psychosis

Question 1

False beliefs not correctable by logic or reason, not based on simple ignorance, and not shared by a culture or subculture; persecution is most common

Answer 1

Delusions

Question 2

sesnory perceptions not generated by external stimuli

Answer 2

Hallucinations

Question 3

disorder characterized by disorganized thinking

Answer 3

Formal Thought Disorders

Question 4

visceral sensations

Answer 4

cenesthetic

Question 5

lack of informative content normally seen in speech (“It is red very red. Things are that way. I am.”)

Answer 5

Alogia

Question 6

associating words by sound, not logical meaning (Í’mvery sure I’ve got a cure and I’m not pure…”’)

Answer 6

Echolalia

Question 7

loss of logical meaning between words or thoughts (Patient begins to answer a question about her parents, then launches into a diatribe about world hunger.)

Answer 7

Loose Associations

Question 8

inventing new words (A patient refers to a restaurant as an automatic automat)

Answer 8

Neologisms

Question 9

repeating the same word or phrase over and over (I’m bad, I’m bad….that I’m bad.)

Answer 9

Perseverations

Question 10

beginning a response in a logical fashion but then getting further and further from the point. (I’ll tell you about my thoughts, but let me tell you about other things in my head, like brains and blood.)

Answer 10

Tangentiality

Question 11

misperception of real external stimuli (A woman interprets a dress in a dark closet as a person)

Answer 11

Illusions

Question 12

• psychotic and residual symptoms lasting at least 6 months
• normal consciousness and memory function
• auditory hallucinations predominate

Answer 12

Schizophrenia

Question 13

• psychotic and residual symptoms lasting 1-6 months

- obvious precipitating psychosocial factors

Answer 13

Schizophreniform

Question 14

• psychotic and residual symptoms lasting more than 1 day but less than 1 month
• obvious precipitating psychosocial factors (eg job loss)

Answer 14

Brief psychotic disorder

Question 15

-prominent hallucinations (often visual or tactile)

Or delusions directly related to use or withdrawal of a drug (esp stimulants and hallucinogens)

Answer 15

Substance induced psychosis

Question 16

• hallucinations that are visible and changeable rather than auditory and recurrent
• occurs in the context of an acute medical illness
• symptoms not due to delirium or dimentia

Answer 16

Psychosis secondary to a general medical condition

Question 17

• fixed, nonbizarre delusional system present for at least one month
• absence of other thought disorders

Answer 17

Delusional Disorder

Question 18

• disturbance of consciousness
• fluctuates, fragmented and unsystematized psychotic symptoms
• treat underlying cause

Answer 18

Delirium

Question 19

-development of a delusion in a person in a close relationship with someone who has a delusional disorder (the inducer)

Answer 19

Shared psychotic disorder (folie a deux)

Question 20

Other behavioral disorders that may present with psychotic symptoms

Answer 20

Major depressive disorder
Bipolar disorder
Schizoaffective disorder
(screen for mood disorders)

Question 21

Personality disorders that may mimic psychosis

Answer 21

Schizoid, Paranoid, Schizotypal, Borderline

Question 22

peak age onset of psychosis in males

Answer 22

15-25

Question 23

peak age onset of psychosis in females

Answer 23

25-35

Question 24

• Systematized delusions of persecution
• Older age of onset and better functioning than other subtypes
• Highest level of functioning and best prognosis

Answer 24

Paranoid Schizophrenia

Question 25

• At least one previous psychotic episode
• subsequent negative symptoms and mild positive symptoms
• No current frank psychotic symptoms
• we are seeing more patients w/schizophrenia live longer, esp. after age 50 their coping mechanisms often improve

Answer 25

Residual Schizophrenia

Question 26

• incoherent speech
• mirror gazing
• facial grimacing
• poor grooming
• inappropriate emotional response (silliness)
• onset before 25 years of age
• worst prognosis; many of these people struggle to even complete a sentence

Answer 26

Disorganized (hebephrenic) Schizophrenia

Question 27

• stupor or extreme agitation
• incoherent speech or muteness
• blank facial expression
• bizarre posturing (waxy flexibility)
• rare since introduction of antipsychotic agents
• they can become willfully unresponsive to their environment-may believe they can’t talk or the world will end, etc.

Answer 27

Catatonic Schizophrenia

Question 28

How do you treat delirium?

Answer 28

Treat underlying condition! Do NOT use antipsychotics unless for the safety of the pt.

Question 29

What conditions cause psychosis secondary to general medical condition?

Answer 29

AIDS, Alzheimer’s, Parkinsons.

Treat with antipsychotics

Question 30

Displays characteristics of more than one subtype

Answer 30

Undifferentiated Schizophrenia

Question 31

A 21 yr old disheveled patient hears voices in her head. She has no systematized delusions but believes that she can communicate with animals. Her affect is blunted but not flat, and she shows no catatonic features.

Answer 31

Undifferentiated Schizophrenia

Question 32

A 34 yr old seems fearful when she tells you that the government has been listeningin on all her phone conversations for the past 2 years.

Answer 32

Paranoid Schizophrenia

Question 33

A 30 yr old man who was hospitalized for 5 yrs previously with auditory hallucinations now shows flat affect, social withdrawal, and strange behavior but no delusions or hallucinations

Answer 33

Residual Schizophrenia

Question 34

An 18 y/o male is unshaven and dirty.He stares into the mirror, posturing and grimacing, and giggles when he tells you that his stomach is “a monster machine ready to throw me on the train.”

Answer 34

Disorganized (hebephrenic) Schizophrenia

Question 35

A 27 y/o patient does not speak and shows extreme psychomotor agitation to the point of physical exhaustion. At times, he holds unusual, uncomfortable looking body positions.

Answer 35

Catatonic Schizophrenia