psyc1030 quiz 3 schizophrenia

Prevalence of mental illness in Weston nations across lifespan

1 in 5

what is NOT a symptom of schizophrenia

violence

difference between thoughts and auditory hallucinations

Whether words spoken are coming from inside your mind or outside your mind

Self talk v someone talking to you

what is catatonia

 rigid in movement and immobility (uncommon)

annual societal cost of schizophrenia in england

11.8 billion pounds ($20 billion)

most common male onset of schizophrenia

~21 yrs old

most common female onset schizophrenia

27 years old

what is schizophrenia often referred to as

the prototypical psychotic disorder

features of schizophrenia

most common psychotic disorder, involves disturbances in all 5 symptom domains

delusions of persecution

paranoid flavour. Other ppl are out to get you

Treatment schizophrenia

-Medication: Frontline
-Psychological

Medication and schizophrenia, failure rate, side effects

-Frontline treatment
-Positive symptom profile: better response to antipsychotics
-25% fail to improve
-Side effects: weight gain, tardive dyskinesia (involuntary neurological movement disorder affecting lower face)

Psychological treatment for schizophrenia

-Psychoeducation patient and family
-Signs of relapse most important
-Behavioral strategies to develop social skills
-CBT for stable patients (but effect size likely to be in small range)
-Family support

How many people who experience mental illness receive any kind of intervention

50%

prevalence of schizophrenia

0.5-1%

Why is schizophrenia the highest impact disorder

Affects on individual
Affects on family
Economic cost associated with

age of onset of schizophrenia

Common 15-35
Uncommon >40, <10

Lifetime risk of suicide in schizophrenia

5%

Risk factors for suicide in schizophrenia

Male
Younger
Higher level education
Family history suicide
Comorbid substance use
Depressive symptoms
Previous suicide attempts

Why do schizophrenics die younger

Up to 40% premature mortality due to suicide and unnatural deaths

late-onset schizophrenia

the schizophrenia that first appears after age 40

potential social factor associated with the incidence of Schizophrenia

lower socioeconomic status

Difference between direct and indirect costs

Direct: resources that are used to treat or support an individual with an illness. e.g. hospital admissions, GP visits, employment support, accomodation

Indirect: value of the loss of productivity that schizophrenics and careers unable to contribute related to:

-illness or
-early mortality related to illness

Examples of indirect costs of schizophrenia

-Loss of earnings patient and career
-income tax
-Cost of support payments
-Costs associated with absenteeism

What's disability adjusted life years (DALYS)

-largest amount of economic burden.

-Sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability.

Diagnostic systems

Diagnostic and Statistical Manual of Mental Disorders or the DSM

The International Classification of Diseases or the ICD.

What are the other criterions for schizophrenia

-Degree of dysfunction
-Duration
-Exclusion of other possible causes

Such as substance use or other mental illnesses

Diagnostic criteria for schizophrenia (DSM-V)

-Symptoms present 6 mos or longer
-At least 1 month of active symptoms
-At least 2+ symptoms below

-Delusions
-Hallucinations
-Disorganized speech
-Disorganized or catatonic behaviour
-Negative symptoms

What category and criterion do we examine for Schizophrenia as per DSM5

-Category: Schizophrenia Spectrum and Other Psychotic Disorders.
-Criterion A (Symptoms):

Positive and negative symptoms

Positive: happening too much (more than normal)
Negative: Occurring not enough (deficits)

Delusions

-Positive symptom
-Related to content of thought that is inaccurate or false and can’t be explained by religious/cultural beliefs
-False belief
-Two types (grandeur, persecutions)

Delusions of grandeur

ppl believe they possess qualities or attributes which make them better than other ppl. e.g. "I am a billionaire" "I am besties w Michael Jackson" "I am jesus" "I have found the cure to cancer"

Disorganized speech symptoms

-Positive symptom
-Related to disturbance is form of thought
(Speech best reflection of thoughts)
-When thoughts disorganized and disturbed so is speech
-Prolonged and extreme

Disorganized speech types

-Neologism
-Word salad
-Tangentiality

Neologism

Person makes up a word. No meaning in mainstream lang and is often a combo of 2 words or distortion of word. Usually is meaningless

Word salad

bunch of words tossed together which make no sense. Reflection of chaotic thought processes and meaningless

Tangentiality

Disturbance in associative thought patterns

Go from one topic to another unrelated topic

Tangentiality is normal, what differentiates it in schizophrenia

-Failure to return to original topic
-Lack insight

Hallucinations

-Disturbances of perception
-False sensory experience

- distressing for ppl experiencing them

Different types of Hallucinations

-Auditory
-Visual
-Olfactory
-Gustatory
-Tactile

most common features/type of hallucination

-Auditory is most common
-Hearing voices most common
-Mostly negative

What type of hallucination most common in organic brain disease

Visual

Olfactory hallucination definition

hallucination of smell

Gustatory hallucination definition

tasting somethig that ur not actually tasting. e.g. food you're eating tastes rotten even if to everyone else it tastes fine

Disorganized or catatonic motor behavior

-positive symptom

-Lack of focus or silliness
-Psychomotor agitation
-Purposeless activity
-Self initiated bizarre postures

Negative symptoms

-Affect
-Speech
-Emotion
-Alogia
-Avolition
-Lack self care hygiene

Alogia

-Poverty of speech
-Involves lack of spontaneous speech
-Impoverished thought processes

Avolition

Lack of motivation and social withdrawal. seen across lots of mental disorders

Course of schizophrenia

Episodic

Phases of psychotic episodes in schizophrenia

-Prodromal: General decline. negative symptoms start to appear. can last days/weeks/months
-Active: positive and negative symptoms. each symptom profile very different
-Residual: positive symptoms remitted, some negative remain. similar to prodromal

Which phase is diagnosed retrospectively in schizophrenia and when

Prodromal usually diagnosed once moved into active stage

Is short or long onset of prodrome associated with better or worse prognosis

Short/Acute: Better prognosis
Long/Chronic: Worse prognosis

Aetiology of schizophrenia

-Biological factors
-Social factors
-Psychosocial factors

-Gene by environment interaction best evidence (diathesis-stress model)

Biological factors in schizophrenia

-Genetics
-10% increased incidence with first degree relative
-50% increased incidence with identical twin
-Physical trauma: birth and pregnancy
-Structural brain abnormalities
-Biochemical abnormalities: Particularly dopamine

Social factors contributing to aetiology

-harmful stressors: stress, social isolation, poor nutrition, lack of access to medical services, Low social economic status
-Social dislocation (higher rates migrants)

Psychosocial factors

Expressed emotion: Level of:
-Criticism
-Hostility
-Emotional over involvement

High lvl of neg expressed emotion = higher risk of relapse

Diathesis-Stress model

interaction between genes and environment

-Underlying vulnerability
-(Diatheses) Genetic factors, physical trauma prenatally or during birth, structural abnormalities in brain or neurotransmitter system
-(stressors) chronic psychological and social stressors, family environment, drug use

Converts to illness if both present and interact