Mehl. Psychotic disorders + commonly confused conditions 04-06 (1)

Question 1

Psychotic. Schizophrenia.
Four points for diagnosis!

Answer 1

.

Question 2

Psychotic. Schizophrenia. 1. duration?

Answer 2

1) At least 6 months in duration

Question 3

Psychotic. Schizophrenia.
2) Two or more of the following:
- Hallucinations (always auditory on USMLE; hearing voices that aren’t there).
- Delusions (false beliefs; can be “bizarre,” which refers to stuff like demons, aliens, and “the lord”).
- Disorganized speech (often nonsensical or muffled speech).
- Disorganized or catatonic behavior.
- Negative symptoms (flattened/blunted affect, anhedonia [inability to feel pleasure], diminished speech).

Answer 3

.

Question 4

Psychotic. Schizophrenia.
2) Two or more of the following:
…..
- Delusions (false beliefs; can be “bizarre,” which refers to stuff like demons, aliens, and “the lord”).
- Disorganized speech (often nonsensical or muffled speech).
- Disorganized or catatonic behavior.
- Negative symptoms (flattened/blunted affect, anhedonia [inability to feel pleasure], diminished speech).

Answer 4

• Hallucinations (always auditory on USMLE; hearing voices that aren’t there).

Question 5

Psychotic. Schizophrenia.
2) Two or more of the following:
- Hallucinations (always auditory on USMLE; hearing voices that aren’t there).
…..
- Disorganized speech (often nonsensical or muffled speech).
- Disorganized or catatonic behavior.
- Negative symptoms (flattened/blunted affect, anhedonia [inability to feel pleasure], diminished speech).

Answer 5

• Delusions (false beliefs; can be “bizarre,” which refers to stuff like demons, aliens, and “the lord”).

Question 6

Psychotic. Schizophrenia.
2) Two or more of the following:
- Hallucinations (always auditory on USMLE; hearing voices that aren’t there).
- Delusions (false beliefs; can be “bizarre,” which refers to stuff like demons, aliens, and “the lord”).
….
- Disorganized or catatonic behavior.
- Negative symptoms (flattened/blunted affect, anhedonia [inability to feel pleasure], diminished speech).

Answer 6

• Disorganized speech (often nonsensical or muffled speech).

Question 7

Psychotic. Schizophrenia.
2) Two or more of the following:
- Hallucinations (always auditory on USMLE; hearing voices that aren’t there).
- Delusions (false beliefs; can be “bizarre,” which refers to stuff like demons, aliens, and “the lord”).
- Disorganized speech (often nonsensical or muffled speech).
….
- Negative symptoms (flattened/blunted affect, anhedonia [inability to feel pleasure], diminished speech).

Answer 7

• Disorganized or catatonic behavior.

Question 8

Psychotic. Schizophrenia.
2) Two or more of the following:
- Hallucinations (always auditory on USMLE; hearing voices that aren’t there).
- Delusions (false beliefs; can be “bizarre,” which refers to stuff like demons, aliens, and “the lord”).
- Disorganized speech (often nonsensical or muffled speech).
- Disorganized or catatonic behavior.
….

Answer 8

• Negative symptoms (flattened/blunted affect, anhedonia [inability to feel pleasure], diminished speech).

Question 9

Psychotic. Schizophrenia.
3) what about social?

Answer 9

3) Must have socio-occupational dysfunction (i.e., significant impairment in work, interpersonal relationships, or self-care).

Question 10

Psychotic. Schizophrenia.
4. not attributed to what?

Answer 10

4) Not attributed to a mood disorder (i.e., depression or bipolar), substance use, or another medical condition.

Question 11

Psychotic. Schizophrenia.
USMLE can give you a massive vignette where they describe a guy with mixed schizotypal (magical thinking) and schizoid (reclusive) qualities, and then they want to know what he’s at ­ risk for, and the answer is just schizophrenia.

Answer 11

.

Question 12

Psychotic. Schizophreniform.
definition/duration?

Answer 12

Same as schizophrenia but 1-6 months in duration.

Question 13

Psychotic. Brief psychotic disorder.
definition/duration?

Answer 13

Same as schizophrenia but <1 month in duration

Question 14

Confused conditions. Schizoaffective. definition/duration?

Answer 14

At least two weeks of psychosis without a mood disorder (i.e., neither depression nor mania/hypomania), followed by periods of time with simultaneous psychotic and mood disorder.

Question 15

Confused conditions.

At least two weeks of psychosis without a mood disorder (i.e., neither depression nor mania/hypomania), followed by periods of time with simultaneous psychotic and mood disorder. Dx?

Answer 15

Schizoaffective.

Question 16

Confused conditions.
For example, the Q will say a college student has been hearing voices for the past 6 weeks + has been staying up all night for the past month (i.e., 4 weeks of mania or hypomania + at least 2 weeks of psychosis alone). Dx?

Answer 16

Schizoaffective.

Question 17

Confused conditions. Schizoaffective.
- The name of the condition starts with “schizo,” so you can remember that psychosis is the baseline of the disorder (i.e., what the patient will have as his/her underlying baseline). Then the mood disorder spikes on top of it.

Answer 17

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Question 18

Confused conditions. Schizoaffective.
Mehl. schema.
Baseline psychosis -> pasibaigia -> tada po kurio laiko spike of depresion –> pasibaigia –> po kurio laiko spike of mania.

Answer 18

.

Question 19

Confused conditions. Depression with psychotic features.
CP?

Answer 19

Depression, rather than psychosis, is the baseline. The patient will have periods of time in which he/she only experiences major depression without any type of psychosis. Then the psychosis periodically spikes on top of the depression.

Question 20

Confused conditions. Depression with psychotic features. Mehl. schema.

Baseline depression -> spike of psychosis –> po kiek laiko naujas epizodas spike of psychosis

Answer 20

.

Question 21

Confused conditions. Bipolar with psychotic features. definition?

Answer 21

Bipolar is the baseline, where the patient will have periods of either depression or mania alone, followed by psychosis spiking on top of it.

Question 22

Confused conditions. Bipolar with psychotic features.

If the patient has periods of mania alone followed by a simultaneous spike of psychosis, this makes the diagnosis easier.

Answer 22

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Question 23

Confused conditions. Bipolar with psychotic features.
If the patient has a period of depression alone followed by spiking psychosis, it can appear like depression with psychotic features, except the patient will ALSO have a history of at least one manic episode in the past.

Answer 23

.

Question 24

Confused conditions. Bipolar with psychotic features.
Mehl. schema.
Baseline yra bipolar -> epizodas of psychosis (gali but arba per bipolar manijos arba depresijos busena) –> po kiek laiko vel psichozes epizodas

Answer 24

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