Psychosis Flashcards
Define schizophrenia.
Severe psychiatric disorder that is characterised by chronic or recurrent psychosis. Effecting thoughts, perceptions and mood. No other causes
What are the subtypes of schizophrenia?
- paranoid
- hebephrenic (mood changes + unpredictable behaviours)
- simple (no +ve Sx)
- catatonic
- undifferentiated
what are the positive symptoms?
change in thought or behaviour
- thought echo
- thought insertion
- thought broadcasting
- THIRD person auditory hallucinations
- delusions
- passivity
- odd behaviours
- lack of insight
What are negative symptoms?
change/decline in normal functioning
- blunted affect
- apathy
- social isolation
- poverty of speech
- poor self care
DDx for psychotic like symptoms?
- delirium
- drug intoxication
- mass lesions in the brain
- HIV brain
- neurosphylisis
- dementia
What are schneider’s first rank symptoms? why they important anyway?
1 or more must be present for greater than 1 month for a diagnosis of schizophrenia to be made
- thought insertion/withdrawal/broadcasting
- 3rd person auditory hallucinations
- delusional perception
- passivity
What is the management for schizophrenia?
- voluntary or compulsory hospital stay
- antipsychotic medication - typical or atypical may be used
What are typical antipsychotics and what is there SE profile?
-haloperidol, chlorpromazine
- EPSEs
- hyperprolactinaemia - ED, osteoporosis, amenorrhoea, gynaecomastia & hypogonadism in men
- metabolic syndrome - weight gain, glucose intolerance - T2DM, hyperlipidaemia
- anticholinergic Sx - tachy, dry mouth, blurred vision, constipation
- neuro tings - seizures, NMS
What are some atypical antipsychotics and how does there SE profile differ from typical?
-risperidone, onlanzapine, clozapine, quietiapine
- No/less EPSEs and hyperprolactinaemia
- still anticholinergic + neuro tings + metabolic tings
What tests should be run before starting a patient on an antipsychotic?
baseline tests:
- BMI
- U&Es
- FBCs
- Lipids
- HbA1C
- ECG - haloperidol, pimozide, sertindole.
Who’s clozapine? Why are they special? What have you got to do with them?
- 2nd line antipsychotic used when a patient’s psychosis is NOT controlled with trail of a typical and atypical drug
- weekly at start 4/12, fortnightly further 8/12, monthly thereafter FBC checks due to increased risk of agranulocytosis
What are schnieder’s 2nd rank Sx?
- delusions
- 2nd person auditory
- hallucinations in other modalities
- catatonic behaviour
- negative Sx
When does postpartum psychosis usually occur?
typically within 2/52 post partum
What are the symptoms of post partum psychosis?
- loss of inhibition
- depression
- paranoia
- hallucinations
- delusions
- suicidal ideation
- thoughts of harming the baby -
What is the treatment for postpartum psychosis?
family support + psychological therapy
antipsychotic medicaiton
+/- hospitalisation
-assess risk for baby
