Psychosis Flashcards
what is psychosis
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
what are the classic symptoms on psychosis
hallucinations, delusions and disorder of the form of thought
what key branches of psychosis are there
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)
what is schizoaffective disorder
cross over between manic depressive psychosis and dementia praecox
what are psychotic experiences
Hallucinations Ideas of reference Delusions Formal thought disorder Thought interference Passivity phenomena Loss of insight
what is a hallucination
internal perception gets confused with external perception without any external stimulus
has same qualities as normal perception
what are the different types of hallucination
visual auditory olfactory gustatory tactile haptic
what is an idea of reference
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.
what is paranoia
self-referential
belief that external events are related to oneself. can vary from a brief thought to frequent intrusive thoughts to delusional intensity.
what are delusions
a fixed falsely held belief - held with unshakeable conviction
impervious to logical argument or evidence to the contrary
what are primary delusions
delusions that arive fully formed in consciousness without the need for explanation
what are secondary delusions
often attempts to explain anomalous experiences eg. hallucinations, passivity experiences, depression
what are the themes fo delusions
Paranoid Persecutory Grandiose Religious Misidentification Guilt Sin Poverty Nihilistic - fear of loosing everything Erotomanic - belief someones fallen in love with them/stalking etc Jealousy
what are some thought disorder
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
what is thought insertion
thinking there are thoughts being put into their head that dont belong to them
what is though withdrawal
thinking people can take the information out of your head eg. by using the internet
what is thought broadcasting
thinking everyone can know what you are thinking
what is thought blocking
getting halfway through thinking something and the thoughts ‘dry up’ and you cant think of anything for a while
what is passivity
belief that things normally under your control are no longer controlled by you
what can you have passivity of
Volition - Actions
Affect -Made feelings
Impulse - Made urges
Somatic passivity - Influence on the body
what is loss of insight
when you can’t tell the difference between what is real and what is caused by the illness
how can you challenge delusions/psychosis
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’
what are differential diagnosis in psychosis
schizophrenia substance misuse mania depression delirium/dementia
characteristics of drug induced psychosis
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
characteristic of depressive psychosis
Mood congruent content of psychotic symptoms
Delusions of worthlessness/guilt/hypochondria/poverty
hallucinations of accusing/insulting/threatening voices - typically 2nd person
Characteristic of mania with psychosis
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
characteristic of delirium psychosis
Acute, transient disturbance
eg. in alcohol withdrawal, infection, medical/surgical in patients
often reversible if underlying problem is addressed
symptoms of delirium
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
