Psych - Pathology (Psychosis, Schizophrenia, Delusional & Dissociative disorders)

Question 1

What is Psychosis? What are its 3 main characteristics?

Answer 1

A distorted perception of reality (psychosis) characterized by delusions, hallucinations, and/or disorganized thinking

Question 2

Psychosis can occur in patients with what kind of condition(s)?

Answer 2

Psychosis can occur in patients with medical illness, psychiatric illness, or both.

Question 3

What are hallucinations? Give an example.

Answer 3

Perceptions in the absence of external stimuli (e.g., seeing a light that is not actually present)

Question 4

What are delusions? Give an example.

Answer 4

Unique, false beliefs about oneself or others that persist despite facts (e.g., thinking aliens are communicating with you).

Question 5

Describe disorganized speech.

Answer 5

Words and ideas are strung together based on sounds, puns, or “loose associations”

Question 6

What are 7 types of Hallucinations?

Answer 6

(1) Visual (2) Auditory (3) Olfactory (4) Gustatory (5) Tactile (6) HypnaGOgic (7) HypnoPOMPic

Question 7

Of what type of illness are visual hallucinations more commonly a feature? Give an example of such an illness.

Answer 7

More commonly a feature of medical illness (e.g., drug intoxication) than psychiatric illness

Question 8

Of what type of illness are auditory hallucinations more commonly a feature? Give an example of such an illness.

Answer 8

More commonly a feature of psychiatric illness (e.g., schizophrenia) than medical illness

Question 9

What are 2 conditions in which olfactory hallucinations often occur?

Answer 9

Often occur as an aura of psychomotor epilepsy and in brain tumors

Question 10

In what condition are tactile hallucinations common? Give an example. In what other condition are tactile hallucinations also seen?

Answer 10

Common in alcohol withdrawal (e.g., formication - the sensation of bugs crawling on one’s skin). Also seen in cocaine abusers (“cocaine crawlies”).

Question 11

When do hypnagogic hallucinations occur?

Answer 11

hypnaGOgic: Occurs while GOing to sleep

Question 12

When do hypnopompic hallucinations occur?

Answer 12

hypnoPOMPic: Occurs while waking from sleep (Think: “POMPous upon awakening”)

Question 13

Define Schizophrenia.

Answer 13

Chronic mental disorder with periods of psychosis, disturbed behavior and thought, and decline in functioning that lasts > 6 months.

Question 14

What are 2 brain changes associated with Schizophrenia?

Answer 14

Associated with increased dopaminergic activity, decreased dendritic branching.

Question 15

What does diagnosis of Schizophrenia require? Clarify positive versus negative symptoms.

Answer 15

Diagnosis requires 2 or more of the following (first 4 in this list are “positive symptoms”): (1) Delusions (2) Hallucinations - often auditory (3) Disorganized speech (loose associations) (4) Disorganized or catatonic behavior (5) “Negative symptoms” - flat affect, social withdrawal, lack of motivation, lack of speech or thought

Question 16

What distinguishes Brief psychotic disorder (from Schizophrenia)?

Answer 16

Brief psychotic disorder - <1 month, usually stress related

Question 17

What distinguishes Schizophreniform disorder (from Schizophrenia)?

Answer 17

1-6 months

Question 18

To what is Brief psychotic disorder usually related?

Answer 18

Usually stress related

Question 19

What distinguishes Schizoaffective disorder (from Schizophrenia)?

Answer 19

At least 2 weeks of stable mood with psychotic symptoms, plus a major depressive, manic, or mixed (both) episode.

Question 20

What are the 2 subtypes of Schizoaffective disorder?

Answer 20

2 subtypes: (1) Bipolar or (2) Depressive

Question 21

What factors in general contribute to the etiology of Schizophrenia?

Answer 21

Genetics and environment contribute to the etiology of Schizophrenia

Question 22

Frequent use of what substance is associated with psychosis/schizophrenia in teens?

Answer 22

Frequent cannabis use is associated with psychosis/schizophrenia in teens.

Question 23

What if the lifetime prevalence of Schizophrenia? How does this differ by gender and race?

Answer 23

Lifetime prevalence - 1/5% (males = females, blacks = whites)

Question 24

How does age of presentation of Schizophrenia differ by gender?

Answer 24

Presents earlier in men (late teens to early 20s vs. late 20s to early 30s in women)

Question 25

For what are Schizophrenia patients at an increased risk?

Answer 25

Patients are at increased risk for suicide.

Question 26

Define Delusional disorder. Give an example.

Answer 26

Fixed, persistent, untrue belief system lasting > 1 month. Functioning otherwise not impaired; Example: a woman who genuinely believes she is married to a celebrity when, in fact, she is not.

Question 27

What are 2 types of Dissociative disorders?

Answer 27

(1) Dissociative identity disorder (2) Depersonalization/Derealization disorder

Question 28

What was Dissociative identity disorder formerly known as?

Answer 28

Formerly known as multiple personality disorder.

Question 29

What is Dissociative identity disorder (Multiple personality disorder)?

Answer 29

Presence of 2 or more distinct identities or personality states

Question 30

In which gender is Dissociative identity disorder more common?

Answer 30

More common in women.

Question 31

What are 6 conditions associated with Dissociative identity disorder?

Answer 31

Associated with history of (1) sexual abuse, (2) PTSD, (3) depression, (4) substance abuse, (5) borderline personality, and (6) somatoform conditions.

Question 32

What is Depersonalization/Derealization disorder?

Answer 32

Persistent feelings of detachment or estrangement from one’s own body, thoughts, perceptions, and actions (depersonalization) or one’s environment (derealization)