Psychotic Disorders Flashcards
What is psychosis?
a term used to describe a distorted perception of reality and exemplified by delusions, hallucinations, or disorganized thought/behavior
What is the most important classification for delusions?
as either non-bizzare (a belief that could be true but just isn’t) or bizarre (a false belief that is impossible)
What are the following delusional themes:
- delusions of persecution
- ideas of reference
- delusions of control
- delusions of grandeur
- delusions of guilt
- somatic delusions
- delusions of persecution: paranoid delusions
- ideas of reference: the belief that cues in the external environment are uniquely meant for the individual
- delusions of control: includes thought broadcasting and thought insertion
- delusions of grandeur: belief that one has special powers
- delusions of guilt: belief that one is responsible for something (like all the world’s wars)
- somatic delusions: the false belief that one is infected with a disease or has a certain illness
Under what circumstances are the following types of hallucinations most common:
- auditory
- visual
- olfactory
- tactile
- auditory: most commonly seen in schizophrenics
- visual: most commonly accompanying drug intoxication, withdrawal, or delirium
- olfactory: most commonly an aura preceding seizures
- tactile: most commonly secondary to drug abuse or alcohol withdrawal
What are the criteria for psychotic disorder secondary to a general medical condition?
- prominent hallucinations or delusions
- symptoms do not occur only during an episode of delirium
What is the difference between positive and negative symptoms?
positive are those added onto normal behavior whereas negative are those subtracted or missing
What are the negative symptoms of schizophrenia?
The 5 A’s of schizophrenia:
- anhedonia
- affect (flat)
- alogia (poverty of speech)
- apathy/avolition
- attention (poor)
What are the criteria for diagnosing schizophrenia?
> two or more of the following for at least one month:
- delusions
- hallucinations
- disorganized speech
- grossly disorganized catatonic behavior
- negative symptoms
or only one of the above if delusions are bizarre, hallucinations consist of a voice keeping a running commentary, or two or more voices are conversing with each other
duration of the illness is at least 6 months including the prodromal or residual periods in which the above may not be met
What are the five subtypes of schizophrenia?
- paranoid type: with delusions or auditory hallucinations
- disorganized type: characterized by disorganized speech, disorganized behavior, and flat/inappropriate affect
- catatonic type: characterized by odd movements or postures
- residual type: negative symptoms predominate
- undifferentiated type: doesn’t fall into any other category
Define echolalia and echopraxia.
- echolalia is repeating words or phrases spoken by others
- echopraxia is mimicking the behavior of others
What is post psychotic depression?
a phenomenon in which schizophrenic patients develop a major depressive episode after resolution of their psychotic symptoms
What are the neurochemical changes thought to underlie schizophrenia?
- an increase in dopamine within the mesolithic pathway responsible for the positive symptoms
- a decrease in dopamine within the prefrontal pathway responsible for the negative symptoms
- elevated serotonin and norepinephrine
- decreased GABA and levels of NMDA receptors
What is the head CT of a schizophrenic likely to show?
diffuse cortical atrophy and enlarged ventricles
Define neologism.
the use of words that have meaning only to the person who uses them and is different than the orthodox meaning of the word
What are positive and negative prognostic factors for those with schizophrenia?
- positive: acute onset, late onset, more positive symptoms, mood symptoms
- negative: gradual onset, early onset, more negative symptoms, comorbid substance abuse
