Psychosis Flashcards
what is psychosis
descriptive term - difficulty perceiving and interpreting reality
what are the different psychotic disorders
schizoaffective disorder bipolar 1 depression with psychotic features substance related delusional disorder schizophrenia due to other medical condition
positive symptoms of psychosis
hallucinations - auditory, voices commenting, voices talking to each other, visual, somatic, olfactory
delusions - fixed, false beliefs out of keeping with social/cultural background: persecutory, control, reference, mind reading, grandiosity, religious, guilt/sin,
negative symptoms of psychosis
alogia - poverty of speech
anhedonia - few close friends, few hobbies/interests
avolition/apathy - poor self care and motivation
affective flattening - poor eye contact, unchanging facial expression
what are the disorganisation symptoms of psychosis
bizarre behaviour - aggression/agitation, bizarre social behaviour/ clothing/ appearance
thought disorder - derailment, circumstantial speech, pressured speech, distractibility, incoherent speech
typical age of onset of psychosis
can occur at any age
peak incidence in early 20s
peak later in women
morbidity of psychosis
substantial, both from disorder itself and increased risk of common health problems e.g heart disease
significant impact on education, employment and functioning
mortality of psychosis
substantial
all cause mortality 2.5 x higher
~ 15 yrs life expectancy lost
high risk of suicide in schizophrenia
contents of a psychiatric history
history of pc past psych history background - family, personal, social past medical history and meds corroborative history
what is included in history of presenting problem
nature, severity, onset, course, worsening factors, treatment received
what is the corroborative history
comparing with info from informants: relatives, friends, authority
confidentiality
need for consent!
what are the factors you look at during mental state examination
appearance and behaviour speech mood thoughts perceptions cognition insight
what should you look out for in appearance and behaviour
neglect - indicative of alcoholism, drug addiction, dementia, depression, schizophrenia
weight loss - anorexia nervosa, depression, cancer, hyperthyroidism, financial issues, homelessness
facial expression - depressive, anxious, wooden parkinsonism?
hunched shoulders, downcast head and eyes = depressive
sitting upright, head erect, hands gripping chair - anxious
what is insight
awareness of oneself as presenting phenomena that other people consider abnormal
recognition that these phenomena are abnormal
acceptance that abnormal phenomena are caused by mental illness
awareness that treatment is required
acceptance of specific treatment recommendations
3 ways to manage psychosis
pharmacological
psychological
social support
