Chapter 3 pt 1 Flashcards
what is psychosis
general term used to describe distorted perception of reality
delusions, perceptual disturbances (illusions or hallucinations), and/or disorganized thinking/behavior
what can cause psychosis
can be a symptom of: schizophrenia, mania, depression, delirium, and dementia
can be substance or medication- induced
what is a delusion
fixed false beliefs that remain despite evidence to the contrary and cannot be accounted for by the cultural background of the individual
what are two categorized of delusions
bizarre: false belief that is impossible
non-bizzare: false belief that is plausible but is not true
what is a delusion of persecution/paranoid delusions
irrational belief that one is being persecuted
what is a delusion of ideas of reference
belief that cues in the external environment are uniquely related to the individual
delusions of control
thought broadcasting: belief that one’s thoughts can be heard by others
thought insertion: belief that others thoughts care being placed in one’s head
what are delusions of grandeur
bell that one has special powers beyond those of a normal person
what are delusions of guilt
bell that on is guilty or responsible for something
what are somatic delusions
belief that one is infected with a disease or has a certain illness
what are perceptual disturbances
illusions
hallucinations
what is an illusion
misinterpretation of an existing sensory stimulus (such as a shadow for a cat)
what is a hallucination and what types are there
sensory perception without an actual external stimulus auditory (most common) visual olfactory tactile
when does one usually see olfactory hallucinations
epilepsy
when does one usually see auditory hallucinations
schizophrenia
when does one usually see visual hallucinations
schizophrenia (less common than auditory)
drug intoxication
drug and alcohol withdrawal
delirium
when does one usually see tactile hallucinations
drug or alcohol withdrawal
what is the differential diagnosis for psychosis
psychotic disorder due to another medical condition
substance/medication-induced psychotic disorder
delirium/ dementia
bipolar disorder, manic/mixed episode
major depression with psychotic features
brief psychotic disorder
schizophrenia, schizophreniform, schizoaffective disorders
delusional disorder
what are some medical causes of psychosis
CNS disease (MS, CVD, neoplasm, Alzheimers, Parkinson's, Huntingtons, syphilis, temporal lobe epilepsy, encephalitis, prion disease, AIDS, neurosarcodiosis) endocrinopathies (addisons/cushings, hyper/hypothyroid, hyper/hypocalcemia, hypopituitarism) nutritional/vitamin deficient states (B12, folate, niacin)
what is the DSM 5 criteria of psychotic disorder due to another medical condition
prominent hallucinations or delusions
symptoms do not occur only during an episode of delirium
evidence from history, physical, or lab data to support other medical cause
what is a command hallucination
auditory hallucinations that tell people what to do
what are the positive symptoms of schizophrenia
hallucinations delusions bizarre behavior disorganized speech -respond robustly to antipsychotic medications
what are the negative symptoms of schizophrenia
flat or blunted affect anhedonia apathy alogia lack of interest in socialization -more often treatment resistant
what re the cognitive symptoms of schizophrenia
impairments in attention, executive function, and working memory
what re the three phases of schizophrenia
prodromal
psychotic
residual
what is the prodromal phase of schizophrenia
decline in functioning that precedes the first psychotic episode
pt may become socially withdrawn and irritable
may have physical complaints, decline in work/school performance and/or new found interest in religion or cult
what is the psychotic phase of schizophrenia
perceptual disturbances, delusions, and disordered thought process/content
what is the residual phase of schizophrenia
occurs following an episode of active psychosis
marked by mild hallucinations or delusions, social withdrawal, and negative symptoms
what important lab workup should one do if pt complains of delusions and hearing voices
TSH
Rapid plasma reagin (RPR) for syphilis
brain imaging (tumor)
what is the DSM-5 criteria for schizophrenia disorder
-two or more of the following for at least one month:
1. delusions
2. hallucinations
3. disorganized speech
4. grossly disorganized or catatonic behavior
5. negative symptoms
* at least one must be # 1, 2, or 3
-must cause significant social, occupational, or self-care functional deterioration
duration of illness for at least 6 months (including prodromal or residual periods)
-symptoms not due to other medical condition or substances
