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Flashcards in Psych Deck (19):
1

Components of Mental Status Exam

-Physical appearance
-Arousal/attention (consciousness/concentration)
-Speech (rate, rhythm, prosody, articulation, coherence, vocabulary)
- Mood (pt's self reported emotional state)
- Affect (pts immediate visible emotions)
- Thought process (organization of pts thoughts)
- Thought content (nature of thought)
- Cognition (includes memory and exec functioning; i.e. MMSE/MOCA)
- Insight (does pt understand illness/impact on their life)
- Judgement (ability to follow provider instructions)

2

Schizophrenia diagnostic criteria

2+
??

3

Etiology of Schizophrenia

?

4

Schizophrenia Treatment

?

5

Major Depressive disorder

?

6

examples of Mood disorders with psychotic features

Major Depressive Disorder (MDD) w/psychotic features
BIpolar disorder with psychotic features
Schizoaffective disorder

7

MDD with psychotic features definition/treatment

-meets major depressive episode criteria plus has delusions and/or hallucinations

-occurs in about 18.5% those diagnosed with MDD


Treat: Antidepressants with antipsychotics; ECT (esp in pregnant and elderly)

8

Bipolar with psychotic features definition/treatment

- Pt experiencing bipolar disorder and delusions or hallucinations

- Prevalence may be as high as 25% of those with bipolar

Treat:
- Mood Stabilizer and antipsychotic (atypical often used since they allow use of one medication)
- ECT may be considered if poor medication response
- Pt may present w/catatonia, which responds to treatment with benzodiazepines

9

Schizoaffective Disorder Dx and treatment

?

10

Delusional disorder

- presence of 1+ delusions lasting at least 1 month
- never met criteria for schizophrenia
- little to no functional impairment and behavior appears relatively normal
- Not due to mood disorder or substance
- Lifetime prevalence about 0.2%
- Mean onset = 40

11

Delusional Disorder subtypes

Erotomanic (more frequent in women)
Grandiose
Jealous
Persecutory- more often in men
Somatic
Mixed
Unspecified

12

Brief Psychotic disorder

Presence of 1+ of the following with at least 1 of the first 3
- Delusions
- Hallucinations
- Disorganized speech
- Disorganized or catatonic behavior
- Lasts from 1 day to

13

Schizophreniform Disorder

?

14

Substance/med induced psychotic disorder characteristics

- Significant hallucinations/delusions
- Evidence from hx, physical, or lab findings of both:
hallucinations or delusions developed during or within a reasonable pd of substance intoxication or withdrawal or after exposure to such a medication
- Substance in question can produce hallucinations or delusions

**Sxs should not precede ingestion of substance/meds, nor should they persist for substantial pd of time (typically > 1 month) after acute withdrawal or severe intoxication)

15

Substance known to induce psychosis

Alcohol
Cocaine
amphetamine
cannabis
opioids
synthetic cannabinoids and cathinones (bath salts)
LSD
Psilocybins (mushrooms)
MDMA/ecstasy
Inhalants
Phencyclidine (PCP, angel dust, ketamine)

16

Medications that can cause psychosis

Levodopa
Anabolic steroids
corticosteroids
antimalarial drugs

17

Psychotic disorder due to another medical condition

-Prominent hallucinations or delusions-
- Doesn't occur solely during course of delirium
- Significant distress or impairment in social, occupational, or other important areas of functioning evident

18

Disorders mimicing psychosis

PTSD
Borderline personality disorder
OCD
Schizotypal personality disorder

19

Medical conditions that can cause psychosis

Parkinsons
Lupus
HIV/AIDS
Brain tumors
Seizure disorders
Delirium
Huntingtons
Thyroid
MS
Cushing's syndrome
vitamin deficiency
Electrolyte abnormalities
SLE
Uremia