Other Psychotic Disorders* Flashcards
What is the disorder where schizophrenia is present but less than 1 month
brief psychotic disorder
Schizophrenia for 1-6 months
schizophreniform disorder
psychosis with another probable cause
secondary psychotic disorder
schizophrenia and a mood disorder, too
schizoaffective disorder
delusions, but no other psychotic symptoms
delusional disorder
What is the criteria for brief psychotic disorder?
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
What is the epidemiology of brief psychotic disorder?
Rare
What is the etiology of brief psychotic disorder?
stressful life events
immigrant status
postpartum period
Unclear exact etiology
Diagnostic clues to the presence of brief psychotic disorder
presence of marked stressor before symptom onset
lack of negative symptoms
confusion during course of illness
duration <1 months
How is brief psychotic disorder treated?
May try antipsychotic medication
may not work in time
What is the criteria for schizophreniform disorder?
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
What is the epidemiology of schizophreniform disorder?
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
What are diagnostic clues for schizophreniform disorder?
duration >1 month, <6 months
What is treatment of schizophreniform disorder?
Antipsychotic medication- second generation preferred
Hospitalization often required
psychotherapy
What is the criteria for secondary psychotic disorder?
1+ psychotic symptom
Determined to be secondary to another condition
Another condition ie medical conditions, psychological disease, substance use
What medical disorders could cause secondary psychotic disorder?
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
What substances can cause secondary psychotic disorder?
Alcohol or cannabis
Sedatives/Hypnotics
cocaine or stimulants
LSD, MDMA, phencyclidine
Prescriptions: fluoroquinolones, high-dose antihistamines, etc
What are diagnostic clues to the presence of secondary psychotic disorder?
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
What is the treatment of secondary psychotic disorder?
Correction of underlying cause
May use antipsychotic medication, sedatives if agitated
Psychotherapy
What is the criteria for schizoaffective disorder?
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
What is the epidemiology/etiology of schizoaffective disorder?
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
What are diagnostic clues for schizoaffective disorder?
meet criteria of mood disorder as well as schizophrenia
What is treatment of schizoaffective disorder?
antipsychotic medication
antidepressants and mood stabilizers are adjunct
What is delusional disorder?
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
What are subtypes of delusional disorder?
Erotomanic type, gradiose type, jealous type, persecutory type, somatic type, mixed type
Delusional disorder with delusions that another person, usually of higher status, is in love with you
Erotomanic type
Delusional disorder with delusions of inflated worth, power, knowledge, identity, or special relationship to a deity or famous person
Grandiose type delusional disorder
What is epidemiology/etiology of delusional disorder?
epidemiology: rare, .03%
Etiology: unknown
What are diagnostic clues that delusional disorder is present?
persistent, isolated delusion
no other evidence of psychosis
preserved overall functioning
What is treatment of delusional disorder?
antipsychotics, especially atypical antipsychotics
2/3 of patients recover or improve significantly
often difficult to get patient to take medication
Delusional disorder with delusions that the patient’s sexual partner is unfaithful
Jealous type delusional disorder
Delusional disorder with delusions that the patient is being malevolently treated in some way
Persecutory type delusional disorder
Delusional disorder with delusions that the patient has some physical defect or general medical condition
Somatic type delusional disorder
Delusional disorder with delusions characteristic of more than one of the other types but no one theme predominates?
Mixed type delusional disorder
