Psychosis Flashcards
(24 cards)
What are the hallmark symptoms of psychosis?
Delusions
Hallucinations
Thought Disorder
Lack of insight
What are some of the investigations and results for organic causes of psychosis?
FBC may show macrocytosis indicating alcohol abuse
Syphilis and HIV serology
Urine screen for drugs of abuse
What are some of the specific symptoms for schzophrenia?
Thought echo/insertion etc. Delusions of somatic passivity i.e. being controlled by an external force Auditory hallucinations Delusional perceptions External control of emotions
Give some examples of typical antipsychotics?
Haloperidol
Chlorpromazine
flupentixol
Give some examples of atypical antipsychotics?
Olanzapine and amisulpride
What is an oculogyric crisis and how can it be reversed?
An acute dystonia that is not being able to move your eyes
It can result from typical antipsychotics and can be reversed with antimuscarinics (procyclidine)
What is the biggest risk for atypical antipsychotics?
Development of metabolic syndrome
What are some of the typical antipsychotic side effects?
Dopamine effects:
-Tardive dyskinesias e.g. facial twitch
-Parkinsonism - revesibel with anticholinergics
-Akathisia (restless legs) - reversible with anticholinergic effects e.g. constipation
Sedation
Blockage of alpha receptors - postural hypotension
What is the main side effect with clozapine?
Agranulocytosis causing neutropenia
How often should bloods be checked for clozapine?
Should do bloods weekly for the first 18 weeks then can reduce afterwards if no neutropenia
What is schizotypal disorder?
A personality disorder characterised by eccentric behaviour and anomolies of thinking
How can schizotypal disorder be treated?
With risperidone (atypical antipsychotic)
What is schizoaffective disorder?
Combination of affective disorder and schizophrenia
What is delusional disorder?
Delusions present for at least 3 months with no underlying cause
What is the management of delusional disorder?
This involves SSRIs and antipsychotics as well as antipsychotics
What SSRI should be used in depression following MI?
Sertraline
What is puerperal psychosis?
This is post natal psychosis that evolves in the first few weeks following pregnancy
This involves racing thoughts, confusion, feelings of paranoia
This is a psychiatric emergency and should be managed in perinatal psychiatry service
Risk factors are previous history of mental health/ family history
What are the first rank symptoms of schizophrenia?
Thought echo/insertion etc.
Delusions of somatic passivity i.e. being controlled by an external force
Auditory hallucinations
Delusional perceptions
What are the diagnostic guidelines for schizophrenia?
At least 1 first rank symptom
The symptoms must have been present for greater than 6 months
Must be impairment in work or home functioning
What are the ICD subtypes of schizophrenia?
Paranoid - commonet subtype where hallucinations and delusions are prominent
Hebephrenic - onset 15-25, poor prognosis, fluctuating affect with fleeting hallucinations and delusions
Catatonic - characterised by stupor, posturing and negativism
What is affective psychoses?
This is depression/bipolar that can occur in psychosis
Can occur in schizophrenics and is known as schizoaffective disorder
What is the treatment of schizoaffective disorder?
Treatment with Antipsychotics e.g. olzanzapine and a mood stabiliser e.g. lithium
What is schizotypal and how is it treated?
Schiotypal is a personality disorder which can express partial schizophrenia. It is usually not treated with medication and treated with dialectical behavioural therapy
What is the early intervention service?
They aim to identify, assess and treat people having their first episode of psychosis. This do this through:
- Reducing amount of time psychosis is untreated
- Attempting to get individual back into work
- Reduce loss of life trajectory
