10 22 2014 Psychosis Lecutre

Question 1

Delusional disorder?

Answer 1

Fixed, persisten, non-bizarre delusional system

• 1 or more delusions for 1 month or longer in an individual with no prior history of schizophrenia
• function is not markedly impaired
• paranoid
• romatic
  - married to a celebrity
  - someone is in love with them

Question 2

Subtypes of Delusional Disorder

Answer 2

1. jealousy
2. Persecutory
3. Erotomanic ( de Clerambault’s)
   - someone is in love with you
4. Grandiose
5. Somatic
6. Mixed

Question 3

Capgra’s Syndrome

Answer 3

Belief that the one you love has been replaced by imposter

-imposter is key feature for the patient ~ usually spouse if married

Question 4

Fregoli’s Syndrome

Answer 4

Delusion that persecutors or familiar persons can assume the guises of strangers
- can change themselves at will.

Question 5

Cotard Syndrom

Answer 5

complaints of haven gloat possession and or status

• Physical : lost heart, blood, intestines
• Non- Physical : courage

Question 6

Schizophrenia criteria for diagnosis

Answer 6

1. eliminate :  
Schizoaffective or mood disorder
Autism Spectrum
Substance intoxication/ withdrawal
General Medical Condition

2. 2 or more symptoms of positive and/or negative symptoms of schizophrenia for at least one month
3. Dysfunction lasts for 6 months or more
4. Life long social and occupational impairment

Question 7

General Medical Conditions

Answer 7

I <3 LADY MACBETH

Immunological
Heart
Lumbar
Anoxia
Drugs
Yam
Malignancy
Ammonia
CBC, CMP, Ceruloplasmin
B12, Folic acid, Thiamine
EEG - non convulsive status
TFT - Hyper/Hypothyroidsm
Head:  CT or MRI -- trauma, abscess, infection..etc.

Question 8

Positive Symptoms of Schizophrenia

Answer 8

• Delusions
• Hallucinations ( auditory)
• Disorganized Speech
• Disorganized or catatonic behavior

Question 9

Negative Symptoms of Schizophrenia

Answer 9

PLANT

• aPathy
• aLogia (poverty of speech, thought)
• Affective flattening
• aNhedonia (withdrawal)
• aTtention deficit

Question 10

Different aspects of Catatonia

Answer 10

Marked behavioral disturbance

1. Abnormal motor immobility
2. Decreased engagement

Question 11

Types of abnormal motor immobility seen in Catatonia

Answer 11

• decreased
  
  • severe= Stupor
  • moderate = Catalepsy
  • mild = lethargy
• Excessive: agitation, manerism, stereotypy

Question 12

Types of decreased engagement (catatonia)

Answer 12

moderate = negativism
Severe = mutism (inability to speak)

Question 13

Schizophreniform vs. Schizophrenia

Answer 13

same as schizophrenia BUT duration is 1-6 months.

33% make a full recovery

Question 14

Brief Psychotic disorder vs. Schizophrenia

Answer 14

Only needs 1 or more the of the criteria
NO NEGATIVE SYMPTOMS
Duration is longer than a day and less than a month
50-80% make a full recovery