SAMENVATTING
KLINISCHE PSYCHOLOGIE
1B
1
,INHOUD
INTRODUCTIE TOT DE CURSUS ________________________________________________________________________ 20
1. NEUROBIOLOGISCHE ONTWIKKELINGSSTOORNISSEN __________________________________________ 21
Inleiding _____________________________________________________________________________________________ 21
INTRODUCTIE _______________________________________________________________________________________ 21
11.1 AUTISMESPECTRUMSTOORNIS (ASS) ________________________________________________________________ 21
11.1.1 Klinisch beeld ___________________________________________________________________________ 21
Kenmerken van de autismespectrumstoornis (ASS)__________________________________________________ 22
11.1.2 Epidemiologie ___________________________________________________________________________ 23
Prevalentie ____________________________________________________________________________________ 23
Beloop ________________________________________________________________________________________ 23
11.1.3 Theoretische visies _______________________________________________________________________ 23
11.1.4 Cultuur en gender ________________________________________________________________________ 24
Cultuur _______________________________________________________________________________________ 24
Gender _______________________________________________________________________________________ 24
11.1.5 Comorbiditeit en differentiële diagnostiek ____________________________________________________ 24
11.1.6 Diagnostiek en behandeling ___________________________________________________________________ 24
Diagnostiek ____________________________________________________________________________________ 24
Behandeling ___________________________________________________________________________________ 25
11.2 AANDACHTSDEFICIËNTIE-/HYPERACTIVITEITSSTOORNIS (ADHD) __________________________________________ 25
11.2.1 Klinisch beeld ___________________________________________________________________________ 25
Kenmerken van de aandachtsdeficiëntie-/hyperactiviteitsstoornis (ADHD) _______________________________ 25
11.2.2 Epidemiologie ___________________________________________________________________________ 26
Prevalentie ____________________________________________________________________________________ 26
Beloop ________________________________________________________________________________________ 26
11.2.3 Theoretische visies _______________________________________________________________________ 26
Risico- en prognostische factoren __________________________________________________________________ 26
Verklaringsmodellen ____________________________________________________________________________ 27
11.2.4 Cultuur en gender ________________________________________________________________________ 27
Cultuur _______________________________________________________________________________________ 27
Gender _______________________________________________________________________________________ 27
11.2.5 Comorbiditeit en differentiële diagnostiek ____________________________________________________ 27
11.2.6 Diagnostiek en behandeling ________________________________________________________________ 28
Diagnostiek ____________________________________________________________________________________ 28
Behandeling ___________________________________________________________________________________ 28
11.3 TOT BESLUIT ___________________________________________________________________________________ 28
SAMENVATTING ____________________________________________________________________________________ 29
SAMENVATTING EXTRA _______________________________________________________________________________ 30
2
, VERWERKINGSOPDRACHTEN __________________________________________________________________________ 33
2. SCHIZOFRENIESPECTRUM- EN ANDERE PSYCHOTISCHE STOORNISSEN _____________________ 40
Inleiding _____________________________________________________________________________________________ 40
INTRODUCTIE _______________________________________________________________________________________ 40
12.1 KLINISCH BEELD _________________________________________________________________________________ 40
12.1.1 Symptomen van psychose _________________________________________________________________ 41
Wanen ________________________________________________________________________________________ 41
Overzicht waantypen __________________________________________________________________________ 42
Hallucinaties ___________________________________________________________________________________ 42
Desorganisatie _________________________________________________________________________________ 43
Negatieve symptomen ___________________________________________________________________________ 43
12.1.2 Schizofreniespectrum- en andere psychotische stoornissen ______________________________________ 43
Kenmerken van schizofrenie en de schizofreniforme stoornis _________________________________________ 44
Kenmerken van de schizoaffectieve stoornis _______________________________________________________ 44
Kenmerken van de waanstoornis ________________________________________________________________ 44
Kenmerken van de kortdurende psychotische stoornis _______________________________________________ 44
12.2 EPIDEMIOLOGIE_________________________________________________________________________________ 45
12.2.1 Prevalentie _____________________________________________________________________________ 45
12.2.2 Stadiëring ______________________________________________________________________________ 45
Stadium 0, 1a en 1b _____________________________________________________________________________ 47
Stadium 2, 3 en 4 _______________________________________________________________________________ 47
12.3 THEORETISCHE VISIES ____________________________________________________________________________ 47
