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Psychiatry > Psychosis - General > Flashcards

Psychosis - General Flashcards

1
Q

What happens in psychosis?

A

The ability to recognise reality and the ability to communicate with and relate to others are significantly impaired which interferes with the capacity to cope with reality

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2
Q

What are the 3 classic characteristics of psychosis?

A

Hallucinations, delusions and formal thought disorders

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3
Q

Psychosis involves the inability to distinguish between what? This is characterised by what?

A

Subjective experience and reality, characterised by a loss of insight

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4
Q

What are the 4 major groups of causes of psychosis?

A

Organic conditions, substance misuse, affective disorders and dementia praecox

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5
Q

What are some organic conditions which can cause psychosis?

A

Delirium, dementia, brain injury, stroke

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6
Q

What are some aspects of substance misuse that can cause psychosis?

A

Withdrawal, DT, acute intoxication

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7
Q

Which affective disorder is most likely to cause psychosis?

A

Bipolar disorder

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8
Q

What is dementia praecox?

A

Schizophrenia and other paranoid illnesses

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9
Q

What is schizoaffective disorder?

A

A condition which lies somewhere between affective mood disorders and schizophrenia

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10
Q

How may a formal thought disorder be evidenced?

A

As disorganised speech

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11
Q

What is a hallucination?

A

A perception which occurs in the absence of an external stimulus

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12
Q

What is an auditory misperception? What can this lead to?

A

This is when you hear something which is actually occurring but interpret it as something else. This is not a halucination but can lead to secondary delusions.

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13
Q

Can a person make hallucinations go away?

A

No - true hallucinations are not subject to conscious manipulation (i.e. you cannot alter the mind to make them go away)

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14
Q

When are visual hallucinations most likely to be seen?

A

In delirium and sometimes substance misuse

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15
Q

What does a haptic hallucination affect?

A

Deep sensation- feeling like the organs have moved or something has been placed inside them

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16
Q

Give some examples of simple auditory hallucinations?

A

Murmuring, formless sound, bangs

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17
Q

Give some examples of complex auditory hallucinations?

A

Voices, music

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18
Q

What is an idea of reference?

A

When an innocuous or coincidental event will be ascribed as being significant or meaningful by the person

19
Q

In ideas of reference, the patient will believe that these messages are being sent to who?

A

Them, and no-one else

20
Q

Ideas of reference also include self-referential experiences. What are these?

A

The belief that external events are related to oneself

21
Q

If an idea of reference is held very strongly, it can become what?

A

A delusion of reference

22
Q

What is a delusion of reference?

A

A more strongly held idea of reference

23
Q

Explain briefly the difference between an idea and a delusion of reference?

A

Someone with an idea of reference may change their mind when evidence dictates they must, while someone with a delusion of reference will believe something refers back to them even in the face of strong evidence to the contrary

24
Q

What is a delusion?

A

A fixed, firmly held belief with unshakable conviction, despite logical argument or evidence to the contrary

25
Q

Delusions are usually held outwith what?

A

The social, cultural and educational background of the patient (can be bizarre/impossible)

26
Q

What is a primary delusion?

A

One that arises out of nothing

27
Q

What is a secondary delusion?

A

One that is understandable with the addition of some other psychopathological event (i.e. attempts to explain hallucinations/abnormal mood)

28
Q

Punning and loosening of associations are seen in which feature of psychosis?

A

Formal thought disorder

29
Q

How will the patients speech be in someone with a formal thought disorder?

A

Difficult to understand and fragmented

30
Q

What are the 4 different types of thought interference?

A

Though withdrawal, thought insertion, thought broadcasting and thought blocking

31
Q

What is passivity?

A

Patients believe that their thoughts, feelings or acts are controlled by others

32
Q

Passivity of volition is responsible for what?

A

Making actions

33
Q

Passivity of affect is responsible for what?

A

Making feelings

34
Q

Passivity of impulse is responsible for what?

A

Making urges

35
Q

Somatic passivity is responsible for what?

A

Making influences on the body

36
Q

Describe the loss of insight seen in psychosis?

A

To the patient, everything seems as real as it always did and things make sense, but people are telling them they are unwell

37
Q

3rd person auditory hallucinations are most suggestive of which diagnosis? What is another cause?

A

Most likely schizophrenia, can also be caused by delirium/dementia

38
Q

Describe the clinical course of drug induces psychosis?

A

Tends to be short lasting if access to the psychoactive substance is removed

39
Q

What should you be aware of if someone presents with psychosis and is under the influence of a substance?

A

This doesn’t mean that the psychosis is definitely caused by the substance. Important co-morbidities of substance misuse are bipolar disorder and schizophrenia.

40
Q

Delusions of worthlessness, guilt, hypochondriasis and poverty are typically features of which differential of psychosis?

A

Depressive psychosis

41
Q

What type of hallucinations might occur in depressive psychosis?

A

Typically 2nd person, accusing/insulting/threatening

42
Q

Delusions of grandeur, special abilities, persecution or religiosity as well as auditory hallucinations and flight of ideas might occur in what differential of psychosis?

A

Mania with psychosis

43
Q

What are some circumstances in which delirium might be seen?

A

Alcohol withdrawal, infection and hospital inpatients with many different conditions

Psychiatry (20 decks)

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