Psychosis Flashcards by Shaquan Moore

A collection of symptoms affecting the mind and impairing one’s ability to determine what is real. Common symptoms include hallucinations, delusions, disorganized thought and/or behavior.

Psychosis

How well did you know this?

Not at all

Perfectly

Type of Hallucinations

Auditory
Visual
Tactile
Olfactory
Gustatory

How well did you know this?

Not at all

Perfectly

sensations of touch without any physical stimulus.

Auditory
Visual
Tactile
Olfactory
Gustatory

Tactile

How well did you know this?

Not at all

Perfectly

Which is common

Auditory
Visual
Tactile
Olfactory
Gustatory

Auditory

How well did you know this?

Not at all

Perfectly

Which is Rare
Auditory
Visual
Tactile
Olfactory
Gustatory

Olfactory
Gustatory

How well did you know this?

Not at all

Perfectly

Fixed false belief
Fixed = does not change if presented with evidence to the contrary

Delusions

How well did you know this?

Not at all

Perfectly

Type of Delusions
P
R
S
R
G
N
E
B

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

How well did you know this?

Not at all

Perfectly

A false belief that someone is being mistreated or harmed, or that someone close to them is being mistreated or harmed.

The police are following me because they want to torture me

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Persecutory

How well did you know this?

Not at all

Perfectly

A false belief that is implausible, not based on normal life experiences, and not part of cultural practices.

Believing that aliens have removed your internal organs and replaced them with someone else’s

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Bizarre

How well did you know this?

Not at all

Perfectly

A common psychotic symptom that involves believing that neutral events have special significance and refer to the individual personally.

That a song is about them

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Referential

How well did you know this?

Not at all

Perfectly

a person believes that someone else is in love with them, even if that person is a stranger or celebrity

Billie Jean is not my lover, but she says I am the one

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Erotomanic

How well did you know this?

Not at all

Perfectly

False beliefs about the body that are a type of delusional disorder

The person believes they are infested with parasites or insects

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Somatic

How well did you know this?

Not at all

Perfectly

A type of psychopathological belief that one or more aspects of reality do not exist or have been destroyed

Believing that one’s face and body are non-existent

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Nihilistic

How well did you know this?

Not at all

Perfectly

Any delusion associated with religious content

Believing that you are being punished for a sin

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Religious

How well did you know this?

Not at all

Perfectly

A false belief that someone has special powers, wealth, or identity

Believing you have extraordinary talents or superpowers

Persecutory
Referential
Somatic
Religious
Grandiose
Nihilistic
Erotomanic
Bizarre

Grandiose

How well did you know this?

Not at all

Perfectly

The repetition of words or phrases spoken by someone else

Echolalia
Echopraxia

Echolalia

How well did you know this?

Not at all

Perfectly

The copying someone else’s physical movements or facial expressions

Echolalia
Echopraxia

Echopraxia

How well did you know this?

Not at all

Perfectly

To be diagnosed with Schizophrenia you most have ? symptoms with last ? months

2 or more
Greater than 6 months

How well did you know this?

Not at all

Perfectly

A disorder that disrupts a person’s awareness of the world around them

Catatonia

How well did you know this?

Not at all

Perfectly

An effect that is being added to the patient

Positive symptoms vs Negative Symptoms

Positive symptoms

How well did you know this?

Not at all

Perfectly

An effect that is being taken away or diminished from the patient

Positive symptoms vs Negative Symptoms

Negative Symptoms

How well did you know this?

Not at all

Perfectly

Delusions

Positive symptoms vs Negative Symptoms

Positive symptoms

How well did you know this?

Not at all

Perfectly

Avolition (lack of motivation)

Positive symptoms vs Negative Symptoms

Negative Symptoms

How well did you know this?

Not at all

Perfectly

Hallucinations

Positive symptoms vs Negative Symptoms

Positive symptoms

How well did you know this?

