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Y2 PSYCHIATRY > Psychosis > Flashcards

Psychosis Flashcards

1
Q

Define psychosis

A

difficulty perceiving and interpreting reality

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2
Q

list some Psychotic disorders

A

schizoaffective disorder, bipolar, schizophrenia, depression with psychotic features, delusional disorder

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3
Q

What are the three symptom domains in psychosis?

A

positive symptoms, negative symptoms, disorganisation

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4
Q

what are the positive signs associated with psychosis?

A

hallucinations and delusions

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5
Q

what are the negative signs associated with psychosis?

A

alogia, apathy, anhedonia, affective flattening

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6
Q

what is alogia?

A

“poverty of speech”

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7
Q

what is anhedonia?

A

reduced ability to experience pleasure

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8
Q

what is affective flattening?

A

lack of emotional response to the given situation

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9
Q

what are the disorganisation symptoms associated with psychosis?

A

bizarre behaviour and thought disorder

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10
Q

define thought insertion

A

belief that thoughts are placed in ones head

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11
Q

define thought broadcasting

A

belief that ones thoughts can be heard by others

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12
Q

Define thought withdrawal

A

belief that others are taking thoughts out of ones head

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13
Q

What classes as thought disorder?

A

derailment, circumstantial speech, pressure speech, distractibility, incoherent/ illogical speech

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14
Q

what is meant by the term derailment in the context of psychosis?

A

A person who experiences derailment uses words and phrases that have a loose association with the original topic in a conversation

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15
Q

what is meant by the term circumstantial speech in the context of psychosis?

A

Circumstantiality is defined as circuitous and non-direct thinking or speech that digresses from the main point of a conversation.

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16
Q

what is meant by the term pressured speech in the context of psychosis?

A

Pressure of speech usually refers to the improperly verbalized speech which is a feature of hypomanic and manic illness.

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17
Q

What are hallucinations?

A

percepts in the absence of a stimulus

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18
Q

what are delusions?

A

fixed, false beliefs out of keeping with social/cultural background

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19
Q

what is the risk of suicide in schizophrenia?

A

28% of excess mortality

20
Q

What are illusions?

A

misperception of a real external stimulus

21
Q

What is a hypnagogic hallucination?

A

visual, auditory, or tactile hallucinations at sleep onset

22
Q

what is a hypnopompic hallucination?

A

visual, auditory or tactile hallucinations at waking

23
Q

What is Charles Bonnet Syndrome?

A

Triad of visual hallucinations, ocular pathology causing bilateral visual deterioration and preserved cognitive status

24
Q

describe the pattern of hallucinations experienced in Charles Bonnet syndrome

A

may be elementary or highly organised and complex, persistent or intermittent

25
Q

what are the six key aspects of cognition?

A

consciousness, orientation, attention and concentration, memory, language functioning, visuospatial functioning

26
Q

What is meant by ‘prodromal symptoms of schizophrenia’ ?

A

symptoms that occur between early manifestations of the disease.

27
Q

What prodromal symptoms occur in schizophrenia?

A

changes in social behaviour, like social withdrawal, and impairments in functioning, often precede onset

28
Q

How heritable is schizophrenia?

A

Highly heritable, MZ twins show 46% concordance

29
Q

How polygenic is schizophrenia?

A

High polygenic, lots of genes of small effect sizes

30
Q

What are the environmental risk factors for schizophrenia?

A

Drug use, especially cannabis. Prenatal/ birth complications, maternal infections, migrant status, socioeconomic deprivation, childhood trauma

31
Q

What is formal thought disorder?

A

Problem with content and form (what patients say and how)

32
Q

What are the two types of thought disorder?

A

Content-thought disorder and formal thought disorder

33
Q

What are the cognitive impairments associated with schizophrenia?

A

Working memory impairments, lower scores in cognitive testing from childhood, poorer educational attainment.

34
Q

What are the pharmacological treatment options for psychosis?

A

Antipsychotic medications

35
Q

What are the physiological treatment options for psychosis?

A

CBT for psychosis, avatar therapy

36
Q

What social support is available to support people with psychosis?

A

Supportive environments, structures and routines, housing and benefits, support with budgeting and employment

37
Q

What neurotransmitter is most implicated in antipsychotic mechanism?

A

Dopamine, but also act of serotonin, acetylcholine and histamine neurotransmitters

38
Q

Increased activity in which neurotransmitter is implicated in causing reality distortion in psychosis?

A

Dopamine

39
Q

What affect can antipsychotics have on the extrapyramidal system? What side effects does this cause?

A

Can cause post-synaptic dopamine blockade in the extrapyramidal system resulting in side effects such as Parkinsonism, acute dystonia, tardive dyskinesia, akathasia

40
Q

What are the symptoms associated with Parkinsonism?

A

Rigidity, slow and shuffling gait, lack of arm swing in gait, pill-rolling tremor

41
Q

What are the symptoms of dystonia?

A

Increased motor tone (sustained abnormal posture)

42
Q

What medication can cause dystonia?

A

Can occur shortly after taking dopamine antagonist

43
Q

When can dystonia be fatal?

A

Laryngeal dystonia e.g. spasmodic torticollis

44
Q

What is tardive dyskinesia?

A

Repeated oral/ facial/ buccal/ lingual movements, initially subtle but can progress

45
Q

What can cause an increased risk of tardive dyskinesia?

A

Long-term antipsychotics, being female

46
Q

What is akathisia?

A

Inner restlessness causing a compelling feeling to move but does little to alleviate

47
Q

What is the first line treatment for psychosis?

A

Avoid typical antipsychotics at first, anticholinergic medications can help

Y2 PSYCHIATRY (6 decks)

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