Psychosis

Question 1

Classic characteristics of psychosis?

Answer 1

Hallucinations
Thought interference
Passivity phenomena
Loss of insight
Ideas of reference 
Delusions
Disorder of form of thought

Question 2

What is a hallucination?

Answer 2

A perception which occurs in the absence of an external stimulus
Can be all 5 senses

Question 3

What is a simple hallucination?

Answer 3

Formless sound
Murmuring
Bangs

Question 4

What is a complex hallucination?

Answer 4

Voice

Music

Question 5

Reality testing in psychosis

Answer 5

This is an internal perception = hallucination
This is my thought = thought insertion
I am moving my arm = passivity of action
This is significant = delusional perception

Question 6

What is an idea of reference?

Answer 6

Innocuous or coincidental events will be ascribed significant meaning by the person for example;
Messages in the newspaper for them
Television news is commenting on their life
Seeing meaning in peoples gestures

Question 7

What is a self referential experience?

Answer 7

External events are related to oneself

Can vary from a brief thought to frequent and intrusive thoughts to delusional intensity

Question 8

What is a delusion?

Answer 8

A fixed, falsely held belief that is held with unshakeable conviction
Impervious to logical argument or evidence to the contrary

Question 9

What is a primary delusion?

Answer 9

Arrives dully formed in the consciousness without the need for explanation

Question 10

What is a secondary delusion?

Answer 10

Often attempts to explain anomalous experiences e.g. hallucinations, passivity experiences, depression

Question 11

Types of delusion?

Answer 11

Paranoid 
Persecutory 
Grandiose
Religious
Misidentification 
Guilt
Sin; almost always paedophilia 
Poverty
Nihilistic
Erotomaniac
Of reference
Jealousy; othello syndrome

Question 12

Different types of thought disorder?

Answer 12

Neologisms; creation of a new vocabulary 
Circumstantiality/ tangentiality 
Clanging and punning
Loosening of associations 
Knight's move thinking
Verbigeration/ word salad

Question 13

Different types of thought interference?

Answer 13

Thought insertion
Thought withdrawal
Thought broadcasting
Thought blocking

Question 14

Different types of passivity phenomena?

Answer 14

Volition; made action
Affect; made feelings
Impulse; mde urges
Somatic; influence on the body

Question 15

What does 3rd person auditory hallucinations suggest?

Answer 15

Schizophrenia

Question 16

Describe drug induced psychosis?

Answer 16

May be florid symptoms or chronic
Tend to be short lasting if access to psychoactive substance removed
Beware comorbid of substance misuse and schizophrenia/ bipolar

Question 17

Hallucination and delusion types in depressive psychosis

Answer 17

Mood congruent content of psychotic symptoms
Delusions of worthlessness/ guilt/ hypochondriasis/ poverty/ sin/ nihilistic
Hallucination of accusing/ insulting/ threatening = 2nd person

Question 18

Hallucinations, thought form and delusions present in mania with psychosis?

Answer 18

Mood congruent
Delusions of grandeur/ speciality ability/ persecution/ religiosity
Hallucinations; 2nd person and auditory
Flight of ideas

Question 19

Describe delirium

Answer 19

Clouding of consciousness
Disorientation in TPP 
Fluctuation with worseness at night 
Impaired concentration/ memory
Visual hallucinations/ illusions +/- threatening auditory hallucinations
Persecutory delusions 
Psychomotor disturbance; agitation OR retardation 
Irritability 
Insomnia

Question 20

Describe the psychosis in schizophrenia

Answer 20

Formal thought disorder
Self-referential delusions
Grandiose delusions
Persecutory delusions
Passivity phenomena
3rd person auditory hallucinations 
Normal consciousness, no fluctuation

Question 21

Describe the psychosis in substance misuse

Answer 21

Self-referential delusions
Grandiose delusions
Persecutory delusions 
Passivity phenomena 
2nd and 3rd person auditory hallucinations 
Visual hallucinations 
Fluctuant and variable

Question 22

Describe the psychosis in mania

Answer 22

Formal thought disorder 
Self-referential delusions 
Grandiose delusions 
PErsecutory delusions 
2nd person auditory hallucinations 
No visual hallucinations 
No fluctuation 
No impaired conscious level

Question 23

Describe the psychosis in depression

Answer 23

Poverty of thought
Persecutory delusions
2nd person auditory hallucinations

Question 24

Describe the psychois in delirium/ dementia

Answer 24

Formal thought disorder
Sometimes poverty of thought
Self-referential, grandiose, persecutory delusions 
Passivity phenomenon 
2nd and 3rd person auditory hallucinations
Visual hallucinations
Fluctuant and variable
Impaired conscious level