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Psych > 1. Psychotic disorders > Flashcards

1. Psychotic disorders Flashcards

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1
Q

Command hallucinations

A

auditory hallucinations that directly tell the pt to perform certain acts

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2
Q

Delusion vs. Illusion vs. hallucination

A 
Delusion = false belief that cannot be altered 
Illusion = misinterpretation of an EXISTING sensory stimulus (such as mistaking a shadow for a cat) 
Hallucinations = sensory perception WITHOUT an actual external stimulus
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3
Q

Most commonly exhibited hallucination exhibited by schiz pts?

A

Auditory

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4
Q

DDx of psychosis secondary to general medical condition (4 categories)

A
  1. CNS disease (ex. MS, neoplasm, Alzheimer, Parkinson, Huntington chorea, tertiary syphilis, temporal lobe epilepsy, encephalitis, prion disease, neurosarcoidosis, AIDS)
  2. Endocrinopathies (Addison/Cushing disease, hyper/hypothyroidism, hyper/hypocalcemia, hypopituitarism)
  3. Nutritional/vit deficiency states (B12, folate, niacin)
  4. Other (SLE, temporal arteritis, porphyria)
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5
Q

What is delirium?

A

Acute confusional state

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6
Q

Work-up needed when pt with suspected schiz comes in

A

TSH, rapid plasma reagin (RPR), brain imaging, urine/serum drug screening

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7
Q

5 A’s of schiz (negative symptoms)

A
  1. Anhedonia
  2. Affect (flat)
  3. Alogia (poverty of speech)
  4. Avolition (apathy)
  5. Attention (poor)
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8
Q

Ecolalia vs. Echopraxia

A 
Ecolalia = repeats words or phrases 
Echopraxia = mimics behavior (PRActices behavior)
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9
Q

Time differences b/w psychotic disorder, schizophreniform disorder, schizophrenia

A

Brief psychotic disorder = < 1month
Schizophreniform = 1-6 months
Schizophrenia = > 6months

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10
Q

Schizophrenics psych exam findings

A
  • disheveled appearance
  • flattened affect
  • disorganized thought process
  • intact memory and orientation!!
  • auditory hallucinations
  • paranoid delusions
  • ideas of reference
  • concrete understanding of similarities/proverbs
  • lack insight into their disease
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11
Q

Lifetime prevalence of schiz?

A

1% over lifetime

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12
Q

Difference in men and women affected by schiz

A

equally affected by diff. presentations and outcomes

  • men = present around 20 yo; more negative symptoms, more impaired social functioning
  • women = present around 30 yo
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13
Q

Genetic predisposition of schiz

A
  • 50% concordance among monozygotic twins
  • 40% risk if both parents have sciz
  • 12% risk if one 1st degree relative is affected
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14
Q

Comorbidity with schiz?

A

substance abuse

  • alcohol (30-50%)
  • cannabis (15-20%)
  • cocaine (5-10%)
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15
Q

Downward drift hypothesis?

A

ppl suffering from schiz are unable to function well in society, thus enter lower socioeconomic groups

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16
Q

What is akathisia?

A

Unpleasant, subjective sense of restlessness (often manifested by the inability to sit still)

17
Q

Bad prognostic factors of schiz?

A

early onset, poor social support, negative symptoms, family hx, gradual onset, male sex, many relapses, poor premorbid functioning (social isolation etc), comorbid substance abuse

18
Q

What is neologism?

A

use of words that have meaning only to the person who uses them

19
Q

Schizoaffective disorder vs. mood disorder w/ psychotic features

A
  • Schizoaffective = delusions or hallucinations for 2 wks in ABSENCE of mood disorder
20
Q

How much % of pts w/ schizoaffective will progress to schizophrenia?

A

60-80%

21
Q

What population of ppl are delusional disorder more prevalent in? (3)

A
  • older pts (>40yo)
  • immigrants
  • hearing impaired
22
Q

Criteria for delusional disorder

A
  • nonbizarre, fixed delusions for at least 1 month
  • does NOT meet criteria for schiz
  • functioning in life NOT significantly impaired
23
Q

Treatment for delusional disorder

A
  • note: very difficult to treat
  • psychotherapy may be helpful
  • anti-psychotics often ineffective (but a course should be tried)
24
Q

What is shared psychotic disorder?

A

pt develops the same delusional symptoms as someone he/she is in a close relationship with (family members)

25
Q

Treatment of shared psychotic disorder?

A

20-40% will recover upon removal from inducing person

  • usually inducing person has an underlying psychotic disorder
  • psychotherapy and anti-psychotic meds if symptoms does not improve in 1-2 wks after separation
26
Q

Prognosis from best to worst of psychotic disorders (5) ex. schizophreniform disorder, schizoaffective, mood disorder

A

mood disorder > brief psychotic disorder > schizoaffective disorder > schizophreniform disorder > schizophrenia

27
Q

What is schizotypal vs. schizoid?

A
  • Both are personality disorders
  • schizotypal = paranoid, odd or magical beliefs, eccentric, lack of friends, social anxiety. Criteria for true psychosis not met
  • schizoid = withdrawn, lack of enjoyment from social interactions, emotionally restricted

Psych (17 decks)

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