves, or other types of hallucinatory voices coming from some part of the body.
d) Persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. beingable to control the weather).
And OR at least two of the following:
e) Persistent hallucinations in any modality, when occurring every day for at least one month.
f) Neologisms, breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech.
g) Catatonic behaviour, such as excitement, posturing or waxy flexibility, negativism, mutism and stupor.
h) “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses.
According to the ICD-10, what are the criteria to diagnose schizophrenia?
For more then a month in absence of organic or affective disorder:
At least one of the following:
a) Alienation of thought as thought echo, thought insertion or withdrawal, or thought to broadcast.
b) Delusions of control, influence or passivity, clearly referred to body or limb movements
actions, or sensations; delusional perception.
c) Hallucinatory voices giving a running commentary on the patient’s behaviour, or discussing him between themselves, or other types of hallucinatory voices coming from some part of the body.
d) Persistent delusions of other kinds that are culturally inappropriate and completely impossible (e.g. beingable to control the weather).
And OR at least two of the following:
e) Persistent hallucinations in any modality, when occurring every day for at least one month.
f) Neologisms, breaks or interpolations in the train of thought, resulting in incoherence or irrelevant speech.
g) Catatonic behaviour, such as excitement, posturing or waxy flexibility, negativism, mutism and stupor.
h) “Negative” symptoms such as marked apathy, paucity of speech, and blunting or incongruity of emotional responses.
What are the genetics of schizophrenia?
- Cf Acknowledged heritability from twin/family studies
- Neuregulin
- Dysbindin
- Di George Syndrome
What is the neurochemistry of schizophrenia?
- “Dopamine hypothesis”
- Glutamate
- GABA
- Serotoninergic transmission
What are some biological factors associated with Schizophrenia?
- Obstetric complications
- Maternal influenza
- Malnutrition and famine
- Winter birth
- Substance misuse
What would be the symptoms of Depressive episode with psychotic symptoms?
- Delusions of guilt, worthlessness and persecution
- Derogatory auditory hallucinations
What would be the symptoms of Manic episode with psychotic symptoms?
- Delusions of grandeur; special powers or messianic roles
- Gross overactivity, irritability and behavioural disturbance: Manic excitement
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History, MSE and Diagnosis31
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Affective Disorders49
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Psychological Approaches to Mental Health Problems17
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Legal Aspects of Psychiatry12
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Antidepressants54
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Mood Stabilizers36
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Antipsychotics29
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Anxiolytics6
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Alochol26
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Science of Addiction12
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Drug misuse16
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Case: Depression12
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Case: Mania and Bipolar7
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Schizophrenia17
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Personality Disorder15
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Anxiety Disorders19
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Child Psychiatry7
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Old Age Psychiatry16
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Eating Disorders17
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Psychiatric History6
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MSE5
