Kap 5. Psychotic disorders Flashcards
Definition of Psychosis
A condition with a loss/disconnect of reality and interpreting environment, thoughts and experiences
It can be normal to have different interpretations, but when it affects ADL functioning its a problem!
What are the diagnoses under Psychotic disorders?
- Schizophrenia
- Schizoaffective disorder
- Schizotypal disorder
- Acute and transient psychotic disorder
- Delusional disorder
- Substance induced psychotic disorders
What is Delusional disorder?
Individual or connected Delusions
No hallucinations
Often long lasting
What is the most important take away from the chapter of psychotic disorders?
Psychosis is a continuum!
What is Acute and transient psychotic disorder?
Quick onset
It usually fades away over several days or weeks. It should not exceed 3 months. They are usually fully psychotic
What is Schizotypal disorder?
It is a personality disorder that is seen as a form of or a precurser to Schizophrenia
weird speech
anhedonia
weird thinking
difficulties socially (which can make them depressed)
Although it is a personality disorder is it classified in the ICD-11 under the psychotic disorders
What is Schizoaffective disorder?
It is Schizophrenia mixed together with a mood disorder
Often episodic
It is rather a diagnosis which describes the current state -> When the person has a mood episode, they get this diagnosis. When they are later schizophren, without mood episode, they will get normal schizoprenia.
Substance induced psychosis
This can be triggered by consumption of a substance or by withdrawal
Requirements for diagnosis of Psychosis
Lasting at least 1 month
Impaired functioning
No other causes
What are the typical symptoms of Psychosis?
Positive Symptoms:
Hallucinations, Delusions, Disorganized thinking
Negative Symptoms:
Apathy, emotional/social disengagement, missing motivation, happiness, interest
All this in a cultural lense
What can be used to diagnose Psychosis?
SCID-I
MINI
What is important with Psychosis to get better outcomes?
An early diagnosis and treatment, can prevent it from going chronic and can reduce symptoms.
What are risk factors for psychosis?
Biological factors
Social factors
Environmental factors
What are Biological risk factors for psychosis?
Genes for dopamine/glutamat receptors
Big ventricles
Less active prefrontal cortex
Late maturity
Nutritional deficiencies
Stress during late pregnancy
What are social risk factors for Psychosis?
- Being bullied
- Serious childhood trauma
- General stress (Migrant background, racial discrimination)
What are environmental risk factors for psychosis?
THC consumption (50% of diagnosed were users)
Amphetamines
Growing up in a city
Immigration background
How can psychosis be treated?
With a good aliance
Using the Family (Expressed Emotion)
What is Expressed Emotion therapy?
It is a family based therapy, for the client that is psychotic.
Here the central theme is, that the family expresses their negative emotions towards the person less and focuses more on the positive emotions. This has a big impact on the course of the disease
Which type of medication is used for Psychosis?
Antipsychotics (neuroleptics)
What are the two generations of Antipsychotics?
- Generation (Typical):
Block D2-Dopamine receptors - Generation (Atypical):
Block D2-Dopamine and Serotonin receptors
Antipsychotics give symptoms of another disease, which one and why?
Parkinsons disease, which is characterized by missing dopamine!
What can be another negative side effect of psychosis relapse?
Whent the patient relapsed while on medication (maybe taking it inconsequently) the medication usually becomes less effective for the person.
Which is why injectables are better for people, so they do not forget to take their medication, which can often be a reason for why they might relapse
Which types of hallucinations happen?
Auditive (60-70% of psychotic patients)
All other senses (taste, feeling, seeing)
What is the difference between Psychosis and Schizophrenia?
Psychosis is a symptom characterized by a disconnection from reality
Schizophrenia is a psychiatric disorder encompassing a range of symptoms, including psychosis, cognitive impairments, and disruptions in social functioning.
