Psychotic Disorders

Question 1

A symptom, NOT a disease; associated with many disorders, both psychiatric and medical; gross impairment of reality and perception; divided into positive symptoms, negative symptoms and cognitive impairment

Answer 1

Psychosis

Question 2

Psychotic symptoms are typically divided into what 3 categories

Answer 2

Positive symptoms (hallucinations, delusions)
Negative symptoms
Cognitive impairment

Question 3

Examples of Positive symptoms for Psychosis

Answer 3

Hallucinations
Delusions
Disorganization

Question 4

false perceptinos in the ABSENCE of a real sensory stimuli; either hypnagogic (going to sleep) or hypnopompic (waking from sleep)

Answer 4

Hallucinations

Question 5

type of hallucination that occurs when 1. GOING to sleep and when 2. WAKING from sleep

Answer 5

1. HypnaGOgic (GOing to sleep)

2. HypnoPOmPic (POP from sleep)

Question 6

Most common type of hallucination with schizophrenia (which sense)

Answer 6

Auditory

Question 7

Most common type of hallucination with substance abuse (which sense)

Answer 7

Tactile

Question 8

fixed false belief that is maintained even in the face of considerable evidence or likelihood to the contrary

Answer 8

Delusions

Question 9

A positive symptom of confused thoughts and disorganized speech; likely the core feature of schizophrenia

Answer 9

Disorganization

Question 10

Groupings of words, usually rhyming words, that are based on similar-sounding sounds, even though the words themselves don’t have any logical reason to be together; sign of psychosis in bipolar disorder or in schizophrenia

Answer 10

Clang Associations

Question 11

Examples of Negative Symptoms for Psychosis

Answer 11

Affective flattening (unchanging facial expression)
Alogia (lack of conversation; poverty of speech)
Avolition-apathy (anergia; decreased hygiene/grooming)
Anhedonia-asociality (decreased interests/sex/intimacy)
Attention deficits

Question 12

Describe “flattened affect”

Answer 12

Describe “flattened affect”

Question 13

One of the psychosis symptoms that precedes the onset of positive symptoms; deals with impairment of processing speed, attention, working memory, etc.

Answer 13

Cognitive Impairment

Question 14

What to rule out in trying to diagnose psychosis

Answer 14

1) Rule out medical conditions that can cause behavior

2) Rule out substance induced behavior

Question 15

What medical conditions can cause the appearance of psychosis

Answer 15

Renal failure
Hypercalcemia (bones, stones, groans and moans)
Hypoglycemia
Hypothyroidism
B12 deficiency

Question 16

Psychotic disorder that meets the criteria for schizophrenia but also has a significant secondary mood component (meets major depressive or manic criteria) present for a majority of the illness

Answer 16

Schizoaffective Disorder

Question 17

Psychotic symptoms <1 month duration

Answer 17

Brief Psychotic Disorder

Question 18

Psychotic symptoms >1 but <6 months duration

Answer 18

Schizophreniform Disorder

Question 19

Presence of only delusions WITHOUT other psychotic symptoms; rare, later onset, and NO functional impairment

Answer 19

Delusional Disorder

Question 20

Psychotic disorder with at least 2 symptoms for at least 1 month (delusions, hallucinations, thought disorganization, catatonia/abnormal movement, negative symptoms) + continuous signs of disturbance for at least 6 months + markedly impaired ability to function

Answer 20

Schizophrenia

Question 21

Structural brain abnormality commonly seen in schizophrenia; more negative symptoms and poor prognosis

Answer 21

Enlarged ventricles

Question 22

Abnormal brain function commonly seen in Schizophrenia

Answer 22

Reduced Frontal lobe activity

Increased activity in temporal lobe and limbic structures

Question 23

Most important NT involved in Schizophrenia symptoms

Answer 23

DOPAMINE (high)

serotonin (high)

Question 24

(Good/Poor) prognosis of schizophrenia

Acute and later age of onset
Episodic course
More positive symptoms
Female

Answer 24

Good prognosis

Question 25

Tx of schizophrenia

Answer 25

1. typical antipsychotics (dopamine blockers)

2. atypical antipsychotics (dopamine and 5HT blockers)

Question 26

The side-effect of schizophrenia dopamine-blocking treatment; involuntary muscle spasms of neck, tongue and back

Answer 26

Dystonia

Question 27

The side-effect of schizophrenia dopamine-blocking treatment; inner sense of restlessness

Answer 27

Akathisia

Question 28

The worst side-effect of schizophrenia dopamine-blocking treatment; involuntary abnormal movements often oral-facial dyskinesia

Answer 28

Tardive Dyskinesia