Psychotic Disorders Flashcards
Idea of reference
Delusion that cues in the external environment are uniquely related to the individual (i.e. The TV characters are talking directly to me…)
What are the two types of delusions of control?
Thought broadcasting: belief that ones thoughts can be heard by others
Thought insertion: belief that others are placing thoughts in ones head
What is a somatic delusion?
Belief that one is infected with a disease or has a certain illness
What are the 6 types of delusions?
- Persecution/ Paranoid
- Ideas of reference
- Control (thought broadcasting/ insertion)
- Grandeur
- Guilt
- Somatic
What is an “illusion” ?
Misinterpretation of sensory stimulus i.e. mistaking a shadow for a cat
List 4 types of hallucinations; with which pathology are they each commonly associated?
- Auditory: schizophrenia
- Visual: intoxication/ withdrawals, delirium, LBD
- Olfactory: epileptic aura
- Tactile: drugs/ ETOH
List 4 medical causes of psychosis:
- CNS disease: CVD, MS, neoplasm, Alzheimers, PD, Huntington’s, Tertiary syphilis…)
- Endodrinopathies: Cushing’s/ Addison’s, Hypo/hyperthyroid, Hypocalcemia, Hypopituitarism)
- Nutritional/ Vitamin deficiency: B12, folate, niacin
- Connective Tissue Disease: SLE, temporal arteritis, porphyria
What are the 3 DSM 5 criteria for psychotic disorder due to another medical condition (not primary psych issue)?
- Hallucinations or Delusions
- Episodes occur outside context of delirium
- History, physical exam, lab data to support alt. dx
What are the 4 DSM 5 criteria for substance/medication induced psychotic disorder?
- Hallucinations or Delusions
- Episodes occur outside context of delirium
- History, physical exam, lab data to support med/sub
- Not better accounted for by psychotic disorder that is NOT sub/ med induced
Which labs should be run with a suspected dx of psychotic disorder? (4)
- TSH
- B12
- RPR
- Urine/ serum drug screen
What are the DSM 5 diagnostic criteria for schizophrenia?
2+ of the following for at least 1 month: **At least 1 of them must be 1, 2, or 3 1. Delusions 2. Hallucinations 3. Disorganized speech 4. Grossly disorganized/ catatonic bx 5, Negative sx
Additionally:
- Pt mus exhibit functional deterioration
- Illness must persist for 6+ MOS
- Sx can’t be explained my medical/substance
What are the three phases of schizophrenia manifestation, and what are the characteristics of each?
- Prodromal- decline in fxn; social withdrawal, etc.
- Psychotic- perceptual disturbances
- Residual- mild perceptual disturbance, social withdrawal, negative sx.
What are the three types of symptoms associated with schizophrenia?
- Positive sx
- Negative sx
- Cognitive sx
5 A’s of Schizophrenia Negative Sx:
- Anhedonia
- Affect (flat)
- Alogia (poverty of speech)
- Avolition (apathy)
- Attention (poor)
What are three cognitive abilities are compromised in schizophrenia?
How does this manifest clinically?
- Attention
- Executive fxn
- Working memory (typically procedural memory and orientation are intact)
**Pts may have decline in work or school performance
What are the DSM 5 criteria for brief psychotic disorder?
How common is the dx?
With what is it commonly associated?
Same as schizophrenia, but for 1 day-1 month duration sx
- *Patients must have full return to premorbid level of fxn within one month
- *RARE dx
- *Commonly occurs in response to extreme stress: bereavement, sexual assault, etc.
What are the DSM 5 criteria for schizophreniform disorder?
Same as schizophrenia but for 1-6 months
What is post-psychotic depression?
Major depressive episode following resolution of psychotic sx in schizophrenic or psychotic patient
_______ commonly occurs comorbidly with schizophrenia:
Substance use; most common substances in order are:
Nicotine –> ETOH –> Cannabis –> Cocaine
What is the downward drift hypothesis associated with schizophrenia?
Schizophrenic patients have difficulty holding jobs/ functioning in society–> more common in patients wof lower SES