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Mental Health > 4 - Psychotic disorders > Flashcards

4 - Psychotic disorders Flashcards

1
Q

Name some organic causes of psychosis:

A
  • Drug-induced
  • Medication-induced
  • Complex partial epilepsy
  • Delirium
  • Dementia
  • Huntington’s disease
  • SLE
  • Syphilis
  • Endocrine disturbances ie Cushing’s
  • Metabolic disorders ie Vit B12 deficiency, porphyria, hypercalcaemia
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2
Q

What is the name given to ‘latent schizophrenia’, where the patient has eccentric behaviour, suspiciousness, unusual speech, thinking and affect similar to schizophrenia, but without delusions/hallucinations?

A

Schizotypal disorder

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3
Q

What is the name given to describe the disorder in which a single or set of delusions are experienced for >3 months?

A

Persistent delusional disorder

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4
Q

What is ‘folie a deux’?

A

Induced delusional disorder, characterised by the presence of similar delusions in 2+ people

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5
Q

What is schizoaffective disorder?

A

Both schizophrenic and mood symptoms present in the same episode of illness

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6
Q

What is the dopamine hypothesis of schizophrenia?

A

Schizophrenia is secondary to over-activity of the mesolimbic system - ^^dopamine in the ventral segmental aresa

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7
Q

What is the peak age of onset range of schizophrenia?

A

15-35 yrs

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8
Q

What are the types of schizophrenia?

A

1) Paranoid
2) Hebephrenic
3) Catatonic
4) Residual

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9
Q

What are Schneider’s 1st rank symptoms?

A

ABCD:

Auditory hallucinations
Broadcast (thought)
Control - someone can control mood/actions ‘Passivity phenomenon’
Delusional perceptions

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10
Q

What is the passivity phenomenon?

A

A 1st rank symptom of schizophrenia, in which the patient believes someone can control their mood/actions

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11
Q

What are the risk factors for schizophrenia?

A
  • FH
  • Obstetric complications
  • Low birth weight
  • Childhood abuse
  • Substance misuse
  • Low socioeconomic status
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12
Q

Which group of symptoms are caused by overactivity of the mesolimbic system?

A

Positive symptoms of schizophrenia

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13
Q

Why do D2 antagonists treat the positive symptoms of schizophrenia?

A

Positive symptoms caused by over-activity of dopamine in the mesolimbic system

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14
Q

What are the positive symptoms in schizophrenia?

A
  • Delusions
  • Hallucinations
  • Formal thought disorder
  • Thought interference
  • Passivity phenomenon
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15
Q

What type of hallucinations is most common in schizophrenia?

A

3rd person auditory, may be running commentary

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16
Q

What are the negative symptoms of schizophrenia?

A
  • Apathy
  • Blunted affect
  • Social isolation
  • Poverty of speech and thought
  • Poor self-care
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17
Q

What are the psychological interventions recommended for schizophrenia?

A
  • CBT
  • Family psychoeducation
  • Art therapy
  • Social skills training
18
Q

What are the social interventions recommended for schizophrenia?

A
  • Support groups ie Rethink for rehab into community
  • Peer support
  • Supported employment programmes
19
Q

What are the 2 classes of antipsychotics?

A
  • Typical ie Haloperidol

- Atypical ie Olanzapine

20
Q

All antipsychotics target which receptors?

A

D2 and D3 receptors to reduce dopamine transmission

21
Q

Which class of drugs is 1st line for schizophrenia?

A

Atypical antipsychotics ie Olanzapine

22
Q

Name some atypical antipsychotics:

A
  • Quetiapine
  • Olanzapine
  • Risperidone
  • Aripiprazole
  • Amisulpride
23
Q

Atypical antipsychotics antagonise which receptors?

A
  • Dopamine
  • Serotonin
  • α
  • Histamine
  • Muscarinic
24
Q

One of the main side effects of all antipsychotics is weight gain. Why doesn’t Aripiprazole cause weight gain to the same degree as the others?

A

It is a partial agonist, rather than a pure antagonist like the others

25
Q

What are the 4 main types of extrapyramidal side effects of antipsychotics?

A

1) Parkinsonism
2) Akathisia
3) Dystonia
4) Tardive dyskinesia

26
Q

How quickly do the sedative and tranquillisation effects of antipsychotics set in?

A

~ hrs

27
Q

How quickly do the antipsychotic effects of antipsychotics set in?

A

~ days/weeks

28
Q

Name 2 typical antipsychotics:

A
  • Haloperidol

- Chlorpromazine

29
Q

What are some indications for typical antipsychotics:

A
  • Schizophrenia
  • Psychosis
  • Mania/hypomania
  • Nausea and vomiting
  • Agitation
  • Aggression
  • Hyperactivity
  • Self-mutilation if intellectual disabilities
  • Tourette’s syndrome/severe tics
30
Q

What are Parkinsonism side effects of antipsychotics?

A
  • Rigidity
  • Bradykinesia
  • Coarse tremor
  • Expressionless face
  • Shuffling gait
31
Q

How long does it take for parkinsonism to occur following antipsychotic meds?

A

~ weeks/months

32
Q

What drug can be used to treat parkinsonism side effects of antipsychotics?

A

IM/IV Procyclidine

33
Q

What is akathisia?

A

Difficulty sitting still, and an unpleasant feeling of restlessness

34
Q

How long does it take for akathisia to occur following starting antipsychotic meds?

A

Within 1st few months of commencing treatment

35
Q

What drug can be used to treat akathisia?

A
  • IM/IV Procyclidine

- Temporarily Propanolol

36
Q

What is dystonia?

A

Acute painful contractions of muscles, often in neck, jaw and eyes (oculogyric crisis)

37
Q

How long does it take for dystonia to occur following starting antipsychotic meds?

A

Within days

38
Q

What drug can be used to treat dystonia?

A

IM/IV Procyclidine

39
Q

What is tardive dyskinesia?

A

Abnormal, involuntary movements, often chewing and pouting of jaw

40
Q

How long does it take for tardive dyskinesia to occur falling starting antipsychotic meds?

A

Years

41
Q

What drug can be used to treat tardive dyskinesia?

A

Tetrabenazine

Mental Health (4 decks)

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