Psych Flashcards
Non-organic causes of Psychosis
Schizophrenia Schizotypal disorder Schizoaffective disorders Acute psychotic episode Mood disorders with psychosis Drug-induced Delusional disorder Induced delusional disorder
Drugs that cause Psychosis
Alcohol, cocaine, amphetamine, methamphetamine, MDMA, cannabis, LSD
Levodopa, methyldopa, steroids, antimalarial
Organic causes (not drug) of Psychosis
Complex partial epilepsy Deliriumdementia Huntington's SLE Syphilis Endocrine -> Cushing's Metabolic -> Vit B12 deficiency, porphyria
Define hallucinations
Perception in the absence of an external stimulus
Rank likelihood of type of hallucinations
Auditory & tactile (top)
Visual, olfactory less likely
What is usual cause of olfactory hallucinations
Frontal lobe pathology. e.g. middle meningioma
Definitaiton of delusion
A fixed firmly held belief that is usually false, that is held despite evidence to the contrary,
that cannot be reasoned away,
and that is out of keeping with a person’s sociocultural norms.
What is grandiose delusion
Exaggerated factors of: self-worth, power, knowledge, identity and/or exceptional relationship to a divinity or famous person
Mostly seen in maniac bipolar
Explain hypochondriacal delusion
Someone is after Pt
Most common
Explain reference delusion (Ideas of reference)
Everything is about the Pt
e.g. special meaning to you in a group talk
What type of delusion believe someone important is in love with Pt
Erotomanic
What type of deulson believe they done something terrible
Guilt
What is formal thought disorders
An impairment in the ability to form thoughts from logically connected ideas
- Speech, (and ∴ thought?) is incoherent
What is disorders of self
Experience of thought interferience
What is a pseudo-hallucination
Not psychosis
involuntary sensor experience vivid enough to be regards as a hallucination
However, Pt recongise it is not from external stimuli
Definition of Schizophrenia
Characterized by hallucination, delusions and thought disorders
Lead to functional impairment
Occurs in absent of organic disease, alcohol or drug related disorder
Name 3 schizophrenia pathology hypthosis
- Dopamine: over activity of mesolimbic dopamine pathways
- Expressed emotion: Those with relatives that are over involved or make hostile/excessive critical comments are more likely to relapse
- Stress-vulnerability model: environmental factors interacting with genetic predisposition or brain injury
Positive Clinical features of Schizophrenia
Delusions Held Firmly Think Psychosis Delusions Hallucination Formal thought disorder Thought Interference Passivity phenomenon
Name 4 Schneider’s 1st rank Sx
3rd person auditory hallucinations
Thought interference
Delusional perception
Passivity phenomena
Name 6 negative Sx of Schizophrenia
Avolition (decrease motivation) Asocial behavior Anhedonia Alogia (poverty of speech) Affect blunted Attention/cognitive deficits
ICD10 criteria of Schizophrenia diagnosis
1 Group A Sx (Schneider’s 1st rank) or
2 Group B Sx (Hallucinations not auditory, thought disorganisation, catatonic symptoms, -ve Sx)
For at least 1 month
What are the types of Schizophrenia
Paranoid Schizophrenia (most common, mostly +ve Sx)
Post-schizophrenic depression (residual Sx, mostly depression)
Hebephrenic (thoughts disorganisation, early onset, poor prognosis)
Catatonic Schizophrenia (rare)
Simple Schizophrenia (Rare, -ve Sx, no psychotic Sx)
Undifferentiated schizophrenia
Residual schizophrenia (1year of chronic -ve Sx, clear psychotic episode)
Prognosis of Schizophrenic
1/3 have one psychotic episode
1/3 recurrent psychotic episodes
1/3 psychotic episodes and some residual change in personality
Rx management for Schizophrenia
2nd gen anti-psychotic: Risperidone, Olanzapine
Clozapine if resistant after 2 drugs
Adjuvants: Benzo ST relief
Antidepressants and lithium as augment
