**_🤯Psychiatry🤯 - Psychosis Flashcards
What is the definition of psychosis?
Difficulty perceiving and interpreting reality
What disorders are typically associated with “psychotic disorders”?
Schizoaffective disorder
Schizophrenia
Bipolar type 1
Delusional disorders
What 3 domains can psychotic symptoms be separated into?
Positive symptoms
Negative symptoms
Disorganisation symptoms
What are positive symptoms?
Hallucinations
Delusions
What are hallucinations?
Perception in absence of a stimulus
Can occur in any sensory modality
Auditory (1st, 2nd, 3rd person)
Visual (consider organic cause)
How are hallucinations different to illusions?
An illusion is misperceiving an existing stimulus (e.g. thinking a coat on a hanger is a man when its dark)
A hallucination is when there is no stimulus at all (e.g. seeing a man even thought there is no coat on a hanger)
What are delusions?
Fixed, false beliefs not in keeping with social/cultural norms
Persecutory/paranoid
Grandiosity, religious, nihilistic/guilt, somatic, erotomanic (leads to stalking)
Passivity experiences
What are negative symptoms?
Alogia - poverty of speech, slow question responses
Anhedonia/asociality - few close friends/hobbies/interests
Avolition/apathy - lack of self-care/drive/motivation
Affective flattening - lack of facial expression
What are disorganisation symptoms?
Bizarre behaviours
Formal thought disorder
When can psychosis onset?
Can occur at any age
Peak incidence in adolescence/early 20s
Peak later in women
What is the course of psychosis?
Often chronic and episodic
Variable prognosis
What is the morbidity of psychosis?
Substantial, both from disorder itself and increased risk of common health problems
What is the mortality of psychosis?
15-20 life years lost
High risk of suicide in schizophrenia - 28% excess mortality
What signs often precede psychosis?
Prodromal symptoms:
6-18 months before psychosis develops
Increasing isolation
Poor self care
Social withdrawal
Declining academic performance
What are some common risk factors for psychosis?
Environmental risk factors:
Drug use, particularly cannabis
Prenatal/birth complications
Socioeconomic deprivation/migrant status
Childhood trauma
Genetics:
Highly heritable (esp. schizophrenia)
Highly polygenic
What might you look for someone with psychosis?
Bizarre or inappropriate clothing
Psychomotor retardation/agitation, abnormal movements (medication related)
Self-neglect, self-harm injuries
Stupor and mutism