12.3.1 Het neuropsychisch model van psychose _____________________________________________________ 47
Bottom-up-proces ______________________________________________________________________________ 48
Top-down-proces _______________________________________________________________________________ 48
Cognitieve tendensen____________________________________________________________________________ 49
Consolideren van psychotische klachten _____________________________________________________________ 49
12.3.2 Risicofactoren voor schizofrenie en psychose __________________________________________________ 50
Biomarkers ________________________________________________________________________________ 50
Genetische Invloeden _______________________________________________________________________ 50
Pre- en Perinatale Risicofactoren ______________________________________________________________ 50
Andere Risicofactoren _______________________________________________________________________ 50
12.3.3 Alternatieve modellen voor psychotische stoornissen ___________________________________________ 51
12.4 CULTUUR EN GENDER ____________________________________________________________________________ 51
12.4.1 Cultuur _________________________________________________________________________________ 51
12.4.2 Gender _________________________________________________________________________________ 51
12.5 COMORBIDITEIT EN DIFFERENTIËLE DIAGNOSTIEK _____________________________________________________ 52
12.6 DIAGNOSTIEK EN BEHANDELING ___________________________________________________________________ 52
12.6.1 Diagnostiek _____________________________________________________________________________ 52
12.6.2 Behandeling_____________________________________________________________________________ 53
12.7 TOT BESLUIT ___________________________________________________________________________________ 53
3
, SAMENVATTING ____________________________________________________________________________________ 54
SAMENVATTING EXTRA _______________________________________________________________________________ 55
VERWERKINGSOPDRACHTEN __________________________________________________________________________ 59
3. DEPRESSIEVE- EN BIPOLAIRE-STEMMINGSSTOORNISSEN______________________________________ 63
Inleiding _____________________________________________________________________________________________ 63
INTRODUCTIE _______________________________________________________________________________________ 63
13.1 KLINISCH BEELD _________________________________________________________________________________ 63
13.1.1 Depressieve-stemmingsstoornissen__________________________________________________________ 63
Depressieve stoornis ____________________________________________________________________________ 64
Kenmerken van de depressieve stoornis __________________________________________________________ 64
Persisterende depressieve stoornis (PDS) ____________________________________________________________ 64
Kenmerken van de persisterende depressieve stoornis_______________________________________________ 64
Premenstruele-stemminsstoornis __________________________________________________________________ 65
Kenmerken van de premenstruele-stemmingsstoornis _______________________________________________ 65
13.1.2 Bipolaire-stemmingsstoornissen ____________________________________________________________ 65
Bipolaire I-stoornis ______________________________________________________________________________ 66
Kenmerken van een manische episode____________________________________________________________ 66
Bipolaire II-stoornis _____________________________________________________________________________ 66
Kenmerken van een hypomane episode ___________________________________________________________ 66
Cyclothyme stoornis _____________________________________________________________________________ 67
Kenmerken van de cyclothyme stoornis ___________________________________________________________ 67
13.1.3 Depressieve- en bipolaire-stemminsstoornissen door een middel/medicatie of een somatische aandoening 67
13.1.4 Restcategorieën _________________________________________________________________________ 68
13.1.5 Nadere omschrijvingen van stemmingsstoornissen _____________________________________________ 68
Specificaties van de laatste (actuele) stemmingsepisode ________________________________________________ 68
Specificaties van het beloop ______________________________________________________________________ 69
13.2 EPIDEMIOLOGIE_________________________________________________________________________________ 69
13.2.1 Prevalentie _____________________________________________________________________________ 69
13.2.2 Beloop _________________________________________________________________________________ 69
13.3 THEORETISCHE VISIES ____________________________________________________________________________ 70
13.3.1 Leertheoretische benadering _______________________________________________________________ 70
De bekrachtigingstheorie van Lewinsohn ____________________________________________________________ 70
Zelfcontrolemodel van Rehm ______________________________________________________________________ 70
13.3.2 Cognitieve benadering ____________________________________________________________________ 71
Becks cognitieve theorie over depressie _____________________________________________________________ 71
De aangeleerde-hulpeloosheidstheorie _____________________________________________________________ 71
Attributiegeoriënteerde aangeleerde-hulpeloosheidstheorie ____________________________________________ 72
13.3.3 Neurobiologische benadering ______________________________________________________________ 72
Genetische factoren _____________________________________________________________________________ 72
De hersenen ___________________________________________________________________________________ 73
