Psychosis & SZ Flashcards
Brian believes that his parents are trying to poison him because the government are controlling them, which psychopathology term is most appropriate?
Persecutory paranoid delusion
Brian believes that news articles on the television about world leaders’ phones being tapped are actually talking about him as he holds important government information?
Ideas of reference
“My guts have rotted, I can’t eat because I have no bowels” is an example of a ______
Nihilistic delusion
When Brian listens to the radio he can hear voices from elsewhere in the room telling him he must not think about the military information he has been given?
Functional hallucination
Brian believes he must not think about the military information as everyone else has access to his thoughts?
Thought broadcasting
Out of amphetamines, cocaine, cannabis and heroin, which is LEAST likely to cause drug induced psychosis?
Heroin
“Inability to distinguish subjective experience from reality” is the definition of ____
psychosis
Is insight present in psychosis?
nope
What is dementia praecox?
old term for schizophrenia
Can unipolar depression cause psychosis?
yes
What type of psychosis is most likely to occur in unipolar depression?
2nd person auditory hallucinations, mood congruent eg “you’re worthless”
What type of psychosis is most likely to occur in bipolar disorder?
2nd person auditory hallucinations, mood congruent eg. “you’re Christ”, “you’ve got a superpower”
“A fixed falsely held belief with no logical evidence” is the definition of ____
delusion
What is grandoise?
delusion of inflated self-worth
Give examples of drugs more likely to cause psychosis?
dopamine agonists, CCS
“A perception in the absence of of a stimulus” is the definition of _____
hallucination
When do physiological hallucinations occur?
hypnogogic or hypnopompic (upon wakening/ falling asleep)
also in sensory deprivation tank
“Giving innocuous events meaning” is the definition of _____, an example is thinking there is a message in newspaper for them
“giving innocuous events meaning” is the definition of IDEAS OF REFERENCE, an example is thinking there is a message in newspaper for them
Neologisms, tangentiality, Knight’s move thinking, clanging and verbigeration are all examples of _____
form of thought disorder
What is a neologism?
creating new words
What is tangentiality?
speaking about a topic unrelated to the discussion
What is Knight’s move thinking?
rapidly changes topic of conversation with unrelated ideas
What is clanging?
associating words by sound not meaning
What is verbigeration?
word salad
Thought insertion, thought withdrawal, thought broadcasting and thought blocking are all examples of _______
thought interference
What is thought insertion?
thinking thoughts are put into your head that aren’t yours
What is thought withdrawal?
thinking thoughts are being taken out of your head
What is thought broadcasting?
thinking everyone knows your thoughts
What is thought blocking?
a mind blank
What is passivity phenomenon
uncontrollable emotion/motor
example: people making your arm move, people controlling your emotions
Thinking external events relate to you is ______, an example of this would be ______
self referential thinking
the TV is messaging me
How long postpartum does puerperal psychosis occur?
2-4wk
Puerperal psychosis is a medical emergency. T or F
true
Puerperal psychosis occurs in patient’s with a history of mental illness. T or F
false, 50% of patients have no history of mental illness
What is the 1st line drug management of psychosis?
PO lorazepam
If PO lorazepam is unsuccessful after ____ minutes in the management of psychosis, the next line is ____
30 minutes
IM lorazepam
What is the 1st line management of psychosis in a PTx is currently or previously was on a typical antipsychotic?
PO lorazepam + PO haloperidol
What sedating drugs are options in the Mx of psychosis?
BDZ or sedating antipsychotic
What gender is SZ more common in?
M
What age range is SZ more common in in males?
15-25yr
What age range is SZ more common in in females?
25-35yr
What drug can trigger SZ onset (in a genetically susceptible individual)?
cannabis
What medical risk factors for SZ are established by birth?
birth complication, 2nd trimester virus, prenatal maternal stress
What is the % risk of developing SZ if you have a monozygotic twin with SZ?
45%
What % heritability is SZ?
78%
There is a SZ gene. T or F
false, many low penetrance mutations increase likeliness of developing condition
What brain changes are individuals with SZ born with?
large lateral ventricles and less well developed neurons
There is a loss of [grey/white] matter in PTx with SZ?
grey matter
What pathway is overactive in SZ?
dopamine
There is evidence of gliosis in SZ. T or F?
false
What areas of the brain have a loss of grey matter in SZ?
superior temporal gyrus, parietal, hippocampus, basal ganglia, orbitofrontal cortex
What is the commonest type of SZ?
paranoid
Excitement, stupor, mutism and wavy flexibility are all seen in _____ type SZ
catatonic
Can you Dx SZ in a child?
no
What types of psychosis are seen in SZ?
3rd person auditory hallucination, delusions, form of thought disorder and thought interference
(less commonly 2nd person hallucinations can also occur)
At what age are premorbid signs of SZ seen? Give an example
childhood, delay talking
At what age are prodromal signs of SZ seen? What would these be observed as?
teenager, odd eccentric behaviour
Slow/lack of speech, decreased motivation, loss of interests/pleasure, blunted affect, isolation and lack of energy are all examples of _______ in SZ
negative syndrome
Hallucinations, delusions, passivity phenomena and form of thought disorders are all examples of ______ in SZ
positive syndrome
How long must S+S must have bene present for a Dx of SZ?
> 1mth
What is the management of negative symptoms in SZ?
antidepressant
What is the 1st line drug management of SZ?
atypical antipsychotic
What is the drug Mx in SZ for a PTx who has already tried 2 atypical antipsychotics?
clozapine
What structural change is a predictor of a worse outcome in SZ?
large ventricles
Is insidious or rapid onset a predictor of a worse outcome in SZ?
insidious
Is onset in a younger or older PTx with SZ a predictor of a worse outcome in SZ?
younger
What % of people with SZ commit suicide?
10-15%
What is schizoaffective disorder?
Schizophrenia with a mood disorder
What types of delusions could be seen in a PTx with SZ?
grandoise, persecutory