Psychotic D/o

Question 1

psychosis is defined as

Answer 1

a group of sx that characterize the most severe of mental illnesses that involves impaired judgement about boundaries b/w what is real and unreal

Question 2

schizophrenia and other psychotic d/o are defined by abnormalities in one or more of the following 5 domains:

Answer 2

Delusions, hallucinations, disorganized thinking/speech, grossly disorganized or abnormal behavior and negative sx

Question 3

Define delusions

Answer 3

fixed ideas or beliefs that are not amenable to change in light of clear and conflicting evidence to the contrary

Types include: persecutory, grandiose, erotomanic, nihilistic, somatic

Question 4

Define Hallucinations

Answer 4

perception like experiences that occur w/o an external stimulus [vivid and clear, full force impact normal perceptions, involuntary].

Types include: auditory, visual, somatic/tactile, olfactory

Question 5

Define thought broadcasting

Answer 5

believes their thoughts are being heard by others (over radio, out loud in the room, voices outside their head)

Question 6

Define thought insertion

Answer 6

believes thoughts are not their own, they have been inserted into their mind by another person or entity

Question 7

Define thought withdrawl

Answer 7

believes thoughts are being taken from their mind by another, thoughts are initiated but cannot be completed because it was removed by an outside force

Question 8

Define bizarre/disorganized behavior

Answer 8

behavior is bizarre, fantastic, unusual, outside of cultural norms→ may manifest in their clothing, appearance, social/sexual behavior, ritualistic/stereotyped behaviors (pt may wear layers of clothes in hot summer, paint body different colors, preach nonsensically to a crowd, outwardly aggressive or verbally abusive to strangers/in public)

Question 9

Define disorganized speech

Answer 9

Fluent and often energetic, but words and flow of speech do not communicate effectively or in a sensible manner→ pt may skip from topic to topic randomly, words may be joined together in a meaningless way (but maybe rhyme)→ allow pt to talk x5 min

Question 10

Define inappropriate affect

Answer 10

Expressed affect is inappropriate or incongruent w/ circumstances, not simply flat or blunted

Question 11

Define labile affect

Answer 11

Going between extremes (happy to sad)

Question 12

Define Affective flattening>blunting>restriction

Answer 12

social interactions impoverished of emotional expression, reactivity and feeling→ can be assessed through physical behavior and speech (unchanging facial expressions, paucity of gestures, poor eye contact)

Question 13

Define Alogia

Answer 13

Impoverished thinking/cognition; only inferred from pt’s speech (may have a poverty of speech vs poverty of content)

Question 14

Define avolition

Answer 14

Apathy, lack of energy/drive→ cannot manage simple, everyday tasks, often unkempt, poor hygiene, poor performance at school or work

Question 15

Define anhedonia/asociality

Answer 15

Difficulty experiencing interest or pleasure→ ↓ recreational activities, no interest in sex, inability to feel intimate/close

Question 16

Define Catatonic motor behavior:

Answer 16

Stupor, rigidity; catatonic excitement, motor activity/agitation that is apparently purposeless

Question 17

Define Attention impairment:

Answer 17

Difficulty focusing attention, sporadic/erratic attention capabilities→ may wander away in the middle of a conversation, does not pick up on social cues, may do poorly on mental status test despite high level of education

Question 18

Name some anxiety sx

Answer 18

Episodes of intense fear or social anxiety (i.e. panic attacks, agoraphobia, social phobias, specific phobias, obsessions or compulsions)

Question 19

What are manic sx

Answer 19

Euphoric mood, ↑ activity, flight of ideas/racing thoughts, inflated self-esteem, ↓ need for sleep, distractibility, poor judgment.

Question 20

What are depressive sx

Answer 20

Dysphoric mood, weight change, insomnia/hypersomnia, loss of energy, interest, pleasure, feeling worthless, poor concentration, thoughts of suicide/death

Question 21

What are positive sx

Answer 21

More active manifestations of abnormal behavior (delusions/hallucinations, thought d/o, movement d/o)

Question 22

What are negative sx

Answer 22

Deficit in nml behavior, often missed or misinterpreted as depression (avolition, alogia, anhedonia, affective flattening)

Question 23

What is schizophreniform d/o

Answer 23

Experience sx of schizophrenia for at least 1 mo, but < 6 mo

Question 24

What is Schizoaffective d/o

Answer 24

Sx of schizophrenia and also major mood d/o (manic or depressive), psychotic sx must be present for 2+ wks w/o prominent mood sx, but otherwise mood sx do predominate for the majority of the duration of the illness/episode

Question 25

What is delusional d/o

Answer 25

Persistent belief contrary to reality (delusion) w/o other sx of schizophrenia that persists for at least 1 mo

Question 26

What is a brief psychotic d/o

Answer 26

Involves delusions, hallucinations, disorganized speech or behavior that lasts at least 1 day but <1 mo (often reaction to stressor), return to previous level of function

Question 27

What is substance/medication induced psychotic d/o

Answer 27

Psychosis sx develop during or soon after substance intoxication, or as part of w/drawal syndrome