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Psych Final > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

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1
Q

When looking at brain imaging for a psychotic patient, the more organic changes you see…

A

The worse the prognosis

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2
Q

What is the definition of psychosis?

A 
Loss of contact with reality as evidenced by:
• Delusion
• Hallucinations
• Disorganized thoughts and speech
• Disorganized or catatonic behavior
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3
Q

Fixed false beliefs despite disproving evidence

A

Delusions

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4
Q

What are the different types of delusion?

A

Bizarre vs non-bizarre

Paranoid or persecutory

Grandiose

Reference

Somatic

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5
Q

Sensory perceptions in the absence of stimulus

A

Hallucinations

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6
Q

What are the different types of hallucination?

A

Auditory***

Visual

Tactile

Olfactory

Gustatory

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7
Q

What is the most common type of hallucination?

A

Auditory

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8
Q

If a patient has auditory hallucinations, what should you ask them?

A

“What do they say?”

“Do they ever tell you to do something specific?”

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9
Q

If a patient has tactile hallucinations, think…

A

SUD, withdrawal

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10
Q

If a patient has olfactory hallucinations, consider…

A

Brain tumor with sudden onset

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11
Q

What’s an example of a gustatory hallucination?

A

“I can taste the poison in my food…”

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12
Q

Examples of disorganized speech

A 
Derailment, tangentiality
Incoherence, word salad
Neologism
Echolalia
Blocking, paucity
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13
Q

What is considered disorganized or catatonic behavior?

A

Activity that is not goal-directed

Inability to complete simple tasks

Immobility

Waxy flexibility***

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14
Q

These symptoms alone are not psychotic but they are often present in psychotic disorders

A

Negative Symptoms

Decrease or absence of function

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15
Q

Examples of negative symptoms

A

Apathy
Anhedonia
Asociality
Alogia

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16
Q

_________ antipsychotics may be more effective against negative symptoms

A

Atypical

17
Q

What are the different causes of psychosis that you’re gonna wanna put in your differential…

A 
Substance intoxication or withdrawal
Med side effect (steroids, stimulants, dopamine agonists, anticholinergics)
Delirium
Dementia
Endocrine (thyroid)
CNS infection (syphilis)
Epilepsy
Vitamin deficiency (B12)
Autoimmune (SLE)
Huntington’s 
Wilson’s
Psychiatric disorders (psychotic, mood, personality)
18
Q

Substances that stimulate ________ mimic symptoms of schizophrenia

A

Dopamine

Examples: Cocaine/Levodopa/Meth

19
Q

Substances that mimic _____ at the NMDA receptor mimic symptoms of schizophrenia

A

Glutamate

Examples: Ketamine/PCP

20
Q

Substances that mimic _______ result in symptoms of schizophrenia

A

Serotonin

Examples: LSD/Mescaline/Ecstasy

21
Q

Which NT serves as a regulatory hormone of dopamine?

A

Serotonin

22
Q

When might you want to do an EEG for a psychotic patient?

A

If you think it might be delirium and not psychosis

23
Q

What are non-bizarre delusions?

A

Plausible but false (ie infestations, being followed by police)

NOT alien abductions, chips implanted in brain

24
Q

What disorder:

Non-bizarre delusions
Does not meet Criterion A for Schizophrenia
Hallucinations could be related to delusional theme (bugs)
Psychosocial functioning NOT markedly impaired
Normal thought process
Poor insight

A

Delusional Disorder

25
Q

What are the DSM5 criteria for Delusional Disorder?

A

A. Non-bizarre delusions for at least 1 month

B. Criterion A for Schizophrenia has NEVER been met (but hallucinations related to delusion ok)

C. Functioning NOT markedly impaired (behavior not obviously odd or bizarre)

D. Mood episodes (if present) are brief relative to delusion

E. Not due to substance or GMC

26
Q

What are the subtypes of delusional disorder?

A

Erotomanic

Grandiose

Jealous

Persecutory

Somatic

Mixed

Unspecified

27
Q

What type of delusional patient?

Another person is in love with the patient

Usually person of high status (think celebrity stalker)

A

Erotomanic

28
Q

What type of delusional patient?

Inflated worth, power, knowledge, identity, or special relationship to deity or famous person

A

Grandiose

29
Q

What type of delusional patient?

Spouse, significant other, or sexual partner is unfaithful

A

Jealous

30
Q

What type of delusional patient?

Being treated malevolently

Conspired against, cheated, spied on, followed, poisoned, harassed

A

Persecutory

31
Q

What type of delusional patient?

Physical defect or medical condition

A

Somatic

32
Q

Sudden onset of at least 1 positive symptom lasting 1 day to 1 month, with return to normal premorbid functioning

A

Brief Psychotic Disorder

Emotional, labile, confused

Onset in late 20s to early 30s - may be with marked stressor or post-partum onset

R/o culturally appropriate experience, malingering, personality disorder

33
Q

Patients with brief psychotic disorders are at high risk for …

A

Suicide

34
Q

DSM 5 for brief psychotic disorder

A

A. Presence of 1 or more:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Grossly disorganized or catatonic behavior

B. Duration 1 day to 1 month with eventual full return to premorbid level of functioning

C. Not due to schizophrenia, schizoaffective, or mood d/o, substance, or GMC

35
Q

What is the main difference between schizophreniform disorder and schizophrenia?

A

Essential features identical (delusions, hallucinations, disorganization, neg sx) but SHORTER DURATION (1-6 months)

Social/occupational functioning may or may not be impaired

36
Q

______ of schizophreniform patients recover, but ______ progress to schizophrenia or schizoaffective d/o

A

1/3 recover

2/3 progress

37
Q

DSM5 for Schizophreniform Disorder

A

A. Presence of 2 or more:

  1. Delusions
  2. Hallucinations
  3. Disorganized speech
  4. Grossly disorganized or catatonic behavior

B. Duration 1 month - 6 months

C. Not due to schizophrenia, schizoaffective, or mood d/o, substance, or GMC

38
Q

Prevalence of schizophrenia is equal between males and females but…

A

Males have earlier age of onset

Males 18-25
Females 25-35

Psych Final (1 decks)

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