Psychosis and Psychotic Disorder Flashcards
_________ is broadly defined as a loss of contact with reality
Psychosis
This defines what?
(a) Strongly held false beliefs
(b) Beliefs are broadly classified as bizarre vs non-bizarre
Delusions
Bizarre vs Non Bizarre delusions
Belief that family members have been replaced by body-doubles
Bizarre
Bizarre vs Non Bizarre delusions
Belief that spouse is cheating despite overwhelming evidence
to the contrary
Non bizarre
What type of delusion
Belief that one is being followed or harassed by outside entity
Persecutory delusions
What type of delusion
Belief that one is a billionaire
Grandiose delusions
What type of delusion
Believing a famous person is in love with them
Erotomanic delusions
What type of delusion
Believing ones sinuses have been infested with worms
Somatic delusions
What type of delusion
Believing a dialog on TV is directed towards you
Delusions of reference
What type of delusion
Believing one’s thoughts and movements are being controlled by a
powerful outside force
-Such as planetary overlords or government
Delusions of control
Wakeful sensory experiences of content that is not actually present
1) NOT illusions
Hallucinations
What is an illusion?
misinterpretations of sensory experiences
True/False
Hallucinations can occur in any of the five sensory modalities
True
Evidence of thought disorganization is derived from the patients ______ during the interview process/
speech pattern
What type of thought disorganization?
a) Very little information conveyed by speech
b) Often very sparse reply or lack of spontaneous speech
Alogia/poverty of content
What type of thought disorganization?
a) Suddenly losing train of thought
b) Characterized by abrupt interruptions in speech
Thought blocking
What type of thought disorganization?
Speech content that has ideas presented in a sequence that is not closely related or does not make sense
Loosening of association
What type of thought disorganization?
a) Answers to interview questions diverge from topic being asked about
b) Is the interview question ever answered?
Tangentiality
What type of thought disorganization?
a) Using words in a sentence that are linked by rhyming or sounding similar
b) “I fell down the well sell bell”
Clanging or clang association
What type of thought disorganization?
a) Using words in a sentence that are linked by rhyming or sounding similar
b) “I fell down the well sell bell”
Clanging or clang association
What type of thought disorganization?
a) Real words are linked together incoherently
b) Real words but basically nonsense
Word salad
What type of thought disorganization?
Repeating words or ideas persistently
Perseveration
acute psychosis is also associated with what issues?
Agitation and aggression
What is done in order to work towards a dx of acute psychosis?
diagnosis of exclusion
R/o Biological cause
-Substance induced
-Psychosis associated with medical conditions
What is used to treat acute agitation associated with psychosis
Haldol
-In certain scenarios may be able to simply “re-direct” the patient to help them with their agitation
1) Offer reassurance and simply talking to them may be enough
What is this issue? Side effect of antipsychotics
a) Involuntary movements of the face
b) Sucking or smacking of the lips
c) Movements of the tongue
d) Facial grimacing
e) Odd movements of extremities
f) Usually occur after greater than six months of treatment on antipsychotic
Tardive Dyskinesia
Second generation antipsychotics examples
Aripiprazole, risperidone, quetiapine, olanzapine
What is this issue? Side effect of antipsychotics
a) Looks like Parkinson’s Disease
(1 Mask like facies, resting tremor, cogwheel rigidity, shuffling gait,
psychomotor retardation (bradykinesia)
Parkinsonian syndrome
What is this issue? Side effect of antipsychotics
Involuntary contractions of muscles
Dystonia
