Psych PACES Flashcards
Specific delusional disorders
Fregoli - different people are in fact a single person who changes appearance or is in disguise, can be related to brain lesion
Cotard syndrome = nihilistic delusion that body is rotting away/patient is dead (seen in severe depression)
Folie a deux = shared delusion/hallucinations between people
Capgras = believing a close acquaintance has been replaced by an identical imposter
Erotomonia / De Clerembault’s syndrome = excessive sexual desire, often believing a celebrity is in love with them
Othello syndrome /delusional jealousy = belief that partner is being unfaithful
Factitious disorder / Munchausen = consciously pretending they have a medical illness (NOT malingering) due to satisfaction in taking a sick role.
Munchausen By proxy = intentional abuse of another individual (often, child) to be able to care for them
Ekbom’s syndrome = somatic delusion, belief that patient is infested with parasites, accompanied by tactile hallucinations
Dementia/Memory Assessment Tools
Screening:
AMTS - <7 suggests cognitive impairment – less sensitive & specific
GPCOG
6CIT
Detailed:
Addenbrooke’s (ACE-R) - 100-point score covering language, memory etc.
MMSE
MoCA - now copyrighted
Organic Dementia Screen
(+ Memory assessment)
Initial Screen: FBC, ESR, U&E, TFTs, HbA1c, B12 & Folate, LFTs, Ca2+, fasting glucose & lipids, VDRL
- Syphilis, HIV serology (if relevant)
- MSU –> exclude delirium (from UTI)
- CXR, ECG
Key Dementia Subtypes & Symptoms
Alzheimer’s - progressive decline (+ family Hx)
Vascular - sudden stepwise decline, emotional lability, + Hx vascular RF/disease
Lewy body - hallucinations, Parkinsonism Sx, Falls, short-term memory OK
Frontotemporal - disinhibition, emotional blunting, hyperorality
Huntington’s - mood changes before memory & motor