Psychology Flashcards: Prodromal Phase

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Questions and Answers

What do clinicians assume the distribution of psychosis to be?

Uniform

Continuous

Bimodal (correct)

Normal

What is the actual distribution of psychosis?

A continuous, semi-normal distribution.

What percentage of individuals have hallucinations but do not come into contact with the medical field?

15% (correct)

10%

20%

What does 'First Episode Psychosis' typically refer to?

The point of initial in-patient hospitalization, when the person starts receiving treatment. Signup and view all the answers

What is the typical course of First Episode Psychosis?

Symptoms and functions start to improve after the first episode, lasting for about two years. Signup and view all the answers

Why is the duration of untreated psychosis concerning?

It predicts many poor clinical outcomes. Signup and view all the answers

Is treatment after onset and management of symptoms the best we can do in the medical field?

False Signup and view all the answers

What is the new model in Australia regarding mental health for adolescents?

Fun places for adolescents to drop-in and speak to a range of mental health professions. Signup and view all the answers

What does 'prodromal phase' mean?

The forerunner of an event. Signup and view all the answers

How is the prodrome determined?

Retrospectively, as it can only be identified after a psychotic disorder develops. Signup and view all the answers

What symptoms typically emerge in the early prodromal phase?

Negative symptoms such as social difficulties, followed by general mood symptoms. Signup and view all the answers

What symptoms are involved in the late prodromal phase?

Attenuated positive symptoms such as impaired social cognition and unusual thoughts. Signup and view all the answers

When does the onset of a psychotic disorder occur?

When conviction becomes prominent, or when a person poses danger to themselves or others. Signup and view all the answers

Where is the DSM-5 location for Attenuated Psychosis Syndrome?

In the back of the book, in a section called 'areas for further consideration.' Signup and view all the answers

What does Criterion A for Attenuated Psychosis Syndrome require?

At least one symptom with sufficient severity or frequency to warrant clinical attention. Signup and view all the answers

What does Criterion B for Attenuated Psychosis Syndrome specify?

Symptoms must occur at least once a week in the last month. Signup and view all the answers

What does Criterion C for Attenuated Psychosis Syndrome require?

Symptoms must have begun or worsened in the past year. Signup and view all the answers

What does Criterion D for Attenuated Psychosis Syndrome state?

Symptoms are sufficiently distressing and disabling for the individual. Signup and view all the answers

What does Criterion E for Attenuated Psychosis Syndrome imply?

Not better explained by other diagnoses, including substance-related disorders. Signup and view all the answers

What does Criterion F for Attenuated Psychosis Syndrome ensure?

Clinical criteria for a psychotic disorder have never been met. Signup and view all the answers

How is psychosis defined?

Intensity, frequency, and urgency. Signup and view all the answers

What does intensity indicate in the context of psychosis?

Conviction, degree of implausibility, preoccupation, and disruption in daily life. Signup and view all the answers

What does frequency in the context of psychosis entail?

At least one hour a day at an average frequency of four days per week over one month. Signup and view all the answers

What does urgency refer to in psychosis?

Seriously disorganizing or dangerous symptoms. Signup and view all the answers

What percentage of individuals identified as being at risk develop a psychotic disorder?

20% within a two-year period. Signup and view all the answers

What are the most common trajectories for individuals who do not convert to a psychotic disorder?

20% develop psychosis, ⅓ develop depression or anxiety, and ⅓ enter remission. Signup and view all the answers

What differentiates converters from non-converters?

A more rapid rate in synaptic pruning, leading to over-pruning. Signup and view all the answers

What occurs during the reduced synaptic density/connectivity?

Connections multiply from birth to age 5 and then plateau until adolescence. Signup and view all the answers

What impact does reduced white matter integrity have?

Less likely to distribute messages effectively. Signup and view all the answers

How do converters demonstrate greater gray matter reduction?

In the orbitofrontal cortex, parahippocampal, fusiform, and cerebellar regions. Signup and view all the answers

What does greater presynaptic dopamine indicate?

