Psychosis

Question 1

What are positive symptoms of psychosis?
What are negative symptoms of psychosis?
What are disorganisation symptoms of psychosis?

Answer 1

Hallucinations
Delusions

Alogia (slow speech), anhedonia (no pleasure), avolition (low will to do things)

Bizarre behaviour (behaviour, clothing, aggression) formal though disorder (lack of though form)

Question 2

What precedes psychosis?

Answer 2

Prodromal phase- changes to personality, behaviour, thought process

Question 3

How does cannabis affect psychosis?
What other risk factors does psychosis have?

Answer 3

Brings the onset of psychosis earlier
RF: childhood trauma, birth complications, socioeconomic deprivation

Question 4

What things would you look out for when suspecting psychosis in the following areas:
Speech
Mood
Thought content
Thought form
Perception
Insight
Cognition

Answer 4

Speech: volume, is it monotonous?
Mood: anxiety, blunt (risk of other mental health disorders and suicide)
Thought content: thought insertion, withdrawal and broadcasting
Thought form: loosening in association
Perception: hallucinations- assess if they are pseudohallucinations
Insight: are they aware of hallucinations?
Cognition: can they carry out functioning movements

Question 5

What is the problem with patients lacking insight?

Answer 5

May refuse treatment- consent
May not keep up treatment even if consented

Question 6

How do you treat psychosis?
What type of antagonist is the first line of treatment?

Answer 6

Anti-psychotics (dopamine antagonists)
CBT
Social support

Question 7

What are extra pyramidal side effects?
What are some examples?
What are other side effects of antipsychotics?

Answer 7

Side effects due to the inhibition of dopamine controlling posture and tone
Examples: Parkinsonism, acute dystonic reactions (involuntary contractions), dyskinesia (irregular movements), akathisia (can’t stay still)
Other SE: constipation, weight gain, sedation