OT 882 Psychosis and Occupation

Psychosis

refers to a collection of symptoms that affect the mind, where there has been some loss of contact with reality. During an episode a person's thoughts and perceptions are disrupted and they may have difficulty recognizing what is real and what is not.

Group of symptoms. May be related to another illness and can be transitory.

Psychosis is not a diagnosis it is a ________

Positive symptoms

symptoms in excess of/added to an individual's normal functioning. Ex. hallucinations, delusions.

Hallucinations

seeing, hearing, feeling, smelling or tasting something that isn't there. Distortions in perception.

Delusions

false beliefs:

- bizarre: implausible beliefs

- non-bizarre: plausible but untrue in reality

Negative symptoms

symptoms that reflect a loss/absence in normal functioning ex:

- flat affect/emotion; lack of speech; apathy; anhedonia; isolation/withdrawal

Disorganized symptoms

thoughts and behaviours that don't follow a normal processes (including speech, grossly disorganized or catatonic behaviour)

Brief psychotic disorder

one month or less of psychosis symptoms

Other specified schizophrenia spectrum

given when information is inadequate or information from client is contradictory

Delusional Disorder

bizarre or non-bizarre delusions, lasting more than a month. Delusions seen as focused and fixed. Daily functioning not affected. Only one symptom experienced.

Schizophreniform Disorder

Provisional diagnosis, if symptoms are for 6 months or less. After that it becomes schizophrenia

Schizoaffective Disorder

Combination of a severe mood disorder and psychosis

4%

What is the lifetime prevalence for psychosis in Canada?

1%

What is the prevalence of schizophrenia?

Men

in which sex is the prevalence higher?

20-34

What was the most common age range of newly diagnosed schizophrenia cases?

Prodromal Phase

What phase is associated with a change in mood, thinking, behaviour, and role functioning? Progression without treatment is seen to affect illness course. Psychosocial treatment is as important as medication.

Acute Phase

in what phase do typical symptoms of psychosis emerge characterized by positive, negative, and disorganized symptoms?

Recovery Phase

In what phase is there a response to treatment resulting in a normalization of life prior to the psychosis?

Brief psychotic disorder

Substance-induced psychosis

Which types of psychosis are unlikely to persist across the lifespan?

Other specified schizophrenia spectrum and other psychotic disorder/psychosis NOS

Delusional Disorder

Which types of psychosis may persist across the lifespan?

Schizophrenia

Schizoaffective disorder

Which types of psychosis are likely to persist across the lifespan?

genetic factors

biochemical abnormalities

abnormal brain structure

environmental influences

substance use

some medical conditions

What causes psychosis (6)?

Likelihood of illness manifestation by looking at their genetic vulnerability and environmental stressors

What does The Diathesis Stress Model look at?

frontal lobe (- symptoms), temporal lobe (+ symptoms), occipital lobe (+ symptoms)

What parts of the brain are associated with psychosis?

dopamine

Which neurotransmitter has been shown to have increased activity in the brain of people with psychosis?

observe; ask open-ended, non-leading questions; use language they will understand; understand cultural context; symptom checklist; Mental Status Examination (MSE)

How to learn about people with psychosis:

ADL skills; time use log; vocational/productivity assessment; AOI; role/interest checklists; COPM; OQ; EMAS

What are some OT specific assessments in psychosis?

antipsychotic medications. Sometimes antidepressants, mood stabilizers and/or anti-anxiety medications

What are some medical approaches to treat psychosis?

alter/block the dopamine receptors, so the excess chemical don't pass on too many messages. Help restore chemical balance in the brain

How does antipsychotic medication help?

using routines and time-use

planning for maintaining control in the early stages of psychosis (managing symptoms)

active coping skills (strategies, healthy lifestyle changes)

How can individual cope with psychosis?

recover

People with mental illness do not go through rehab they ______?

Relapse in psychosis

a process of gradual decline in function which leads to the recurrence of psychotic symptoms. often preventable if individuals can recognize the warning signs and symptoms, and take charge by making changes for preventions

disturbances in thinking or perception

changes in feeling

behavioural changes

changes in sleeping patterns

return to substance use

What are possible warning signs and symptoms of a relapse in psychosis?