Psychosis Flashcards
Define Psychosis
A loss of contact with reality
Define Delusions
Strongly held false beliefs that are not part of the patient’s cultural or religious backgrounds
Types of Delusions
Persecutory Grandiose Erotomanic Somatic Delusions of reference Delusions of control
Define Hallucinations
Wakeful experiences of content that is not actually present
Auditory most common
Thought Disorganization
Alogia/poverty of content
Thought blocking
Loosening of association
Tangentiality
Clanging or clang association: rhyming words
Word salad: words linked incoherently
Perseravation: repeating words phrases no matter the topic
Differential Diagnosis of Psychotic Disorders
Schizophrenia Bipolar disorder + psychotic features Major depression + psychotic features Schizoaffective disorder Schizophreniform disorder Brief psychotic disorder Substance induced psychotic disorder Delusional disorder Psychosis secondary to medical condition
Define Schizoaffective Disorder
Affective disorder but have psychotic features at a separate time than the affective disorder
Define Schizophreniform Disorder
Schizophrenia that doesn’t quite meet the criteria for Schizophrenia
Labs for Psychosis Work-up
CBC CMP RPR/VDRL TSH HIV UA Urine drug screen
What is the peak age of schizophrenia?
Men: 12-25
Women: 25-35
Items that make schizophrenia difficult to deal with
Highly disabling
Persists throughout patient’s life
Poor care & social ostracism
Only 1/2 obtain treatment
DSM-5 Criteria: 2 of the following characteristics during a 1 month period
Delusions
Hallucinations
Disorganized speech
Grossly disorganized or catatonic behavior
Negative symptoms
Social or occupational dysfunction
Continuous signs of disturbance persisting for at least 6 months within 1 month of “active-phase” symptoms
Positive Symptoms of Schizophrenia
Delusions
Hallucinations
Negative Symptoms of Schizophrenia
Affective flattening Poverty of speech (Alogia) Blocking Poor grooming Lack of motivation Anhedonia Social withdrawal
Which types of symptoms have better responses to treatment?
Positive symptoms
Subtypes of Schizophrenia
Paranoid type
Disorganized type
Catatonic type
Define Paranoid Schizophrenia
Preoccupation with one or more delusions or frequent auditory hallucinations
No disorganized speech, disorganized or catatonic behavior, or flat or inappropriate affect
Characteristics of Disorganized Schizophrenia
Disorganized speech
Disorganized behavior
Flat or inappropriate affect
Characteristics of Catatonic Schizophrenia
Motoric immobility Excessive purposeless motor activity Extreme negativism or mutism Peculiarities of voluntary movement Echolalia or echopraxia
Define Echolalia & Echopraxia
Mimic your movements or your speech
Four Components of Delusions
False belief
Based on incorrect inference about external reality
Not consistent with patient’s intelligence & cultural background
Cannot be corrected by reasoning
Name this type of Delusion: “I can’t believe that they’ve now sabotaged my car! Last week they stole my mail and I know they are following me overtime I leave the house”
Delusion of Persecution
Name this type of Delusion: “God has chosen me to be the world’s representative at the universal meeting at Mars next month”
Delusion of Grandeur
Name this type of delusion: “Invaders from space have infiltrated my testicles so I wouldn’t be allowed to father any children.”
Bizarre Delusion
Name this type of delusion: “It doesn’t matter anyway with how my thoughts are controlled by the government.”
Delusion of Control
Name this type of delusion: “The DJ is really giving me instructions on what to do. He just disguises it so no one will pick up on it.”
Delusion of Reference
Different Thought Form & Process’s
Flight of ideas Thought blocking Incoherence Poverty of content Poor abstraction abilities Verbigeration Tangentiality Circumstantiality Loose associations Derailment Neologisms
