psychotic disorders Flashcards
what is the Key Features in psychotic disorders
- Delusions
- Hallucinations
- Disorganized speech/thinking
- Grossly disorganized or abnormal motor behavior
- Other symptoms
describe Delusions
- Fixed beliefs that are not amenable to change in
light of conflicting evidence. - Themes:
– Persecutory (most common)
– Referential (second most common)
– Erotomanic
– Grandiose
– Etc
describe Persecutory Delusions
Belief that one is going to be harmed, harassed,
and so forth by an individual, or organization.
describe Referential Delusions
- False belief that certain gestures, comments,
environmental cues, and so forth are directed at oneself. - The person falsely believes that insignificant remarks, events or objects in one’s environment
have personal meaning or significance
describe Erotomanic Delusions
- False belief that another person is in love with
the individual. - That person is usually of higher status (e.g., a
famous individual or a superior at work), but
can also be a complete stranger.
describe Grandiose Delusions
- Belief that one has exceptional abilities, wealth,
fame, or a special destiny. - Conviction of having some great (but
unrecognized) talent or insight or having made
some important discovery.
describe Delusion of false identification
(Capgras’ Syndrome)
False belief that a person is an impostor.
“My mother is not my mother, I know”.
describe Cotard delusion (delirium of negation)
False belief that people are already dead, do no
exist or have lost internal organs or blood.
describe Delusion of doubles (Fregoli’s delusion)
Different people are in fact a single person who changes.
describe thought withdrawal
Belief that one’s thoughts have been “removed”
by some outside force
describe thought insertion
- Alien thoughts have been put into one’s mind
describe delusions of control
- One’s body or actions are being acted on or
manipulated by some outside force
what is Hallucinations
- Perception-like experiences that occur without an external stimulus.
- They are not under voluntary control.
- They are vivid and clear.
- They are of any sensory modality (most common auditory).
- They must occur in the context of a clear sensorium:
– Not while falling asleep (hypnagogic)
– Not waking up (hypnopompic)
– Not taking drugs
describe Auditory Hallucinations
- Usually experienced as voices, whether familiar
or unfamiliar. - Perceived as distinct from the individual’s own
thoughts.
what is Disorganized Speech/Thinking
- Mildly disorganized speech
– Switching from one topic to another
(derailment or loose associations).
– Answers to questions may be obliquely
related or completely unrelated
(tangentiality) - (Rarely) nearly incomprehensible (incoherence
or “word salad”)
what is Grossly Disorganized or Abnormal Motor Behavior
- Difficulty in goal directed behavior
- Unpredictable agitation
- Social disinhibition
- Bizarre behavior
- Catatonia/waxy flexibility
what are some other symtoms of psychotic disorders
- Reduced affect display
– Reduced facial expression
– Flat affect - Inappropiate emotions
– Laugh at inappropiate times - Asociality
what is emil kraeplelin known for
- “Dementia praecox” is a physical disease.
- Within the term dementia praecox, he
combined the old concepts of:
*Hebephrenia (coined by Ewald HECKER)
(now Disorganized Schizophrenia) - Catatonia (coined by Karl KAHLBAUM)
- Paranoia
what is eugen bleuler known for
- First to introduce the term squizophrenia (= splitting of the mind).
- Distinction between positive and negative symptoms of schizophrenia (positive = delusions,
hallucinations, etc.; negative = lack of pleasure, etc), and basic and accesory symptoms.
what is a provisional model for psychotic disorders
genetics–>
abnormal neural development
(life style: drugs, abuse) (Stressful Events: trauma, social
conflict…)–>
Disrupted neural connectivity
–>
psychosis
what kind of schizophrenia spectrum and psychotic disorders is there
- Schizophrenia
- Schizophreniform Disorder
- Brief Psychotic Disorder
- Delusional Disorder
- Schizoaffective Disorder
describe schizophrenia
- more than 6 months
at least 2 of:
– Delusions
– Hallucinations
– Disorganized speech/thought
– Grossly disorganized or catatonic behaviors
describe schizophreniform disorder
- 1-6 months
at least 2 of:
– Delusions
– Hallucinations
– Disorganized speech/thought
– Grossly disorganized or catatonic behaviors
describe Brief Psychotic Disorder
- less than 1 month
At least 1 of:
– Delusions
– Hallucinations
– Disorganized speech/thought
– Grossly disorganized or catatonic behaviors
describe Delusional Disorder
- at least 1 month of delusions
Types:
* Specific: persecutory, grandiose, erotomanic, jealous, somatic, etc.
* Mixed
*Unspecified
- No other psychotic symptoms.
- Apparent normality (behavior and appearance) when delusional ideas are not being discussed or acted on.
describe Schizoaffective Disorder
- at least 2 weeks
- A mood episode and the active-phase symptoms of
schizophrenia occur together and were preceded or are followed by at least 2 weeks of delusions or hallucinations without prominent mood symptoms. - Subtypes:
– Bipolar type
– Depressive type
what objectives is there to evaluate for psychotic disorders
- Comprehensive history
– Cultural and religious background
– Family history
– Substance/medication use
– Symptoms - Degree of cognitive deficits
- Severity of moods symptoms
name some questionaries for psychotic disorders
- PANSS: Positive and Negative Syndrome Scale. interview
- PDI: Peters’ Delusions Inventory.
what objectives is there for intervention
- Security and proteccion
- Hospitalization (in risky situations)
- Good treatment must address
symptoms and social/occupational dysfunction
what kind of pharmacotherapy is there
- Antipsychotics or neuroleptic
- Atypical antipsychotics (now preferred: more specific and less side effects)
what kind of Psychotherapy is there
- Cognitive Behavior Therapy
- Psychosocial rehabilitation:
- Problem solution
- Social skills
- Job
- Family psycho-education
- Excercise therapy for negative symptoms
