Psychosis

Question 1

What is psychosis

Answer 1

Symptom not a diagnosis

• Always implies the severest form a disease

Inability to distinguish between symptoms of delusion, hallucination and disordered thinking from reality

Lack of insight

Question 2

Cause of psychosis

Answer 2

Schizophrenia (most common)

Delirium

Severe affective disorder

• Depressive episode with psychotic symptoms
• Manic episode with psychotic symptoms

Question 3

Risk factors for psychosis

Answer 3

Biological

Psychological & social

FH

Question 4

Biological risk factors of psychosis

Answer 4

Genetics – neuregulin, dysbindin, Di George syndrome

Neurochemistry – dopamine synthesis, glutamate, GABA, serotoninergic transmission

Other – obstetric complications, maternal influenza, malnutrition, winter birth, substance misuse

Question 5

Psychological & social risk factors of psychosis

Answer 5

Occupational & social class

Migration

Social isolation

Life events as precipitants

Question 6

Presentation of psychosis

Answer 6

Hallucination

Delusions

Question 7

Hallucinations

Answer 7

Full force and clarity of true perception

Located in external space (not inside head)

No external stimulus

Not willed or controlled

5 senses – auditory, visual, tactile, olfactory, gustatory

Question 8

Delusions

Answer 8

unshakable idea/belief which is held with extraordinary conviction

Grandiose, self-referential

Paranoid (persecutory)

Hypochondriacal

Stages

• State of fear
• Delusional idea appears
• Effort to makes sensor of experience by altering view of world
• Final breakdown – thought disorder and behavioural symptoms emerge

Question 9

Differential of psychosis

Answer 9

Delirium or acute organic brain syndrome

• Persecutory & evanescent
• Worse at night

Question 10

management of psychosis

Answer 10

Antipsychotics

Treat associated factors