psychosis Flashcards
(29 cards)
what is psychosis and examples
difficulty perceiving and interpreting reality
umbrella for many diseases, ie- schizophrenia, bipolar I, delusional disorder, drug induced etc
types of psychosis symptoms domain
positive
negative
disorganised
example of positive symptoms
hallucination-perception in absence of stimulus
-all 5 senses
-commonly auditory
-1st= though echo, 2nd, 3rd person running commentary/command hallucinations
delusions-fixed, false belief not in keeping with social/cultural norms.
-passive experience- thought are controlled by external agent. ie. thought broadcasting, insertion, withdrawal.
what are some negative symptoms
alogia
anhedonia
asociality-
avolition
apathy
affective flattening
what is alogia
decreased speech
what is anhedonia
inability to feel pleasure
what is
asociality-
being more alone
what is avolition
lack of motivation
what is apathy and affective flattening
apathy -lack of enthusiasm
affective flattening-reduced facial expression/body language, poor eye contact
examples of disorganised symptoms
-bizzare behaviour=
-aggression, agitation, inappropriate social behaviour
-formal though disorder- lack of logical connection between thoughts
psychosis onset, course, morbidity, mortality?
onset- commonly early 20s, (peak later in women)
course- chronic+ episodic
morbidity- impact QoL (risk heart disease)//impact education, employment
mortality-high risk of suicide
what is in the Mental state examination (MSE)
A Sailor Makes Tea, Pours Calmly, and Ignores
Appearance and behaviour
Speech
Mood and Affect
Thoughts
Perceptions
Cognition
Insight
psych hx for psychosis: HPC/Psych hx, fam hx, environemnt?
HPC: 6-18 months before has prodromal symptoms similar to depression
Psych Hx: increased risk if they had mental issues in the past
fam hx- important as schizophrenia=highly heritable. High concordance in MZ twins. Highly polygenic
environmental-drugs, ACE, prenatal/birth complication
Examples of prodromal symptoms in psychosis that’s often misdiagnosed in depression
-increasing isolation
-poor self care
-social withdrawal
-declining academic performance
what to look out for in MSE for psychosis - appearance and behaviour
appearance:
Bizarre or inappropriate clothing
Self-neglect
Self-harm injuries
behaviour:
eye-contact
unreactive
agitation
Abnormal movements
what to look for in speech compartment of MSE
Comment on rate/rhythm/volume
description of thought disorder
circumstantial
tangential
flight of ideas
derailment
word salad
what is pseudohallucination (vs hallucination
pseudohallucination:
-insight preserved
-ie voices perceived originating from inside head rather than outside
what is tactile hallucination
involving sense of touch- ie ‘can feel chip inside his brain’
What difficulties might you have treating someone with poor insight into their psychosis?
-consenting to treatment
-FU attendance
-willing to admit to hospital
psychosis diagnosis?
can’t diagnose schizophrenia based from 1 psychotic episode.
-follow up for 3 years under Early Intervention of Psychosis Service
management of psychosis
antipsychotic
CBT
social support
antipsychotics in psychosis -2 types name of drug
dopamine antagonist-ie.risperidone
(but can also target NTs like serotonin, acetylcholine, histamine)
new partial agonist= aripiprazole
describe dopamine activity in psychosis
Increased dopamine activity in mesolimbic dopamine system cause positive symptoms of psychosis