4
KLINISCHE PSYCHOLOGIE
1B
1
,INHOUD
INTRODUCTIE TOT DE CURSUS ________________________________________________________________________ 20
1. NEUROBIOLOGISCHE ONTWIKKELINGSSTOORNISSEN __________________________________________ 21
Inleiding _____________________________________________________________________________________________ 21
INTRODUCTIE _______________________________________________________________________________________ 21
11.1 AUTISMESPECTRUMSTOORNIS (ASS) ________________________________________________________________ 21
11.1.1 Klinisch beeld ___________________________________________________________________________ 21
Kenmerken van de autismespectrumstoornis (ASS)__________________________________________________ 22
11.1.2 Epidemiologie ___________________________________________________________________________ 23
Prevalentie ____________________________________________________________________________________ 23
Beloop ________________________________________________________________________________________ 23
11.1.3 Theoretische visies _______________________________________________________________________ 23
11.1.4 Cultuur en gender ________________________________________________________________________ 24
Cultuur _______________________________________________________________________________________ 24
Gender _______________________________________________________________________________________ 24
11.1.5 Comorbiditeit en differentiële diagnostiek ____________________________________________________ 24
11.1.6 Diagnostiek en behandeling ___________________________________________________________________ 24
Diagnostiek ____________________________________________________________________________________ 24
Behandeling ___________________________________________________________________________________ 25
11.2 AANDACHTSDEFICIËNTIE-/HYPERACTIVITEITSSTOORNIS (ADHD) __________________________________________ 25
11.2.1 Klinisch beeld ___________________________________________________________________________ 25
Kenmerken van de aandachtsdeficiëntie-/hyperactiviteitsstoornis (ADHD) _______________________________ 25
11.2.2 Epidemiologie ___________________________________________________________________________ 26
Prevalentie ____________________________________________________________________________________ 26
Beloop ________________________________________________________________________________________ 26
11.2.3 Theoretische visies _______________________________________________________________________ 26
Risico- en prognostische factoren __________________________________________________________________ 26
Verklaringsmodellen ____________________________________________________________________________ 27
11.2.4 Cultuur en gender ________________________________________________________________________ 27
Cultuur _______________________________________________________________________________________ 27
Gender _______________________________________________________________________________________ 27
11.2.5 Comorbiditeit en differentiële diagnostiek ____________________________________________________ 27
11.2.6 Diagnostiek en behandeling ________________________________________________________________ 28
Diagnostiek ____________________________________________________________________________________ 28
Behandeling ___________________________________________________________________________________ 28
11.3 TOT BESLUIT ___________________________________________________________________________________ 28
SAMENVATTING ____________________________________________________________________________________ 29
SAMENVATTING EXTRA _______________________________________________________________________________ 30
2
, VERWERKINGSOPDRACHTEN __________________________________________________________________________ 33
2. SCHIZOFRENIESPECTRUM- EN ANDERE PSYCHOTISCHE STOORNISSEN _____________________ 40
Inleiding _____________________________________________________________________________________________ 40
INTRODUCTIE _______________________________________________________________________________________ 40
12.1 KLINISCH BEELD _________________________________________________________________________________ 40
12.1.1 Symptomen van psychose _________________________________________________________________ 41
Wanen ________________________________________________________________________________________ 41
Overzicht waantypen __________________________________________________________________________ 42
Hallucinaties ___________________________________________________________________________________ 42
Desorganisatie _________________________________________________________________________________ 43
Negatieve symptomen ___________________________________________________________________________ 43
12.1.2 Schizofreniespectrum- en andere psychotische stoornissen ______________________________________ 43
Kenmerken van schizofrenie en de schizofreniforme stoornis _________________________________________ 44
Kenmerken van de schizoaffectieve stoornis _______________________________________________________ 44
Kenmerken van de waanstoornis ________________________________________________________________ 44
Kenmerken van de kortdurende psychotische stoornis _______________________________________________ 44
12.2 EPIDEMIOLOGIE_________________________________________________________________________________ 45
12.2.1 Prevalentie _____________________________________________________________________________ 45
12.2.2 Stadiëring ______________________________________________________________________________ 45
Stadium 0, 1a en 1b _____________________________________________________________________________ 47
Stadium 2, 3 en 4 _______________________________________________________________________________ 47
12.3 THEORETISCHE VISIES ____________________________________________________________________________ 47
