Comps - Psychopathology (Subdomain 3)

Question 1

What is the definition of psychosis? (APA, 2013)

Answer 1

Impaired reality testing characterized by delusions, hallucinations, and disordered thinking (the specific symptoms differ depending on the disorder)

Question 2

What are some limits to the current definition? (Tandon, 2016)

Answer 2

1. Unclear boundaries between other disorders (e.g., between psychotic bipolar disorder, schizoaffective disorder, and schizophrenia)
2. Clinical heterogeneity of psychotic disorder
3. Comorbidity with mood disorders
4. Undefined relationship between subclinical phenomena in general population and defined psychotic disorders

Question 3

What is reality testing? (Tsola & Anastassiou-Hadjucharalmbous, 2012)

Answer 3

-The process during which the real world and one’s relationship to it are reflected on and evaluated
-It is recognizing the internal world from the external world
-Hallucinations and delusions mark a loss of contact with reality

Question 4

Primary Psychosis (Tsola & Anastassiou-Hadjucharalmbous, 2012)

Answer 4

Direct relationship/organic basis (e.g., schizophrenia and related disorders)

Question 5

Secondary Psychosis (Tsola & Anastassiou-Hadjucharalmbous, 2012)

Answer 5

A byproduct of something else (e.g., psychosis from a medical condition or drugs)

Question 6

What are signs of potential secondary psychosis? (Tsola & Anastassiou-Hadjucharalmbous, 2012)

Answer 6

1. Lack of family history of psychosis
2. No prior episodes
3. Nonauditory hallucinations
4. Acute onset
5. Age of onset in 30s
6. Co-existing deficient syndromes (e.g., dementia, amnesia, delirium, aphasia)

Question 7

What to consider when differentiating between primary psychosis from mental disorders with psychotic features? (APA, 2013)

Answer 7

-If hallucinations and delusions only occur within a mood episode, then it is more likely to be MDD with psychotic features of BP1/2, NOT schizophrenia, schizophreniform, or brief psychotic disorder
-If the person does not have the 2-week period of positive symptoms in the absence of a major mood episode, it might be MDD with psychotic features or BP1/2, NOT schizoaffective disorder