Reduced dopamine synthesis in the striatum. Signup and view all the answers

What are some predictors of conversion to psychosis?

Early age, first-degree relative, and male sex. Signup and view all the answers

What are other prodromal identifiers?

Demographics, symptoms, drug abuse, cognition, social cognition, stress reactivity. Signup and view all the answers

What happens to youth who do not convert within two years?

36% experience symptom remission, 30% functional recovery. Signup and view all the answers

Can conversion to psychosis be prevented in clinically high-risk youth?

Yes, through early intervention. Signup and view all the answers

Do clinical trials show that treatment is effective for preventing conversion?

True Signup and view all the answers

What are the recommendations regarding antipsychotics and psychosocial therapy?

Antipsychotics are typically prescribed if symptoms are dangerous. Signup and view all the answers

What are some barriers to treatment?

Denial, stigma, poor symptom recognition, lack of mental health education. Signup and view all the answers

Study Notes

Distribution of Psychosis

Clinicians traditionally view psychosis distribution as bimodal; however, it is a continuous, semi-normal distribution.
Approximately 15% of individuals experience hallucinations without engaging with the medical field; only 1% receive a psychotic disorder diagnosis.

First Episode Psychosis

Typically marks the initiation of in-patient hospitalization when treatment begins.
Generally, symptoms show improvement post-first episode, with effects lasting around two years before stabilizing.

Duration of Untreated Psychosis

Extended untreated duration leads to poorer clinical outcomes, including increased risks of suicidality, violence, depression, anxiety, and overall quality of life decline.

Early Identification and Prevention

The focus in psychology is shifting towards early identification and prevention instead of only post-onset treatment.

Prodromal Phase

Originates from the Greek word "prodromos," meaning the forerunner of an event, indicating early symptoms before a full disorder manifests.
Typically occurs between ages 15-25, lasting 2-4 years prior to a first episode.

Symptoms of Prodrome

Early symptoms include negative manifestations (e.g., drive, affect, social difficulties) followed by general mood symptoms such as anxiety and depression.
Late symptoms consist of attenuated positive symptoms like unusual thoughts, paranoia, and impaired social cognition.

Onset Characteristics

Psychotic disorder onset is characterized by an absolute conviction in beliefs, increased danger to self or others, and functional decline.

Attenuated Psychosis Syndrome (APS)

Listed under "areas for further consideration" in DSM-5, yet holds clinical significance.
Diagnostic criteria for APS includes symptoms of delusions, hallucinations, or disorganized speech occurring at least once a week over the past month, began or worsened in the past year, and must cause significant distress.

Defining Psychosis

Based on severity, frequency, and urgency:
- Intensity involves conviction and disruption to daily life.
- Frequency requires symptoms present for 1 hour daily over 4 days a week for a month.
- Urgency implies serious disorganization or danger, irrespective of duration.

Risk of Developing Psychosis

Roughly 20% of individuals identified as at-risk for psychosis develop a disorder within two years.
Common outcomes for non-converters include mood or anxiety disorders and symptom remission.

Biological Factors

Greater synaptic pruning rates and reduced connectivity can distinguish converters from non-converters.
Converters display greater grey matter reduction in key areas like the orbitofrontal cortex and have higher presynaptic dopamine levels.

Predictors and Other Identifiers

Age, first-degree relatives, and male sex are significant predictors for conversion to psychosis.
Additional identifiers include demographics, symptoms, cognition issues, and stress responses.

Clinical Implications

Treatment efficacy shows that 10% of treated individuals convert compared to 30% of untreated ones; psychosocial treatment is emphasized over specific modalities.
Challenges to treatment include stigma, lack of symptom recognition, insufficient mental health education, and limited available programs.

Recommendation for Antipsychotics

In cases of dangerous symptoms during the attenuated phase, antipsychotic medications are commonly prescribed.

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Description

Explore key concepts related to the prodromal phase of psychosis through these flashcards. Test your understanding of the distribution of psychosis, the prevalence of hallucinations, and their significance in clinical contexts. Ideal for psychology students and professionals.