12.3.1 Het neuropsychisch model van psychose _____________________________________________________ 47
Bottom-up-proces ______________________________________________________________________________ 48
Top-down-proces _______________________________________________________________________________ 48
Cognitieve tendensen____________________________________________________________________________ 49
Consolideren van psychotische klachten _____________________________________________________________ 49
12.3.2 Risicofactoren voor schizofrenie en psychose __________________________________________________ 50
Biomarkers ________________________________________________________________________________ 50
Genetische Invloeden _______________________________________________________________________ 50
Pre- en Perinatale Risicofactoren ______________________________________________________________ 50
Andere Risicofactoren _______________________________________________________________________ 50
12.3.3 Alternatieve modellen voor psychotische stoornissen ___________________________________________ 51
12.4 CULTUUR EN GENDER ____________________________________________________________________________ 51
12.4.1 Cultuur _________________________________________________________________________________ 51
12.4.2 Gender _________________________________________________________________________________ 51
12.5 COMORBIDITEIT EN DIFFERENTIËLE DIAGNOSTIEK _____________________________________________________ 52
12.6 DIAGNOSTIEK EN BEHANDELING ___________________________________________________________________ 52
12.6.1 Diagnostiek _____________________________________________________________________________ 52
12.6.2 Behandeling_____________________________________________________________________________ 53
12.7 TOT BESLUIT ___________________________________________________________________________________ 53
3
, SAMENVATTING ____________________________________________________________________________________ 54
SAMENVATTING EXTRA _______________________________________________________________________________ 55
VERWERKINGSOPDRACHTEN __________________________________________________________________________ 59
3. DEPRESSIEVE- EN BIPOLAIRE-STEMMINGSSTOORNISSEN______________________________________ 63
Inleiding _____________________________________________________________________________________________ 63
INTRODUCTIE _______________________________________________________________________________________ 63
13.1 KLINISCH BEELD _________________________________________________________________________________ 63
13.1.1 Depressieve-stemmingsstoornissen__________________________________________________________ 63
Depressieve stoornis ____________________________________________________________________________ 64
Kenmerken van de depressieve stoornis __________________________________________________________ 64
Persisterende depressieve stoornis (PDS) ____________________________________________________________ 64
Kenmerken van de persisterende depressieve stoornis_______________________________________________ 64
Premenstruele-stemminsstoornis __________________________________________________________________ 65
Kenmerken van de premenstruele-stemmingsstoornis _______________________________________________ 65
13.1.2 Bipolaire-stemmingsstoornissen ____________________________________________________________ 65
Bipolaire I-stoornis ______________________________________________________________________________ 66
Kenmerken van een manische episode____________________________________________________________ 66
Bipolaire II-stoornis _____________________________________________________________________________ 66
Kenmerken van een hypomane episode ___________________________________________________________ 66
Cyclothyme stoornis _____________________________________________________________________________ 67
Kenmerken van de cyclothyme stoornis ___________________________________________________________ 67
13.1.3 Depressieve- en bipolaire-stemminsstoornissen door een middel/medicatie of een somatische aandoening 67
13.1.4 Restcategorieën _________________________________________________________________________ 68
13.1.5 Nadere omschrijvingen van stemmingsstoornissen _____________________________________________ 68
Specificaties van de laatste (actuele) stemmingsepisode ________________________________________________ 68
Specificaties van het beloop ______________________________________________________________________ 69
13.2 EPIDEMIOLOGIE_________________________________________________________________________________ 69
13.2.1 Prevalentie _____________________________________________________________________________ 69
13.2.2 Beloop _________________________________________________________________________________ 69
13.3 THEORETISCHE VISIES ____________________________________________________________________________ 70
13.3.1 Leertheoretische benadering _______________________________________________________________ 70
De bekrachtigingstheorie van Lewinsohn ____________________________________________________________ 70
Zelfcontrolemodel van Rehm ______________________________________________________________________ 70
13.3.2 Cognitieve benadering ____________________________________________________________________ 71
Becks cognitieve theorie over depressie _____________________________________________________________ 71
De aangeleerde-hulpeloosheidstheorie _____________________________________________________________ 71
Attributiegeoriënteerde aangeleerde-hulpeloosheidstheorie ____________________________________________ 72
13.3.3 Neurobiologische benadering ______________________________________________________________ 72
Genetische factoren _____________________________________________________________________________ 72
De hersenen ___________________________________________________________________________________ 73
4
