Other Psychotic Disorders*

Question 1

What is the disorder where schizophrenia is present but less than 1 month

Answer 1

brief psychotic disorder

Question 2

Schizophrenia for 1-6 months

Answer 2

schizophreniform disorder

Question 3

psychosis with another probable cause

Answer 3

secondary psychotic disorder

Question 4

schizophrenia and a mood disorder, too

Answer 4

schizoaffective disorder

Question 5

delusions, but no other psychotic symptoms

Answer 5

delusional disorder

Question 6

What is the criteria for brief psychotic disorder?

Answer 6

1+ psychotic symptom (delusion, hallucinations, disorganized speech, disorganized or catatonic behavior)
acute onset
episode is at least 1 day but less than a month and eventually there is a return to premorbid level of functioning

not due to substance use or another psychological disorder

Question 7

What is the epidemiology of brief psychotic disorder?

Answer 7

Rare

Question 8

What is the etiology of brief psychotic disorder?

Answer 8

stressful life events
immigrant status
postpartum period

Unclear exact etiology

Question 9

Diagnostic clues to the presence of brief psychotic disorder

Answer 9

presence of marked stressor before symptom onset
lack of negative symptoms
confusion during course of illness
duration <1 months

Question 10

How is brief psychotic disorder treated?

Answer 10

May try antipsychotic medication

may not work in time

Question 11

What is the criteria for schizophreniform disorder?

Answer 11

2+ psychotic symptoms
symptoms >1 month but <6 months
more rapid onset than classic schizophrenia

not better accounted for by substance use of another psychological disor

Question 12

What is the epidemiology of schizophreniform disorder?

Answer 12

most go on to be diagnosed with schizophrenia
some recover fully
Good prognostic indicators include acute onset, brief prodrome, good premorbid functioning, prominent mood symptoms

Question 13

What are diagnostic clues for schizophreniform disorder?

Answer 13

duration >1 month, <6 months

Question 14

What is treatment of schizophreniform disorder?

Answer 14

Antipsychotic medication- second generation preferred
Hospitalization often required
psychotherapy

Question 15

What is the criteria for secondary psychotic disorder?

Answer 15

1+ psychotic symptom
Determined to be secondary to another condition

Another condition ie medical conditions, psychological disease, substance use

Question 16

What medical disorders could cause secondary psychotic disorder?

Answer 16

Neuro
Endocrine
Metabolic
Hepatic or renal Impairment
autoimmune

Pay attention to these because of clinical scenarios

Neuro: CNS infections, cancer, vascular events, cognitive disease, porphyria, seizures
Endocrine: thyroid, parathyroid, or adrenal disease
Metabolic: hypoxia, hypercarbia, hypoglycemia, fluid or electrolyte imbalance, and abnormal copper clearance
Autoimmune: SLE

Question 17

What substances can cause secondary psychotic disorder?

Answer 17

Alcohol or cannabis
Sedatives/Hypnotics
cocaine or stimulants
LSD, MDMA, phencyclidine
Prescriptions: fluoroquinolones, high-dose antihistamines, etc

Question 18

What are diagnostic clues to the presence of secondary psychotic disorder?

Answer 18

Presence of another disorder that could be a plausible cause, improving in psychotic symptoms with improvement of underlying cause
Can be substance related or psych related

difficult to diagnose if has substance

Question 19

What is the treatment of secondary psychotic disorder?

Answer 19

Correction of underlying cause
May use antipsychotic medication, sedatives if agitated
Psychotherapy

Question 20

What is the criteria for schizoaffective disorder?

Answer 20

Meet criteria for schizophrenia and major mood disorder
Both symptoms are prominent
At least one 2 week period where hallucinations and/or delusions are present in the absence of a prominent mood episode

not due to direct effects of a substance or a general medical condition

Question 21

What is the epidemiology/etiology of schizoaffective disorder?

Answer 21

Epidemiology: <1%
Etiology: Bipolar- more likely to have family history and usually have better outcome than depressive
Depressive: may have family history of affective disorder, more likely to have history of psychotic disorder, worse outcomes
Both-better prognosis than schizophrenia without mood symptoms

Question 22

What are diagnostic clues for schizoaffective disorder?

Answer 22

meet criteria of mood disorder as well as schizophrenia

Question 23

What is treatment of schizoaffective disorder?

Answer 23

antipsychotic medication
antidepressants and mood stabilizers are adjunct

Question 24

What is delusional disorder?

Answer 24

Isolated delusions in an otherwise high-functioning person for at least 1 month
Generally no other psychotic symptoms

Typically non-bizarre delusions ie followed, poisoned, infected, deceive

no other medical condition/substance use

Question 25

What are subtypes of delusional disorder?

Answer 25

Erotomanic type, gradiose type, jealous type, persecutory type, somatic type, mixed type

Question 26

Delusional disorder with delusions that another person, usually of higher status, is in love with you

Answer 26

Erotomanic type

Question 27

Delusional disorder with delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person

Answer 27

Grandiose type delusional disorder

Question 28

What is epidemiology/etiology of delusional disorder?

Answer 28

epidemiology: rare, .03%
Etiology: unknown

Question 29

What are diagnostic clues that delusional disorder is present?

Answer 29

persistent, isolated delusion
no other evidence of psychosis
preserved overall functioning

Question 30

What is treatment of delusional disorder?

Answer 30

antipsychotics, especially atypical antipsychotics
2/3 of patients recover or improve significantly

often difficult to get patient to take medication

Question 31

Delusional disorder with delusions that the patient’s sexual partner is unfaithful

Answer 31

Jealous type delusional disorder

Question 32

Delusional disorder with delusions that the patient is being malevolently treated in some way

Answer 32

Persecutory type delusional disorder

Question 33

Delusional disorder with delusions that the patient has some physical defect or general medical condition

Answer 33

Somatic type delusional disorder

Question 34

Delusional disorder with delusions characteristic of more than one of the other types but no one theme predominates?

Answer 34

Mixed type delusional disorder