Psychosis Flashcards
What is Psychosis
Psychosis is an umbrella term for several disorders, including schizophrenia
What two main things does psychosis affect
Interpretation and perception
What can cause psychosis
Substance abuse
Trauma
Medical Conditions
Genetics
Environment
Medical conditions that can cause psychosis
Brain tumour
Epilepsy
Delirium
Dementia
Encephalitis
Head injury
Positive symptoms of psychosis
Delusions
Hallucination
Disorganised speech and response
Agression, agitation
Negative symptoms of psychosis
Flat/inappropriate affect
Poor eye contact
Avolition
Withdrawal
Poverty of speech
Poor ADLS
Severely disturbed relationships
Hallucinations can include
-Seeing things that others dont (visual)
-Experiencing tastes, smells, sensations that have no apparent cause (gustatory, olfactory, tactile)
-Hearing voices that others dont (auditory)
Schizophrenia
-Abrupt onset
-Presence of acute and resolvable life stressor
-Family HX of affective disturbance
-Florid symptoms
-Absence of blunted affect
Subtypes of schizophrenia
-Paranoid
-Disorganised
-Catatonic
-Undifferentiated
-Residual
Related disorders confused with schizophrenia
-Schizoaffective disorder
-Acute and Transient psychotic disorder
-Schizotypal personality disorder
-Persistent delusional disorder
Atypical Antipsychotics used
Risperidone
Olanzapine
Quetiapine
Clozapine
Aripiprazole
Typical Antipsychotics used
-Haloperidol
-Chlorpromazine
-Stelazine
-Thioridazine
-Flupenazine
Possible adverse effects of antipsychotics
-Tardive Dyskinesia
-Akathisia
-Neuroleptic Malignant Syndrome
-Acute dystonic reaction
-Pariksonism effects
Tardive Dyskinesia
a movement disorder: uncontrollable, abnormal and repetitive movements of face, torso, and other body parts
Neuroleptic malignant syndrome
A life threatening reaction to antipsychotic drugs causing: a change in mental state, fever, muscle rigity, autonomic dysfunction
Akathisia
Inability to remain still - psychomotor restlessness
Acute dystonic reaction
Involuntary contractions of muscles in extremeties, face, neck, abdomen, pelvis or larynx
Parkinsonism effects
-shaking
-stiffness
-off balance + coordination
Metabolic syndrome characteristics
-Visceral obesity
-Insulin resistance
-Hypertension
-Low HDL Cholestrol
-High Triglycerides
Relationship between antipsychotics and metabolic syndrome
Atypical antipsychotics increase the risk of hyperglycaemia and impaired glucose levels, therefore increase risk of metabolic syndrome
Interventions
De-escalation
Self help
Mindfulness
Goal setting
CBT
Strength drawing - recovery focus
Liasion with services across MDT
Grounding techniques
Validation
Re-orientation to the here and now
Identify feelings and their intensity
Triggers
Problematic coping
-Alcohol and drugs
-Over reliance on prescription medication (sleeping pills, pain relief)
-Interpersonal conflict
-Avoidance/Withdrawal from society
-Self harm, violence, suicide
What sections of the MHA cover compulsory treatment
Sections 11 or 13
Mechanism of action - Atypical Antipsychotics
Serotonin-dopamine antagonist. Low affinity to D2 receptor, High affinity to 5-HT2a. Thus less adverse effects
Mechanism of action - Typical antipsychotic
D2 antagonist. High affinity to D2 receptor
Paranoid Schizoprenia
Paranoid behaviour causing delusions and auditory hallucinations
Disorganised Schizoprenia
behaviours that are disorganised, speech that is bizarre or difficult to understand
Catatonic Schizoprenia
Varies between being elevated and repetitive to immobile, quiet and progressing to muscle rigidity and inability to care for self (severe)
Residual Schizoprenia
Past HX of at least 1 episode of schizophrenia but has no current symptoms
Undifferentiated Schizoprenia
Behaviour that fits into two or more types of schizophrenia
