Psychosis - 1 Flashcards
schizo in short?
impairment in reality testing
&
Alteration in behaviours
Mnemonic for schizophrenia in ICD 11?
S. P. L. I. T.
Essential features of Schizophrenia in ICD 11?
S. P. L. I. T.
S. Symptoms (positives & negatives)
P-Peception, passivity and purposelss behaviorus (psychomotor disturbances)
L- Loss of reality
I- Identity disturbance
T- Thought Disorder
4 main symptoms in schizo 1 of which has to be present to meet the ICD criteria?
Persistant delusion
Persistant Hallucination
Passivity
Disorganized thought
Negative symptoms in schizophrenai?
Affective flattening
Anhedonia
Avolition
Apathy
Asociality
Flat mood
paucity of speech (or alogia)
how long ICD 11 especifies Schizo symptoms to be present
1 months or more
psychomotor disturbances in schizophrenia?
catatnonic
what are catatonic psychomotor disturbances in schizophrenia?
reslessness
agitation
negativism
mutism
posturing
waxy flexibility
stupor
what if full catatonic syndrom was present in patient dx with schizophrenia?
dx will change to catatonia associated with another mental disordered
most common features in schizophrenia?
LAIDS
Lack of insgiht 97%
Auditory hallucination 74%
Idea of reference 70%
Delusion of reference 67%
Suspiciousness 66%
prevalence of flatness of affect in schizophrenia?
66%
most common + symptom in schizo?
lack of insight 97%
how schizoaffective disorder is diagnosed in ICD 11?
all schizo criteria met
in addition to…
All criteria for moderate to severe major depression, mania or mixed mania
for at least 1 months
what is said in ICD 11 about depressive symtpms in schizoaffective disorder?
depressive symptoms must include depressed mood not just reduced interest
can mood and psychotic symptoms happen simultaneously in schizoaffective disorder, acc. ICD 11?
yes
how shchizotypal disorder is diagnosed in ICD 11 in simple terms?
same schizophrenia symptoms but not enought to med diagnostic criteria for schizophrenia, schizoaffective or delusional disorder
mnemonic for schizotypal disorder?
COP
C- Constricted affect (Cold)
O-Odd behaviours, speech(Vague), thoughts (disorganized)
P- Poor rapport, Parania
How long ICD 11 required schizotypal to be present?
at least 2 years
Essential features for acute and transient psychotic disorder IN ICD 11?
psychotic symptoms w/out a prodrome
Within 2 weeks (rapid onset)
Change in intensity rapidly
No negative symptoms
Not exceeding 3 months
Last few days to 1 month
Another condition very similar to acute psychosis
bouffee delirante
Diagnostic features for delusional disorder in ICD 11 ?
- Delusion or set of related delusions
- for at least 3 months
- absence of depressive, manic or mixed episode.
-no hallucinations or clear ones
-no affect, attitude or speach symptoms
usual delusion themes in delusional disorder?
remarkable stability
evolve over time maybe
Persecutory, somatic, grandiose, jealous and erotomania
What is psychotic depression?
- presence of delusion and or hallucination in addition to depressive symptoms
what are depressive symptoms in pschotic depression?
- Anhedonia
- Loss of interest
- Psychomotor retardation
what hallucination and delusions themes in psychotic depression?
- Worthlessness
-Guilt
-Disease
-Impending Disaster
of all depression cases, how many are psychotic depression?
14-18%
True or false?
Psychotic depression is more prevalence in elderly?
True (1-3%)
True or False
Psychotic depression is more commonly associated with suicidalityy?
True
Difference between ICD 11 and DSM 5 to dx psychotic depression?
ICD 11 requires depressive symptoms to be moderate to severe…DSM 5 accepts all severities
1st line treatment in psychotic depression? Mausdley
TCAs (like amitriptyline) )with antipsychotic augmentation
2nd line of Rx in Psychotic depression Mausdley
SSRI/SNRIw
what antipsychotics can you use in augmentation with TCAs?Mausdley
olan or quetiapine
where would one consider ECT in Rx for pscyhotic depression?Mausdley
IF rapid response is needed
other Rx fail
So, what is recommended medication in psychotic depression?
TCA + Antipsychotic (olan or que)
Puerperal psychosis should be thought of as a type of……?
bipolar in dsm 5
what is the incidence of puerperal psychosis?
1-2/ 1000 pregnancies
onset of puerporal psychosis?
day 2- 14 usually
almost all in first 8 weeks
Risk of puerperal psychosis
-Parity (highest in 1st child)
-Hx of Psych disorder
-Family Hx (1st or 2nd cousin) of affective psychosis
Rx of puerperal psychosis
antipsychotic
Risk for postpartum psychosis (puerperal psychosis)
family history of mood disorders
Responsiveness of Puerperal psychosis
very responsive
recurrence is common
impact of hormones in postpartum depression and psychosis?
fluctuation of aestrogen and progesterone may cause them
Indication for life-long treatment in schizophrenia?
History of aggressive behaviour
Serious suicide attempts
Those with residual psychotic symptoms
