Psychosis Flashcards
What is the differentials of Psychosis?
What are the extrapyramidal Symptoms (EPS)?
inability to sit still, involuntary muscle contraction, tremors, stiff muscles, and involuntary facial movements
(EPSEs:akathisia, dystonia, parkinsonism, tremor).
What is pre-psychotic episode?
Early or first-episode psychosis (FEP) refers to:
when a person first shows signs of beginning to lose contact with reality
What do these terms means?
Prodromal phase
First psychotic episode
Recurrent psychotic episodes
((Prodromal phase)):
Attenuated psychotic symptoms, mood/anxiety symptoms, cognitive decline, and cortical loss in those who convert to psychosis.
((First psychotic episode)):
Delusions, hallucinations, bizarre behaviour. Excellent treatment response in most patients, and full remission is possible with full medication adherence.
((Recurrent psychotic episodes)):
Progressive deterioration and longer time to response. Treatment resistance develops, serious loss of functioning, suicide risk becomes significant.
Stages of Schizophrenia?
What are the core features of schizophrenia?
Inability to distinguish reality from fantasy
Impaired reality-testing with creation of a new reality
Characterized by:
- Delusions
- Hallucinations
- Disorganized thinking
- Abnormal motor behavior:
- childlike“silliness”
- unpredictable agitation
- catatonia (marked decrease in reactivity to the environment)
- Negative symptoms
What are the “negative symptoms” of Schizophrenia?
Diminished emotional expression: (reductions in the expression of emotions in face, eye contact, intonation of speech and movements)
Avolition:
(decrease in self-initiated purposeful activities, and lack of motivation)
Alogia:
(diminished speech output)
Anhedonia:
(inability to experience pleasure from positive stimuli)
Asociality:
(apparent lack of interest in social interactions)
What are the examples of the core feature of schizophrenia: Disorganized thinking (speech)?
Thoughts not connected in any coherent or logical manner.
Flight of ideas; switches quickly from one idea to another.
Circumstantiality; long-winded, delayed reaching goal.
Blocking; thoughts suddenly stopped.
Neologisms; new words.
Echolalia; repeating own or others words.
Echopraxia; repeating actions/movements.
Derailment or loose associations; switch from one topic to another.
“We’ve seen the downfall of the radium crown by the Roman Catholics, where as when you come to see the drinking side of the business, God saw that Noah, if he lost his reason, he got nobody there to look after them.”
What core feature of schizophrenia this example is?
Disorganized thinking (speech):
Thoughts not connected in any coherentor logicalmanner
“What is your name?”
“Well, sometimes when people ask me that I have to think about whether or not I will answer because some people think it’s an odd name even though I don’t really because my mom gave it to me and I think my dad helped but it’s as good a name as any in my opinion, I think it’s a little weird to have the same name as two of my other names, but the fact that I like it, is a good thing… but yeah, it’s Tom.”
What core feature of schizophrenia this example is?
Disorganized thinking (speech):
Circumstantiality; long-winded, delayed reaching goal.
“Many mouldy mushrooms merge out of the mildew mud on Mondays.” “I heard the bell. Well, hell, then I fell.”
What core feature of schizophrenia this example is?
Disorganized thinking (speech):
Clanging; sounds, rather than meaningful relationships, appear to govern words or topics. Excessive rhyming, and/or alliteration.
What is the diagnostic criteria of schizophrenia based on DSM-5?
Have a look at the classification of Schizophrenia
Have a look at the differentials of Schizophrenia
Have a look at COURSE OF ILLNESS
Have a look at prognosis
What is the treatment of psychosis?
Clozapine:
Patients have FBC (full blood count) monitored weekly for first 18 weeks, then 2 weeks for rest of year, 4 weeks for ever after
Have a look
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