Psychotic disorders Flashcards
Define Psychosis
When a person experiences a reality different to the rest of us without realising
What disorders can people experience psychosis?
Schizophrenia Bipolar disorder Organic - Delirium, Dementia, SoL, Hyperthyroidism, drug induced Personality disorders Severe depression with psychosis
Define Hallucination
Perception in the absence of external stimulus.
What is the most common form of hallucination?
Auditory
What are the different types of hallucinations a person can experience?
Auditory Visual Tactile Olfactory Gustatory
What pathology can an olfactory hallucination suggest?
Frontal lobe pathology due to the path of the cranial nerve
What hallucination can commonly accompany delirium?
Visual
Define Delusion
Firm + fixed belief/thought that is usually false (99% of the time), but is held even with evidence of the contrary. It cannot be reasoned away and is out of keeping with the person’s sociocultural norms/views.
What are some of the different types of Delusions?
Grandiose Persecutory Hypochondrical Reference Guilt Erotomanic Nihilistic Somatic (Similar to Hypochondrical)
Define Grandiose delusion
The person has an overinflated sense of self
Define Reference delusions
When a person takes an innocuous stimuli and believes it has a particular and unusual significance to them despite there being no evidence
Define Persecutory delusions
When a person believes they are being targeted by people despite there being no evidence
Define Hypochondrical delusions
When a person believes there is something wrong with their health despite evidence of the contrary
Define Guilt delusions
When a person believes they have done something wrong without any reason
Define Erotomanic delusions
When a person believes someone is in love with them despite evidence of the contrary
Define Nihilistic delusions
When a person believes they are dead or part of their body is dead despite evidence of the contrary
Define Formal thought disorder
The person has issues with forming coherent thoughts, flight of ideas/knight’s move causing incoherent speech.
What is Flight of ideas?
Where a person’s thoughts are not coherent, but related
What is Knight’s move?
Loosening of associations between thoughts
What are disorders of self?
A person has difficulty distinguishing self from other entities eg time, people, space. There is a lack of self as an agent, unity of experience and private space.
What are some of the symptoms of disorders of self?
Thought broadcast
Thought insertion
Thought withdrawal
Important to remember passive
Define thought broadcast
A person believes their thoughts can be heard by other people eg thoughts coming out of fingers, telepathy
Define thought insertion
A person believes some of their thoughts are not their own and are placed into their mind by other people
Define thought withdrawal
A person believes some of their thoughts have been removed by other people
Define Delirium
A global cognitive impairment
Patients have fluctuating levels of consciousness + confusion
May have visual hallucinations
How do you manage Psychosis?
May depend on risk, insight, compliance and condition
Bio - Drug screen, CT head, Blood test, Urinalysis, Antipsychotics
Psycho - Family, GP
Social - Patient education, Housing support
Name some commonly used antipsychotics
Olanzipine Risperidone Quetiapine Aripiprazole Typical - Haloperidol, Chlorpromazine
What are some of the side effects of antipsychotics?
Atypical - Weight gain, hyperglycaemia/diabetes, sedation, sexual issues
Typical - extra pyramidal eg tremor, tardive dyskinesia, akathisia, muscle stiffness, dry mouth
Why does Clozapine require regular blood tests?
Risk of agranulocytosis
Red - stop Clozipine immediately
Amber - closely monitor WCC
Green - WCC within normal limits (3.6-11.0)
Why does Lithium require regular blood tests?
Very narrow therapeutic range (0.4-1.0mmol/L)
Takes 5 days to reach steady state - check bloods after 1 week to titrate dose
