Psychosis

Question 1

what is psychosis

Answer 1

umbrella diagnosis characterised by lack of insight and difficulty with what is real and what is not

Question 2

what areas of the mental state examination are particularly affected in psychosis

Answer 2

mood
thoughts
behaviours
perceptions

Question 3

list the main causes of psychosis and examples of each

Answer 3

drugs - ingestion such as legal highs or withdrawal from benzodiazepines
psychiatric disease - schizophrenia, schizoaffective disorder, mania
organic - delirium, depression, SLE, huntingtons disease

Question 4

list the main symptoms that are associated with psychosis

Answer 4

hallucinations 
delusions 
thought disorder 
loss of insight 
self-referential experiences 
ideas of reference

Question 5

what part of the mental state examination do hallucinations come under

Answer 5

perception

Question 6

what is a hallucination

Answer 6

a perception that occurs in the absence of a stimulus but have the qualities of a normal perception eg are vivid and compelling

Question 7

what is the difference between simple and complex hallucinations

Answer 7

simple - murmur, flash of light, unspecific

complex - a voice or person or music

Question 8

describe ideas of reference

Answer 8

innocuous or coincidental events that will be ascribed significant meaning by the person

Question 9

list some examples of ideas of reference

Answer 9

thinking a message in newspaper is about them

the news is commenting on their life

Question 10

describe self-referential experiences

Answer 10

the belief that external events are related to onself in some way

Question 11

list some examples of self-referential experiences

Answer 11

feeling that others are out to get them/laughing at them

the belief that they are the second coming of christ

Question 12

what are delusions

Answer 12

a fixed falsely held belief that is outwith the patients own socio-cultural beliefs
held with unshakeable conviction

Question 13

what area of the mental state examination do delusions come under

Answer 13

disorder of thought

Question 14

what is the difference between primary and secondary delusions

Answer 14

primary - arrive fully in consciousness with no need for explanation
secondary - require attempts to explain how the delusions arrive eg through hallucinations or passivity phenomena

Question 15

describe thought insertion

Answer 15

the belief that other people are putting thoughts into the persons head

Question 16

describe thought withdrawal

Answer 16

the belief that thoughts are being taken out of the patients head

Question 17

describe thought broadcasting

Answer 17

the belief that others can hear their thoughts without having to say them

Question 18

what are the other disorders of thought seen in someone with psychosis

Answer 18

clanning and punning 
loosening of associations 
knights move thinking
neologisms 
circumferentiality/tangentiality

Question 19

describe passivity phenomena

Answer 19

the belief that one is no longer in control of their thoughts and feelings - an external agent is controlling them

Question 20

what are the content of delusions commonly seen in depressive psychosis

Answer 20

worthlessness
guilt
poverty 
sin 
nihilism

Question 21

what hallucinations are commonly seen in someone with depressive psychosis

Answer 21

second person auditory with accusatory tone

Question 22

what is Cottard syndrome

Answer 22

part of depressive psychosis where the patient feels they have already died

Question 23

what are the content of delusions commonly seen in someone with mania and psychosis

Answer 23

grandiosity
special ability
religiosity

Question 24

what hallucinations are commonly seen in someone with mania and psychosis

Answer 24

second person auditory hearing Gods voice telling them they are great