Psychotic Disorders Flashcards
What is a delusion?
fixed false belief that cannot be altered by rational arguments
What is delirium?
a/w fluctuating sensorium, sudden onset, brief course, VT hallucinations
What is a hallucination?
sensory perception w/out an actual external stimulus
What are the types of delusions?
paranoid ideas of reference thought broad casting grandeur guilt
What are positive symptoms?
hallucinations (auditory), delusions, disorganized thought, bizarre behavior
What are negative symptoms?
5 As affect- flattened anhendonia alogia - poverty of speech avolition - apathy attention - poor
What are the criteria for schizophrenia?
constellation of abnormalities in thinking, emotion and behavior. no single symptom
What are the phases of schizo?
prodromal
psychotic
residual - neg symptoms
What are the subtypes of schizo?
DR. CUP
disorganized - poorest functioning, early onset, disorganized behavior and thought
residual - neg symptoms
catatonic - immobility, awkward posture purposeless motor movement, echolalia
undifferentiated
paranoid - highest functioning, older onset, delusions and AH
What is the treatment of schizo?
multi-modality
typical neuroleptics - better with pos symptoms - cause EPS, neuroleptic malignant syndrome and tardive dysk.
ex: chlorpromazine and haloperidol
atypical- treats more neg symptoms, SE is CVA in elderly
ex: risperidone, clozapine
What is associated with a better prognosis for schizo?
female acute onset no fhx later onset good social support positve symptoms
What is EPS?
dystonia (spasms), resting tremor, rigidity, bradykenisia, akathsia - restlessness
What is neuroleptic malignant syndrome?
confusion, high fever, tachycardia, lead pipe rigidity, increased BP
Tx with daloxone
What is tardive dyskensia?
darting and writhing movements of the tongue, mouth face or neck
How do we treat EPS complications?
anti parkinson agents (benztropine) and BZD
What is schizoaffective disorder?
major depressive episode, manic episode, or mixed WITH schizo
delusion or hallucinations for 2 weeks in absence of mood symptoms
BETTER prognosis than schizo, not as good as mood
What is the treatment for schizo affective?
hospitalization, psychotherapy, antipsychotics, mood stabilizers, or ECT
How long are patients with schizoaffective on meds?
rest of lives, where else are they on for rest of life? bipolar
What types of delusions are more common in men?
persecutory and jealous
What delusions are more common in female?
erotomanic
What are the tx for delusional disorders?
psychotherapy
