3MB Psychiatry: Psychosis
Overall Description: This flashcard set defines schizophrenia as a group of brain disorders affecting thought, behaviour, perception, and emotion. It highlights the absence of a single pathognomonic symptom, confirms its strong genetic component, and distinguishes between positive symptoms (e.g., delusions, hallucinations) and negative symptoms (e.g., apathy, social withdrawal).
What is schizophrenia and how is it characterised?
Group of brain disorders characterised by disorders of thought, behaviour, perception and emotion
Key Terms
What is schizophrenia and how is it characterised?
Group of brain disorders characterised by disorders of thought, behaviour, perception and emotion
What is the one pathognomonic symptom of schizophrenia?
There isn’t one!
Having more than one symptom increases the risk
There is a strong genetic link to schizophrenia. True/False?
True
List 3 “positive” symptoms of schizophrenia
Delusions
Hallucinations
Thought disorder
List 4 “negative” symptoms of schizophrenia
Apathy
Lack of volition
Social withdrawal
Cognitive impairment
Positive symptoms are harder to treat than negative symptoms in schizophrenia. True/False?
False
Positive symptoms are often easier to treat
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| Term | Definition |
|---|---|
What is schizophrenia and how is it characterised? | Group of brain disorders characterised by disorders of thought, behaviour, perception and emotion |
What is the one pathognomonic symptom of schizophrenia? | There isn’t one! Having more than one symptom increases the risk |
There is a strong genetic link to schizophrenia. True/False? | True |
List 3 “positive” symptoms of schizophrenia | Delusions |
List 4 “negative” symptoms of schizophrenia | Apathy |
Positive symptoms are harder to treat than negative symptoms in schizophrenia. True/False? | False Positive symptoms are often easier to treat |
According to Schneider’s first rank symptoms for schizophrenia, list some thought disorders | Thoughts spoken out loud |
What is passivity phenomena? | Experience where acts/emotions/feelings are being controlled by an external party |
A patient must have Schneider’s first rank symptoms to be diagnosed with schizophrenia. True/False? | False They are not pathognomonic and can be seen in other psychoses |
What is a delusion? | A fixed belief that cannot be changed by logical thought or evidence |
What is a hallucination? | Perceptual, fantastical experience that is believed to be real without evidence |
List the different modalities by which hallucinations can occur | Auditory (most common) Visual Olfactory Gustatory Tactile Kinaesthetic |
Which type of auditory hallucination - 1st, 2nd or 3rd person - is more typical of schizophrenia? | 3rd person |
What is meant by “word salad”? | Mish mash of words that together don’t make sense |
What is meant by thought withdrawal? | Belief that thoughts are being removed by an external party - a delusional explanation for thought blocking |
What is meant by thought broadcasting? | Belief that people understand your thoughts without you having to voice them |
List features of emotional disorder that can occur in psychoses such as schizophrenia | Blunted affect Incongruent mood Apathy Lack of motivation Anhedonia |
What is the main motor disorder that may occur in schizophrenia? | Catatonia |
What is catatonia? | State of increased tone of muscles at rest, abolished by voluntary activity |
What are the main treatments for catatonia? | ECT Benzodiazepines |
What is the peak incidence of schizophrenia for men and women? St | Men: 15-25 |
List factors that indicate good prognosis for schizophrenia | Older age of onset |
List factors that indicate poor prognosis for schizophrenia | Long duration of untreated psychosis |
Psychosis is a diagnosis. True/False? | False Description of symptoms rather than diagnosis |
What is psychosis? | Inability to distinguish subjective experience from reality, characterised by lack of insight |
List psychotic experiences | Hallucinations Delusions Thought disorders Emotional disturbance Physical disruption |
List the main differential diagnoses of psychosis | Schizophrenia Schizoaffective disorder Drug toxicity Mania Depression Delusional disorder Puerperal psychosis Delirium Dementia |
What is meant by flight of ideas? | Jumping from topic to topic by associating words together inappropriately |
How does tangential thinking differ from circumstantial thinking? | Tangential: wander off from topic/question and never return |
What is meant by self-referential experience? | Belief that environment is reacting to you, i.e. external events are related to oneself |
List some common drugs that can cause psychosis | Steroids Cannabis Amphetamine Cocaine Tobacco Alcohol Opioids |
How is depressive psychosis classically typified? | Mood congruent with psychosis - delusions of guilt/pessimism on top of depressed mood |
What is a grandiose delusion? | Delusion where one thinks they are vastly superior and have superhuman like qualities |
What is schizoaffective disorder? | Mixed picture of schizophrenia + bipolar disorder where someone displays schizophrenia but their mood is also affected |
At what time of day is delirium typically worse at? | Night |
What are the 3 main cortical changes that occur in schizophrenia? | Reduced frontal lobe volume |
Which neurotransmitter causes a psychotic state when in excess? | Dopamine |
List the 3 main dopaminergic pathways in the brain | Nigrostriatal Mesolimbic Tuberoinfundibular |
Which dopaminergic pathway is typically involved in schizophrenia? | Mesolimbic system |
Name some dopamine antagonists (anti-psychotics) that can be used for schizophrenia | Haloperidol Raclopride Clozapine |
Subcortical dopamine hyperactivity/hypoactivity leads to psychosis | Subcortical dopamine hyperactivity leads to psychosis |
What is the benefit of atypical antipsychotics over typical antipsychotics? | Less likely to induce extra-pyramidal side effects | Better efficacy |
List some atypical antipsychotics | Clozapine |
What is the fatal side effect of clozapine that makes it a 3rd line agent for psychosis? | Agranulocytosis |