3. Psychotic Disorders Flashcards
Nonbizarre delusion
false belief that is plausible but is not true
Bizarre delusion
False belief that is impossible
Ideas of reference
belief that cues in the external environment are uniquely related to the individual
Thought broadcasting
Belief that one’s thoughts can be heard by others
Thought insertion
Belief that other’s thoughts are being placed in one’s head
Delusions of grandeur
Belief that one has special powers beyond those of a normal person
Somatic delusions
Belief that one is infected with a disease or has a certain illness
Command hallucinations
Auditory hallucinations that directly tell the patient to perform certain acts
Hallucination usually associated with epilepsy
Olfactory hallucination
Tactile hallucination
Usually secondary to drug use or alcohol withdrawl
Most common hallucination exhibited by schizophrenic patients
Auditory
Vitamin deficiencies that can cause psychosis
B12
Folate
Niacin
Misinterpretation of external stimulus
Illusion
24-year-old male with 9 months of anxiety, concern that people are watching him, hearing voices…What is the important workup?
TSH
RPR
Brain imaging
Type of symptoms in schizophrenia that respond more robustly to antipsychotic medications
Positive symptoms
Three phases of schizophrenia
- Prodromal: Patient may become socially withdrawn, irritable, have declining work/school performance, newfound interest in religion etc.
- Psychotic: perceptual disturbances, delusions, disordered thought content
- Residual: Follows an episode of active psychosis. Mild hallucinations or delusions, social withdrawal, negative symptoms
Alogia
Poverty of speech, too few ideas expressed (reduction in amount of speech)
Length of brief psychotic disorder
less than 1 month
Echopraxia
Mimics behavior (PRActices behavior)
Echolalia
Repeats words or phrases
Concordance rate of Schizophrenia among mono-zygotic twins
50 %
Most commonly abused substance in schizophrenics
Nicotine
Downward drift hypothesis
People with schizophrenia are unable to function well in society and hence end up in lower socioeconomic groups
Pathways affected in shizophrenia
prefrontal cortical: decreased activity-negavitve sx
Mesolimbic: increased activity-positive sx
Pathway blocked by antipsychotics that causes Parkinsonian like symptoms
Nigrostriatal
Acute onset…prognosis
Better
Mood symptoms…prognosis
Better
Primary actions of 1st generation antipsychotics
D2 antagonists
Second generation receptor interactions
5-HT2
D4 > D2
Treatment for dystonia and Parkinsonism
Benztropine or diphenydramine
Anticholinergics
Treatment for akathisia
Beta blocker or benzodiazapene
Anticholinergic side effects
dry mouth
constipation
blurred vision
hyperthermia
Metabolic syndrome: constellation of conditions?
Group of antipsychotis?
HTN
Elevated blood sugar
Excess body fat around waist
Abnormal cholesterol levels
2nd generation antipsychotics
Increase risk for CV disease, stroke, type 2 diabetes