Not at all

Perfectly

Anhedonia (inability to experience joy or pleasure) Positive symptoms vs Negative Symptoms

Negative Symptoms

Bizarre Behavior Positive symptoms vs Negative Symptoms

Positive symptoms

Alogia (poverty of speech) Positive symptoms vs Negative Symptoms

Negative Symptoms

Disorganization Positive symptoms vs Negative Symptoms

Positive symptoms

Blunted/flat affect( reduction in the outward expression of emotion) Positive symptoms vs Negative Symptoms

Negative Symptoms

Social Withdrawal Positive symptoms vs Negative Symptoms

Negative Symptoms

Attention & *cognitive deficits Positive symptoms vs Negative Symptoms

Negative Symptoms

Schizophrenia Onset 2

Late in Adolescence Earlier in Males

Schizophrenia is the ? leading cause of disability

9th

Schizophrenia Treatment Primarily life-long pharmacologic treatment Often preference to utilize ? for improved adherence

Long Acting Injectables (LAI)

Schizophrenia Treatment For uncontrolled symptoms

Electroconvulsive Therapy

Schizophrenia Treatment The third one ?

Psychosocial

Schizophrenia Treatment Psychosocial ? – for psychosis ? training Promote ? Treat ?? ? Support

CBT Social skills coping skills comorbidities such as SUD, anxiety Vocational

Indicated for acute and maintenance a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

a. Antipsychotics 1st Gen

MOA: Dopamine antagonism (postsynaptic blockade), Ach and NE activity as well a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

a. Antipsychotics 1st Gen

Antipsychotics 1st Gen Antipsychotics 2st Gen Antipsychotics 3nd Gen Formulations: 3 ?

PO, IM, LAI

Antipsychotics 1st Gen Side Effects/Adverse Effect Neuroendocrine: g?, m? S? W? E? N?

Side Effects/Adverse Effect Neuroendocrine: gynecomastia, menstrual irregularities Sedation Weight gain Extrapyramidal Symptoms (EPS) Neuroleptic Malignant Syndrome (NMS)

Neuroendocrine: gynecomastia, menstrual irregularities a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

a. Antipsychotics 1st Gen

Haldol/haloperidol a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

a. Antipsychotics 1st Gen

Thorazine/chlorpromazine a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

a. Antipsychotics 1st Gen

Antipsychotics 1st Gen Antipsychotics 2nd Gen Antipsychotics 3nd Gen BLACK BOX: Not approved for ? related psychosis.? implications

dementia Cardiac

Neuroleptic Malignant Syndrome mnemonic

Hot, stiff, out of it

Neuroleptic Malignant Syndrome mnemonic

Neuroleptic Malignant Syndrome Etiology not totally clear but likely dopamine blockade in ?

hypothalamus

Neuroleptic Malignant Syndrome Risk Factors D ? month of treatment ? Predisposition ? dose or ? antipsychotics

Risk Factors Dehydration First month of treatment Genetic Predisposition Increasing dose or multiple antipsychotics

Neuroleptic Malignant Syndrome Symptoms S? “?” ? Temperature ? Status Autonomic Instability HTN, tachycardia, diaphoresis, tachypnea

Severe Muscle Rigidity “Lead Pipe” Elevated Temperature Altered Mental Status Autonomic Instability HTN, tachycardia, diaphoresis, tachypnea

Neuroleptic Malignant Syndrome  Nursing Interventions S? C? Monitor ? & ? Expect orders for ? agonists (?) and/or ? relaxants (? or ?)

Nursing Interventions Stop Medication Cool off Monitor I/O & Vital Signs Expect orders for dopamine agonists (bromocriptine) and/or muscle relaxants (dantrolene or benzodiazepines)

dopamine agonists (bromocriptine) Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Neuroleptic Malignant Syndrome

muscle relaxants (dantrolene or benzodiazepines) Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Neuroleptic Malignant Syndrome

Akathisia Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

Dystonia Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

Pseudoparkinsonism Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

inability to sit still

Akathisia

involuntary muscle spasms, stiffness

Dystonia

rigidity, tremor, slowed movement

Pseudoparkinsonism

? can occur due to medications that block dopamine receptors

pseudoparkinsonism

Treatment Acute: Benztropine (Cogentin) Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

Diphenhydramine (Benadryl) IM or IV Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

Long term: daily oral anticholinergic therapy Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

Uncontrollable facial movement such as lip smacking Tardive Dyskinesia pseudoparkinsonism

Tardive Dyskinesia

Tardive Dyskinesia: later onset, and harder/impossible to reverse Uncontrollable facial movement such as lip smacking Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

