Psychotic Disorders Flashcards
What is psychosis?
Not a condition or a syndrome - an umbrella term for a form of disorder. It is a disorder of perception, where people experience the world to be different from how it is in actuality
There any different syndromes and diseases that have psychotic features
List some examples of disorders/diseases where psychotic symptoms can occur (12)
1) Delusional disorder
2) Schizophrenia
3) Schizoaffective disorder
4) Acute and transient psychosis
5) Substance misuse (cannabis, LSD, shrooms)
6) Substance withdrawal (alcohol and opiates)
7) Dementia (LBD)
8) Sleep deprivation
9) Post-partum
10) Sensory deprivation
11) Severe depression or mania
12) Bereavement
What are three broad features of psychosis?
1) Thought disorder
2) Delusions
3) Hallucinations
What is a thought disorder?
An abnormality in the mechanism of thinking such that to an outside observer the person speaking does not make any sense
What is a delusion?
A false, unshakeable belief despite compelling evidence to the contrary that is not held by others in the same culture and held with intense personal conviction or certainty
What is a hallucination?
A perception which occurs in the absence of a stimulus
The perceptual experience is false but to the person experiencing it, has the full force and impact of a real perception and is consequently indistinguishable from a real perception
Occurs in external space (not in mind’s eye)
Auditory, Visual, Olfactory, Gustatory, Tactile, Somatic
What is the most common type of hallucination in psychosis?
Auditory
When do visual hallucinations tend to occur?
Not a feature of psychosis but tend to be more common in organic disorders
What is a pseudo-hallucination?
A sensory experience vivd enough to be regarded as a hallucination but recognised by the subject not to be the result of external stimuli and therefore not real
What questions are important to ask to someone who is hearing voices?
Start with - do you ever hear voices when no one else is around / that no one else can hear?
1) How many are there?
2) What gender are the voices?
3) Are they talking about you or to you?
4) Do you recognise the voices?
5) Is there anything that triggers the voices?
6) What do they say?
7) How do they make you feel?
8) Are they constant / worse at a specific time of day?
9) Do they ever command you to do anything?
10) Do you think theres any chance the voices might not be real?
What is thought broadcast?
The subject experiences his thoughts as actually being shared with others, often with large numbers of people
The subject often claim this sharing is via telepathy, radio and TV
What is adhedonia?
A total inability to enjoy anything in life or even get the accustomed satisfaction from everyday events or objects
What is lability?
The subjects affect is rapidly changeable and there are marked fluctuations
The subject maybe cheerful and smiling and then shortly after crying (emotional incontinence may be used in this extreme)
What are ideas of reference?
A delusional belief that innocuous events or coincidences are directly linked and have personal significance to the subject
Eg the TV / radio is talking about / to them
What are neologisms?
New words that have no meaning
What is an illusion?
A false perception of a real stimulus. 3 types:
1) Affect
2) Completion
3) Pareidolia
What is loosening of associations?
Loss of normal structured thinking
The subjects discourse seems muddled and illogical and does not become clearer with further questioning
As the interviewer it may feel that the more questions you ask to gain clarity the more difficult it is to understand them
= Disorder of thought form
What is clouding of consciousness?
A step down from normal alertness
There is a deterioration in thinking, attention, perception and memory and usually drowsiness and reduced awareness of environment
What are 3rd person auditory hallucinations?
The subject hears voices talking about him / herm, referring to them in the third person
What is thought withdrawal?
The subject believes that their thoughts have been removed from their mind by an external agency and they do not have control over it
What is affect?
Short lived observable pattern of behaviour that expresses the subjective emotional state of an individual
Subject to variation over brief periods of time
Affect = Weather Mood = Climate
What are nihilistic delusions?
Delusions of extreme negativity - no longer existing, about to die or even being dead, about to experience terrible doom
What is concrete thinking?
The inability to understand abstract ideas or concepts
Subjects will be focused on the hear and now, physical objects and literal meanings / delusions
What are delusions of control / passivity?
The subject believes that their thoughts, feelings and/or actions are not their own but are being imposed/ controlled by an outside force
Eg they believe that someone else’s words are coming out using their voice or they are being made to think a certain way