Psychotic Disorders Flashcards
Psychosis (Definition)
A Break from reality involving:
- Delusions
- Perceptual Disturbances
- Disordered Thinking
Examples of Psychosis Disorders
Schizophrenia and substance-induced psychosis
Disordered thought (types)
Disorders of thought content and thought process
Disorders of thought content
Reflect the patiet’s beliefs, ideas, and interpretations of his or her surroundings.
Disorders of thought process
Reflect the manner in which the patient links ideas and words together
Disorders of thought content, examples
PAranoid delusions, ideas of reference, and loss of ego boundaries
Disorders of thought process, examples
Tangentiality, circumstantiality, loosening of associations, thought blocking, perseveration
Delusions
Fixed, false beliefs that cannot be altered by rational arguments and cannot be accounted for by the cultural background of the individual.
Paranoid delusion
Irrational belief that one is being persecuted
“The CIA is after me and taps my phone”
Ideas of reference
Belief that some event is uniquely related to the individual.
“Jesus is speaking to me through TV characters”
Thought broadcasting
Belief that one’s thoughts can be heard by others
Delusions of grandeur
belief that one has special powers beyond those of a normal person.
“I am the all-powerful son of God and I shall bring down my wrath on you if I cannot have a smoke.”
Delusions of guilt
False belief that one is guilty or responsible for something.
“I caused the flood in Mozambique”
Hallucination
Sensory perception without an actual external stimulus
Auditory hallucination
Most commonly exhibited by schizophrenic patients
Visual halluciantion
Commonly seen with drug intoxication
Olfactory hallucination
Usually an aura associated with epilepsy
Tactile hallucination
Usually secondary to drug (cocaine) abuse or alcohol withdrawal
Illusion
Misinterpretation of an existing sensory stimulus (such as mistaking a shadow for a cat)
Psychosis secondary to General Medical Condition
Medical causes of psychosis include: CNS Disease, Endocrinopathies, Nutritional/Vitamin Deficiency states, Other
Loss of ego boundaries
Unawareness of where one’s mind and body end and those of others begin
CNS Disease as a medical cause of psychosis
Cerebrovascular disease, multiple sclerosis, neoplasm, Parkinson’s disease, Huntington’s chorea, temporal lobe epilepsy, encephalitis, prion disease
Endocrinopathies as a medical cause of psychosis
Addison’s/Cushing’s diease, hyper/hypothyroidism, hyper/hypocalcemia, hypopituitarism
Nutritional/Vitamin Deficiency states as a medical cause of psychosis
Deficiency in B12, folate, and niacin
Other medical causes of psychosis
Connective tissue disease (SLE, temporal arteritis) and porphyria
DSM-IV criteria for psychotic disorder secondary to a general medical condition include:
- Prominent hallucinations or delusions
- Symptoms do not occur only during episode of delirium
- Evidence to support medical cause from lab data, history, or physical
Psychosis secondary to medication or substance use
Due to: antidepressants, antiparkinsonian agents, antihypertensives, antihistamines, anticonvulsants, digitalis, beta blockers, antituberculosis agents, corticosteroids, hallucinogens, amphetamines, opiates, bromid, heavy metal toxicity, and alcohol.
Psychosis secondary to medication or substance use. DSM IV Criteria
- Prominent hallucinations or delusions
- Symptoms do not occur only during episode of delirium
- Evidence to support medication or substance-related cause from lab data, history, or physical
- Disturbances is not better accounted for by a psychotic disorder that is not substance-induced.
