Psychotic Disorders

Question 1

Delusions

Answer 1

Fixed and firm beliefs that are not centered in reality

Wont change even with evidence

Question 2

Hallucinations

Answer 2

Perception without external stimuli

Question 3

Illusions

Answer 3

Perceived something incorrectly

Ex: seeing a sweater on the ground and thinking it is a cat

Question 4

2 types of catatonia

Answer 4

Inhibited

Catatonic excitement

Question 5

What is the highest yield question to determine between primary and secondary psychosis?

Answer 5

Could you tell me today’s complete date?

Secondary etiologies often will be confused and won’t know the date

Question 6

Prominent visual hallucinations as the main symptom point more to…

Answer 6

Secondary causes of psychosis

Question 7

Characteristic symptoms of schizophrenia

Answer 7

Audible thoughts
Voices arguing
Voices heard commenting on one’s actions
Somatic passivity experiences (aliens controlling body)
Thought withdrawal
Diffusion of thought or thought broadcasting

Question 8

Delirium

Answer 8

Hallucinations or delusions can be present
Key aspect is that they are disoriented and confused
Acute, confusional syndrome
Circadian rhythms also messed up - asleep during day, awake at night
Often see in the ICU/post surgery/wards

Question 9

ABCDE approach to diagnosis in the DSM

Answer 9

A: signs/symptoms
B: functional impairment
C: duration
D: exclusion from other primary causes
E: exclusion from secondary causes

Question 10

Brief psychotic disorder

Answer 10

Duration is 1 day to 1 month
Before episode was fine (no prior psych hx)
Quick onset (within 2 weeks)
Person recovers fully and returns to baseline
No negative symptoms

Question 11

Schizophreniform disorder

Answer 11

Duration is 1 to 6 months
Looks like schizophrenia just not for long enough
Can be some signs before the episode that they weren’t doing well (not out of the blue)
Will see negative symptoms

Question 12

Schizoaffective disorder

Answer 12

Psychosis and mood disorder

The psychosis can present with mood symptoms but will also present in isolation

Question 13

Delusional disorder

Answer 13

Only delusions
Does not present with negative symptoms
Can be functioning very well in other life aspects

Question 14

Schizophrenia

Answer 14

Duration > 6 months
Remitting/relapsing course (90%)
Acute episodes most frequently followed by residual defect (not full recovery)
Reduces life span by ~10 years

Question 15

Risk factors for schizophrenia

Answer 15

Poor premorbid functioning
Cognitive dysfunction
Male
Obstetric complications
Increased paternal age

Question 16

Factors that point to a poor outcome with schizophrenia

Answer 16

Low SES
Substance use
Prolonged duration of untreated psychosis
Early onset
Increased Lat Ventricle