Valbenazine (Ingrezza) Treats ? Tardive Dyskinesia pseudoparkinsonism

Tardive Dyskinesia

Deutetrabenazine (Austedo) Treats? Tardive Dyskinesia pseudoparkinsonism

Tardive Dyskinesia

Which is life-threatening Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Neuroleptic Malignant Syndrome

Not typically fatal but can significantly impact a person’s comfort and quality of life if not treated? Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

AIMS: Abnormal Involuntary movement scale is associated with? Neuroleptic Malignant Syndrome or Extrapyramidal Symptoms

Extrapyramidal Symptoms

MOA: dopamine and serotonin antagonism a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

b. Antipsychotics 2nd Gen

*Preferred due to side effects, not efficacy* a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

Anticholinergic effects* a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

Hyperprolactinemia a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

Weight gain a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

All

metabolic syndrome a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

Agitation, insomnia a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

Weakness, fatigue, sedation a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c.Antipsychotics 3nd Gen

all

Cardiac Implications a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

All

Sexual dysfunction a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

EPS/NMS (but less likely) a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

EPS/NMS a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

a. Antipsychotics 1st Gen

Clozaril/clozapine a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen

b. Antipsychotics 2nd Gen

High Risk, High Regulation Drug Risk: Severe Neutropenia Clozaril/clozapine Invega/paliperidone

Clozaril/clozapine

Clozaril/clozapine Monitoring: ? at initiation Weekly absolute neutrophil count (ANC) for the first ? months ? for another 6 months Then ? for duration of therapy

Monitoring: CBC at initiation Weekly absolute neutrophil count (ANC) for the first 6 months Biweekly for another 6 months Then monthly for duration of therapy

Which is not used first with b. Antipsychotics 2nd Gen Clozaril/clozapine Invega/paliperidone

Clozaril/clozapine

Often grouped with SGA/atypicals a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

c. Antipsychotics 3nd Gen

used as adjunctive or monotherapy in mood disorders a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

c. Antipsychotics 3nd Gen

MOA: partial dopamine agonist, serotonin-dopamine activity modulator a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

c. Antipsychotics 3nd Gen

Claims of being “weight neutral” a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

c. Antipsychotics 3nd Gen

Similar to 2nd Gen a. Antipsychotics 1st Gen b. Antipsychotics 2nd Gen c. Antipsychotics 3nd Gen

c. Antipsychotics 3nd Gen

What I always have to remember about Anticholinergic Side Effects

Body stays in Sympathetic State But Fluid production is bloked because the body cannot regulate it self in parasympathic is blocked. Urine rentiontion Sweat decreases Dry Mouth

Schizophrenia Spectrum Brief psychotic disorder Less than ? month

Schizophrenia Spectrum Schizophreniform ? months

1-6

Less than 1 month Brief psychotic disorder Schizophreniform

Brief psychotic disorder

1-6 months Brief psychotic disorder Schizophreniform

Schizophreniform

With Schizophrenia you checks signs of 3?

NMS EPS Anticholinergic Crisis

With Schizophrenia you have pt ? Balance

Promote Fluid

You will AIMS: Abnormal Involuntary movement scale to cheach for movent of al these disorders

Yes

what are used to diagnosis Schizophrenia D H D D or C Behavior N

Delusions Hallucinations Disorganized speech Disorganized or catatonic behavior Negative symptoms

Schizoaffective Criteria What 3 must pt have

Schizophrenia, Major depressive, Mania

Schizoaffective Co-occurring ? and ? episode

psychosis ( Schizophrenia symptoms) Mood d/o (Mania or MDD)

Schizoaffective Delusions or hallucinations for ? weeks in the absence of a major mood episode

2 or more

Schizoaffective Mood disorder symptoms must be present for >?% of total duration of illness

Schizoaffective is same treatment as Schizophreniia just atypical no 1st genration.

Delusional Disorder Logical, stable, well-systematized delusions that occur in the absence of other psychiatric disorders for >?month

Delusional Disorder All subtype of psychosis just two more ?

jellous Mixed

Delusional Disorder Goal: ?

reduce severity of delusion

Delusional Disorder No ? only ? to treat it.

Meds CBT