Psychosis

Question 1

what is psychosis

Answer 1

mental disorder in which thoughts, affective response or ability to recognise reality and the ability to communicate and relate to others are sufficiently impaired to interfere grossly with the capacity to deal with reality

not being able to determine between internal experience and external reality

lack of insight

Question 2

what are the classic symptoms on psychosis

Answer 2

hallucinations, delusions and disorder of the form of thought

Question 3

what key branches of psychosis are there

Answer 3

Manic depressive psychosis (bipolar and unipolar depression)

Dementia praecox (schizophrenia and other paranoia illnesses)

Organic conditions (delirium, dementias, brain injury, stroke)

Substance use (acute intoxication, withdrawal, delirium tremens etc)

Question 4

what is schizoaffective disorder

Answer 4

cross over between manic depressive psychosis and dementia praecox

Question 5

what are psychotic experiences

Answer 5

Hallucinations 
Ideas of reference Delusions 
Formal thought disorder 
Thought interference 
Passivity phenomena 
Loss of insight

Question 6

what is a hallucination

Answer 6

internal perception gets confused with external perception without any external stimulus

has same qualities as normal perception

Question 7

what are the different types of hallucination

Answer 7

visual 
auditory
olfactory 
gustatory 
tactile 
haptic

Question 8

what is an idea of reference

Answer 8

innocuous or coincidental events will be given significant meaning

eg. thinking the news reporter on TV is talking just to you. thinking peoples social media posts and conversations are about you. hearing people laughing or gesturing etc and assuming its at them.

Question 9

what is paranoia

Answer 9

self-referential
belief that external events are related to oneself. can vary from a brief thought to frequent intrusive thoughts to delusional intensity.

Question 10

what are delusions

Answer 10

a fixed falsely held belief - held with unshakeable conviction

impervious to logical argument or evidence to the contrary

Question 11

what are primary delusions

Answer 11

delusions that arive fully formed in consciousness without the need for explanation

Question 12

what are secondary delusions

Answer 12

often attempts to explain anomalous experiences eg. hallucinations, passivity experiences, depression

Question 13

what are the themes fo delusions

Answer 13

Paranoid 
Persecutory 
Grandiose 
Religious 
Misidentification 
Guilt 
Sin 
Poverty 
Nihilistic - fear of loosing everything 
Erotomanic  - belief someones fallen in love with them/stalking etc
Jealousy

Question 14

what are some thought disorder

Answer 14

Neologisms (have there own words)

Circumstantiality/tangentiality (talk around the q asked and take ages to get to the point/doesnt get to q)

Clanging and punning

loosening of associations

knight’s move thinking (jumping from though to thought via a linking work)

verbigeration/word salad

Question 15

what is thought insertion

Answer 15

thinking there are thoughts being put into their head that dont belong to them

Question 16

what is though withdrawal

Answer 16

thinking people can take the information out of your head eg. by using the internet

Question 17

what is thought broadcasting

Answer 17

thinking everyone can know what you are thinking

Question 18

what is thought blocking

Answer 18

getting halfway through thinking something and the thoughts ‘dry up’ and you cant think of anything for a while

Question 19

what is passivity

Answer 19

belief that things normally under your control are no longer controlled by you

Question 20

what can you have passivity of

Answer 20

Volition - Actions
Affect -Made feelings
Impulse - Made urges
Somatic passivity - Influence on the body

Question 21

what is loss of insight

Answer 21

when you can’t tell the difference between what is real and what is caused by the illness

Question 22

how can you challenge delusions/psychosis

Answer 22

Make an effort to understand

‘can you explain to me how this is possible’

‘what would you stay to someone if they said to you these beliefs are not true’

‘how much do you think it would cost to set up a fake hospital for you’

Question 23

what are differential diagnosis in psychosis

Answer 23

schizophrenia 
substance misuse 
mania 
depression 
delirium/dementia

Question 24

characteristics of drug induced psychosis

Answer 24

may be florid or chronic but tends to be short lasting if access to substance is removed

beware of comorbidity of substance use and schizophrenia & bipolar disorder

Question 25

characteristic of depressive psychosis

Answer 25

Mood congruent content of psychotic symptoms

Delusions of worthlessness/guilt/hypochondria/poverty

hallucinations of accusing/insulting/threatening voices - typically 2nd person

Question 26

Characteristic of mania with psychosis

Answer 26

delusions fo grandeur/special ability/persecution/religiosity

hallucinations: auditory (eg. gods voice)

flight of ideas

a symptom of first rank present in about 20% manic episodes

Question 27

characteristic of delirium psychosis

Answer 27

Acute, transient disturbance

eg. in alcohol withdrawal, infection, medical/surgical in patients

often reversible if underlying problem is addressed

Question 28

symptoms of delirium

Answer 28

Clouding of consciousness 
Disorientation in time, place and person 
Fluctuating severity over time 
Worse at night 
Impaired concentration/memory 
Visual hallucinations/illusions _/- auditory hallucinations 
Psychomotor disturbance 
Irritability 
Insomnia