Psychotic Disorders Flashcards
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
Psychosis
Psychotic symptoms are typically divided into what 3 categories
Positive symptoms (hallucinations, delusions)
Negative symptoms
Cognitive impairment
Examples of Positive symptoms for Psychosis
Hallucinations
Delusions
Disorganization
false perceptinos in the ABSENCE of a real sensory stimuli; either hypnagogic (going to sleep) or hypnopompic (waking from sleep)
Hallucinations
type of hallucination that occurs when 1. GOING to sleep and when 2. WAKING from sleep
- HypnaGOgic (GOing to sleep)
2. HypnoPOmPic (POP from sleep)
Most common type of hallucination with schizophrenia (which sense)
Auditory
Most common type of hallucination with substance abuse (which sense)
Tactile
fixed false belief that is maintained even in the face of considerable evidence or likelihood to the contrary
Delusions
A positive symptom of confused thoughts and disorganized speech; likely the core feature of schizophrenia
Disorganization
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
Clang Associations
Examples of Negative Symptoms for Psychosis
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
Describe “flattened affect”
Describe “flattened affect”
One of the psychosis symptoms that precedes the onset of positive symptoms; deals with impairment of processing speed, attention, working memory, etc.
Cognitive Impairment
What to rule out in trying to diagnose psychosis
1) Rule out medical conditions that can cause behavior
2) Rule out substance induced behavior
What medical conditions can cause the appearance of psychosis
Renal failure Hypercalcemia (bones, stones, groans and moans) Hypoglycemia Hypothyroidism B12 deficiency
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
Schizoaffective Disorder
Psychotic symptoms <1 month duration
Brief Psychotic Disorder
Psychotic symptoms >1 but <6 months duration
Schizophreniform Disorder
Presence of only delusions WITHOUT other psychotic symptoms; rare, later onset, and NO functional impairment
Delusional Disorder
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
Schizophrenia
Structural brain abnormality commonly seen in schizophrenia; more negative symptoms and poor prognosis
Enlarged ventricles
Abnormal brain function commonly seen in Schizophrenia
Reduced Frontal lobe activity
Increased activity in temporal lobe and limbic structures
Most important NT involved in Schizophrenia symptoms
DOPAMINE (high)
serotonin (high)
(Good/Poor) prognosis of schizophrenia
Acute and later age of onset
Episodic course
More positive symptoms
Female
Good prognosis
Tx of schizophrenia
- typical antipsychotics (dopamine blockers)
2. atypical antipsychotics (dopamine and 5HT blockers)
The side-effect of schizophrenia dopamine-blocking treatment; involuntary muscle spasms of neck, tongue and back
Dystonia
The side-effect of schizophrenia dopamine-blocking treatment; inner sense of restlessness
Akathisia
The worst side-effect of schizophrenia dopamine-blocking treatment; involuntary abnormal movements often oral-facial dyskinesia
Tardive Dyskinesia
