Clinical Approach to Psychotic Disorders

Question 1

These types of hallucinations are generally related to zinc.

Answer 1

Gustatory hallucinations

Question 2

What is psychosis?

Answer 2

Impairment in the ability to assess reality

Question 3

How long must symptoms last for a diagnosis of schizophrenia?

Answer 3

6+ months

Question 4

What class of antipsychotics are used to treat patients with both positive and negative symptoms?

Answer 4

Atypical antipsychotics - typical antipsychotics only treat positive symptoms

Question 5

What drugs/substances are known to induce psychosis?

Answer 5

Bath salts, corticosteroids (generally with loading dose)

Question 6

In this psychotic disorder, functioning is generally not impaired, however, patients hold some belief and do not waver even when presented with evidence to the contrary.

Answer 6

Delusional Disorder

Question 7

Patients with schizophrenia generally present with positive and negative symptoms. Which present first?

Answer 7

Negative symptoms

Question 8

True/False. Visual symptoms are reported by nearly all patients with a psychotic disorder.

Answer 8

False - auditory hallucinations are reported by 95% of psychiatric patients

Question 9

Visual hallucinations are generally due to what cause?

Answer 9

Medication/medical-induced psychosis

Question 10

How long do symptoms persist with schizophreniform disorder?

Answer 10

1 month to 6 months

Question 11

What is Schizoaffective disorder?

Answer 11

Baseline of psychosis with periods of mood symptoms, with at least 2+ week periods of psychotic symptoms alone

Question 12

Olfactory hallucinations are most associated with what condition?

Answer 12

Temporal lobe epilepsy

Question 13

What illnesses are known to cause psychosis?

Answer 13

Tertiary syphilis, hypothyroidism, CVA/stroke, traumatic brain injury

Question 14

What are the requirements for schizophrenia diagnosis?

Answer 14

Two or more symptoms (Delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, negative symptoms)

Postmorbid decline

Symptoms of at least 6 months

Question 15

What is the difference between brief psychotic disorder, schizophreniform disorder, and schizophrenia?

Answer 15

Disorder are the same. The only difference is the duration of symptoms.

Brief Psychotic Disorder - 1 day to 1 month

Schizophreniform Disorder - 1 to 6 months

Schizophrenia - 6+ months

Question 16

Physical examination of psychotic patients is generally unremarkable. What finding may be present that supports diagnosis of psychosis?

Answer 16

Nystagmus

Question 17

How long do symptoms persist with brief psychotic disorder?

Answer 17

1 day to 1 month