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Year 4 Psychiatry > Psychosis > Flashcards

Psychosis Flashcards

1
Q

Define Psychosis

A

A mental state in which reality is greatly distorted

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2
Q

Name the three prevalent features of Psychosis

A

Delusions (Fixed false belief held firmly despite evidence to the contrary)
Hallucinations (Perception in the absence of external stimuli)
Thought Disorder

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3
Q

Describe the ICD10 class 1-8 of Psychotic Disorders

A 
1 - Schizophrenia
2 - Schizotypal Disorder
3 - Persistent Delusional Disorder
4 - Acute and Transient Psychotic Disorder (<1m)
5 - Induced Delusional Disorder
6 - Schizoaffective Disorder 
7 - Other non organic Psychotic
8 - Unspecified
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4
Q

What is Schizotypal Disorder (AKA Latent Schizophrenia)?

A

Eccentric Behaviour, Suspiciousness, Unusual Speech

No Hallucinations or Delusions

More common in those with a first degree relative with Schizophrenia

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5
Q

What is Schizoaffective Disorder?

A

Symptoms of both Schizophrenia and Mood Disorder in the same episode, with mood disorder meeting criteria

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6
Q

What is Persistent Delusional Disorder

A

Single or set of delusions for at least 3 months

Other areas of thinking intact, unlike Schizophrenia

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7
Q

What is Folie à Deux?

A

‘Thought shared by two’

A delusional belief shared between two people

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8
Q

Name three common types of Delusions

A

Grandiose
Persecutory
Hyperchondriacal

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9
Q

Name three ways of classifying Delusions

A

Cause: Primary vs Secondary
Mood : Congruent vs Incongruent
Plausibility: Bizarre vs Non Bizarre

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10
Q

Name four Organic Causes of Psychosis

A

Drug Induced
Iatrogenic (Steroids)
Dementia
Delirium

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11
Q

Define Schizophrenia

A

Most common form of Psychosis characterised by Hallucinations, Delusions and Thought Disorders which lead to functional impairment

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12
Q

Give three PREDISPOSING risk factors for Schizophrenia

A

Neurochemical Imbalance (Increased Dopamine, Decreased GABA/Glutamate/Serotonin)
Family History
Substance Misuse

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13
Q

Give two PRECIPITATING risk factors for Schizophrenia

A

Smoking Cannabis

Adverse Life Events

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14
Q

Give three PERPETUATING risk factors for Schizophrenia

A

Substance Misuse
Poor Medication Compliance
Lack of Social Support

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15
Q

What are Schneider’s First Rank Symptoms for Schizophrenia?

A

Delusional Perception
Third Person Auditory Hallucinations
Thought Interference (Insertion, Withdrawal, Broadcast)
Passivity Phenomenon (They have no control)

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16
Q

Positive symptoms are normally seen in the ‘Acute Phases’ of Schizophrenia, and can be remembered by ‘Delusions Held Firmly Think Psychosis’. What does this mnemonic stand for?

A 
Delusions
Hallucinations
Formal Thought Disorder
Thought Interference 
Passivity Phenomenon
17
Q

The negative symptoms are normally seen in the Chronic Phases of Schizophrenia. Give three features.

A

Avolution (reduced motivation)
Affect Blunted
Alogia (Poverty of Speech)

18
Q

There are 7 main subtypes of Schizophrenia. Define Paranoid Schizophrenia.

A

Most common, dominated by positive symptoms

19
Q

There are 7 main subtypes of Schizophrenia. Define Post Schizophrenic Depression.

A

Depression predominates with Schizophrenic illness in the past 12 months, and some symptoms still present

20
Q

There are 7 main subtypes of Schizophrenia. Define Hebephrenic Schizophrenia.

A

Though disorganisation predominates
Illness onset is earlier (15-25)
Poorer Prognosis

21
Q

There are 7 main subtypes of Schizophrenia. Define Catatonic Schizophrenia.

A

Rare form characterised by one or more Catatonic Sx

22
Q

There are 7 main subtypes of Schizophrenia. Define Simple Schizophrenia.

A

Rare form with negative symptoms only (no psychotic)

23
Q

There are 7 main subtypes of Schizophrenia. Define Undifferentiated Schizophrenia.

A

Meets criteria for Schizophrenia but doesn’t fit in any categories

24
Q

There are 7 main subtypes of Schizophrenia. Define Residual Schizophrenia.

A

One year of chronic negative symptoms preceded by a clear cut psychotic episode

25
Q

What are the four symptoms in ICD10 Group A Criteria of Schizophrenia?

A

Thought Interference
Delusions of Control/Influence/Passivity
Running Commentary Auditory Hallucinations
Bizarre Persistent Delusions

26
Q

What are the four symptoms in ICD10 Group B Criteria of Schizophrenia?

A

Hallucinations in other modalities that are persistent
Thought Disorganisation
Catatonic Symptoms
Negative Symptoms

27
Q

What is required to diagnose Schizophrenia from ICD10 categories?

A

One clear symptom from Group A, and at least two from Group B
For at least one month

28
Q

Describe the expected Appearance, Behaviour, Speech and Thought of a Schizophrenic patient (MSE)

A

Appearance - may be normal or may have self neglect

Behaviour - Positive (Preoccupied, Restless) or Negative (Withdrawn, Poor Eye Contact)

Speech - Loosening of Associations, Thought Blocking

Thought - Delusions, Thought Interference, Formal Thought Disorder (Circumstantiality)

29
Q

Describe the expected Mood, Perception, Cognition and Insight of a Schizophrenic patient (MSE)

A

Mood - Incongruent
Perception - Hallucinations
Cognition - Orientated but attention and concentration impaired
Insight - Poor

30
Q

Name 5 bloods you would like to do for a Schizophrenic Patient

A 
FBC
TFTs
Glucose (Antipsychotics can cause metabolic syndrome)
Serum Calcium (Hypercalcemia)
Baseline U&Es
31
Q

Other than blood tests, name four investigations for Schizophrenia

A

Urine drug tests
ECG (Antipsychotics can cause Long QT)
CT (rule out SOL)
EEG (Rule out Temporal Lobe Epilepsy)

32
Q

Describe the pharmacological management of Schizophrenia

A

1) Atypical Antipsychotics (Risperidone, Olanzapine)
2) Clozapine reserved for treatment resistant Schizophrenia

Adjuvants: Short term Benzodiazepines, Antidepressants, Lithium

33
Q

When would you consider ECT for a Schizophrenic patient?

A

If Resistant or Catatonic

34
Q

Name four potential psychological interventions for Schizophrenia

A

CBT
Family Intervention
Art Therapy
Social Training Skills

35
Q

How does Family Intervention help Schizophrenic patients?

A

Psychoeducation helps families decrease high levels of expressed emotion

36
Q

Name three Social Interventions that can be done for Schizophrenic Patients

A

Support groups (Rethink, Sane)
Peer Support
Supported Employment Programmes

37
Q

Define Paraphrenia

A

Late onset schizophrenia characterised by positive symptoms
Similar to Paranoid Schizophrenia but less severe
Thought disorder and catatonic symptoms are rare

Year 4 Psychiatry (12 decks)

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