Psychosis Flashcards
Perception disturbances types
Perception = making sense of physical information
Hallucinations = perceptions in the absence of a physical stimulus -> feel the same as a normal perception
Illusions = misinterpretations of real stimuli
Pseudo hallucinations = hallucinations that arise in the patients mind
Classification of perceptual disturbances
Auditory -> elementary - simple sounds -> complex - 1st, 2nd, 3rd person Visual Somatic Olfactory + gustatory
Extracampine hallucinations
Location or other characteristic prevent perception
eg. Seeing a person standing behind you
Hypnopompic/hypnagogic
Conciousness leading in to and out of sleep
Delusions
Unshakable false belief
-> faulty reasoning
-> out of keeping with social and cultural background
Primary-> do not occur in response to any previous psychopathological state -> primary psychotic disorders
Secondary -> consequence of pre existing psychopathological state -> affective disorders
Classification of delusions
Persecutory Grandiose Reference -> objects/people have increased meaning Religious Love Infidelity/jealousy/othellos Misidentification Nihilistic-> don't exist Somatic Infestation Control
Over valued ideas
Plausible belief that a patient becomes preoccupied with to an reasonable extent
Becomes distressing
Common in personality disorders
Thought disorder (form)
Over inclusion-> very round about way of reaching conclusions of topic
Loosening of associations-> odd/lack of association between topics
-> word salad
Flight of ideas -> rapid speech that jumps from topic to topic but is linked
Thought blocking-> sudden cessation of thought flow
Neoglisms
Echolalia
Negative symptoms
Apathy Poverty of thought and speech Blunting of affect Social isolation Poor self care Cognitive deficits
Psychomotor function
Abnormalities of motor function
Catatonia-> excessive or decreased motor activity that is apparently purposeless
Differential diagnosis of psychosis organic causes
Delirium
Medication -> steroids, stimulants, dopamine antagonists, anticholinergics
Endocrine disorders -> cushings, thyroid
Neurological -> temporal lobe epilepsy, MS, huntingtons
Systemic diseases -> porphyria, SLE
Differential diagnoses of psychosis, mental disorders
Schizophrenia Schizophrenia like disorder Schizoaffective disorder Delusional disorder Alcohol withdrawal Mood disorder PD Autism
Management of psychosis
1) history, MMSE and risk assessment
2) examination -neuro, endocrine
3) investigations - exclude organic causes, ECG
4) where to manage? In patient/ community
5) who will manage? EIP, CMHT, CRHT, AOT, CPA
Definition of psychosis
A state in which there is loss of contact with reality
