Psychosis Flashcards
What is the definition of psychosis?
term used to describe a person experiencing things differently from those around them; thought and emotions are so impaired that contact is lost with external reality
What are 3 key features of psychosis?
- Hallucinations e.g. auditory
- Delusions
- Thought disorganisation (alogia, tangentiality, clanging, word salad)
What are 3 possible forms of thought disorganisation that may occur in psychosis?
- Alogia: little information conveyed by speech
- Tangentiality: answers diverge from topic
- Clanging: mode of speech characterised by association of words based upon sound rather than concepts e.g. compulsive rhyming or alliteration without logical connection
- Word salad: linking real words incoherently - nonsensical content
What is meant by the term clanging when describing a phenomenon seen in psychosis?
mode of speech characterised by association of words based upon sound rather than concepts e.g. compulsive rhyming or alliteration without logical connection
“I wrote the boat overload showed by goat float tote”
What are 4 features which may be associated with psychosis?
- Agitation/ aggression
- Neurocognitive impairment (e.g. in memory, atention or executive function)
- Depression
- Thoughts of self harm
What are 8 examples of conditions in which psychosis may be seen?
- Schizophrenia
- Depression: psychotic depression
- Bipolar disorder
- Puerperal psychosis
- Brief psychotic disorder
- Neurological conditions: Parkinson’s disease, Huntington’s disease
- Prescribed drugs e.g. corticosteroids
- Certain illicit drugs e.g. cannabis, phencyclidine
In which age group of ptients is psychotic depression more common?
elderly patients
What is brief psychotic disorder?
where symptoms last less than a month
What are 2 examples of neurological conditions that can cause psychosis?
- Parkinson’s disease
- Huntington’s disease
What is an example of a prescribed drug which can cause psychosis?
corticosteroids
What are 2 examples of illicit drugs which can cause psychosis?
- Cannabis
- Phencyclidine (PCP, angel dust)
What is the peak age of the first episode of psychosis?
15-30 years
What are 2 broad aspects to the management of acute psychosis?
- emergency treatment of behavioural disturbance
- instigation of antipsychotic treatment
What are 4 aspects of emergency treatment of behavioural disturbance in psychosis?
- attempt to defuse whenever possible
- reassurance and offer of voluntary oral/IM meds often successful
- act decisively + with sufficient support to ensure management proceeds without unnecessary delay/risk to patient or staff
- don’t attempt to manage severe violence on open ward when secure facilities with appropriately trained staff available elsewhere
What is the benefit of knowing the content of delusions and hallucinations in the emergency treatment of behavioural disturbance in psychosis?
poor diagnostic value but may better predict violence/ behavioural disturbance
