Psychotic Disorders

Question 1

Schizoprenia

Answer 1

• chronic, relapsing remitting pattern

- deterioration in functioning over time

Question 2

Schizophreniform disorder

Answer 2

> 1mo but <6mo

-rapid onset from prodrome, returns to baseline functioning or can continue past 6mo and become schizophrenia

Question 3

Brief psychotic disorder

Answer 3

1 day - 1 month

-may develop in response to a severe stressor

Question 4

Schizoaffective Disorder

Answer 4

Uninterrupted period of illness with

• Major Depressive Episode / Manic Episode / mixed episode
• concurrent with criteria A for schizophrenia (pos + neg Sx)

2w period of hallucinations and delusions (absent mood Sx)
Mood Sx for substantial period of total illness duration (>50%)

Bipolar type or Depressive type

Question 5

Delusional Disorder

Answer 5

Non-bizarre delusions >1mo
Doesn’t meet Schitzophrenia criteria A
Brief mood Sx if any

Question 6

Mood congruent delusions

Answer 6

Depressed: personal inadequacy, guilt, disease, death, punishment, nihilism

Manic: inflated worth/power/knowledge, special relationship with deity / famous person

Question 7

Mood incongruent delusions

Answer 7

• persecutory delusions
• thought insertion / broadcasting
• delusions of being controlled

Question 8

Delusional Disorder types

Answer 8

Erotomanic type
Grandiose type
Jealous type
Persecutory type
Somatic type (odour/infestation/dysmorphobhobia)
Mixed type
Unspecified type (Capgras’s, Fregoli’s, intermetamorphosis)

Question 9

Delusional disorder DDx

Answer 9

• other psychotic disorders
• substance induced delusional disorder
• delusional disorder due to GMC
• dementia and delirium
• body dysmorphic disorder
• OCD
• hypochondriasis
• paranoid personality disorder

Question 10

Shared Psychotic disorder

Answer 10

Transfer of delusions from one person to another

-closely related for a long time (one ill person influences a suggestible person)

Question 11

Psychotic disorder not otherwise specified

Answer 11

-does not meet criteria for another disorder

• postpartum psychosis
• auditory hallucinations in absence of other features
• unable to determine if GMC/substance related

Question 12

Good prognostic factors

Answer 12

Acute onset
Precipitated by stressors
Later age of onset
Prominent mood component
No family Hx of schizophrenia
Stable pre-morbid personality
Consistent social support
Short duration of Sx
Little affective blunting

Question 13

Psychotic disorders DDx

Answer 13

GMC/substance induced
Intoxication / substance withdrawal
Delirium
Other Psychotic disorders
Culture specific disorders
Mood disorders with psychotic features