Psychotic Disorders (inc. schizophrenia)

Question 1

list the 5 features of psychosis

Answer 1

• delusions
• hallucinations
• disorganized thought
• disorganized behaviour
• negative symptoms

Question 2

def psychosis

Answer 2

constellation of s/s resulting in a loss of touch with reality

Question 3

def psychotic disorders

Answer 3

severe mental disorders characterized by changes in thought, reality-testing, and perception

Question 4

def delusions

Answer 4

fixed false beliefs

Question 5

types of delusions

Answer 5

MC: persecutory
other
- referential: external environment are directed at them
- grandiose: unrealistic views of oneself
- erotomanic: others in love with them
- nihilistic: major catastrophes will occur
- somatic: bodily function

bizzare vs non-bizzare

Question 6

def hallucinations

Answer 6

5 senses - perceived stimuli where there is no actual external stimuli

Question 7

types of hallucinations

Answer 7

auditory ➔ MC schizo
visual ➔ MC lewy body dementia
visual and tactile ➔ alcohol withdrawal

other: olfactory, proprioceptive

Question 8

def disorganized thought

Answer 8

thought process isn’t straight forward

Question 9

types of disorganized thought

Answer 9

circumstantial: circular but returns to the point
tangential: never returns to the point
word salad: unintelligble
neologism: made up words/phrases
perseveration: repetition

Question 10

types of disorganized behaviour

Answer 10

lack of impulse control
nonsensical/socially appropriate actions
catatonic behaviour

Question 11

types of negative symptoms

Answer 11

• emotionally blunted
• flat affect
• algoia: poverty of speech
• psychomotor retardation
• decrease energy, interest, concentration
• anhedonia

Question 12

def brief psychotic disorder

Answer 12

DSM: ≥1 positive psychotic symptom (delusions, hallucinations, disorganized speech) for >1d but <1M +/- grossly abnormal psychomotor behaviour (including catatonia)

Question 13

def delusional disorder

Answer 13

DSM: ≥ 1 delusion that persist for ≥1M

Question 14

def delusional parasitosis

Answer 14

not DSM5
Psychodermatological disorder → recurrent and fixed belief they are infested by small organisms or unanimated materials under the skin (like fibers/hairs → Morgellons disease) w/o objective evidence of infestation/parasitosis

Question 15

def schizophrenia

Answer 15

Criteria A (active phase):
- ≥ 2 symptoms each present for a sig portion of time during a 1M period (must have at least 1 of the first 3)
- Delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behaviour, or negative symptoms

also have continous disturbance for at least 6M

Question 16

def schizoaffective disorder

Answer 16

DSM: Major mood episode (either manic or depressive) that co-occurs at the same time with symptoms of schizophrenia → but the schizo symptoms (delusions or hallucinations) must occur for ≥2 weeks in the absence of a major mood episode

Question 17

def schizophreniform disorder

Answer 17

DSM: 1-6M with at least 2 of the psychotic symptoms (criteria A)

Question 18

common meds/substances that cause induced psychotic disorder

Answer 18

Common meds: steroids, interferon therapy, mefloquine (antimalarial), and diphenhydramine (allergy meds; think breaking bad and meth)

Common recreational substances: alcohol, amphetamines, cannabis, cocaine, hallucinogens, opioids, phencyclidine (PCP), and sedative/hypnotics

Question 19

def postpartum psychosis

Answer 19

psychiatric emergency

high rates of suicide and infanticide

Mothers may experience command hallucinations to kill the infant or delusions that the infant is possessed

Question 20

tx of psychotic disorders

Answer 20

psychotic episodes and disorders: antipsychotic meds (risperidone) ➔ useful vs positive symptoms

consider benzodiazepines

for acutely agitated ➔ hospitalized and may harm self/others ➔ antipsychotic w/benzo

also give CBT