Psychotic Disorders Flashcards

Question

What is the general management of schizophrenia and psychosis?

Answer 1

``` Risk assessment Use of Mental Health Act may be required if refuse admission Care Programme Approach Early intervention Assess social circumstances Bio-psychosocial model ```

Answer 2

BIOLOGICAL Antipsychotics: atypical are first line e.g. risperidone or olanzapine, clozapine is most effective used for treatment-resistant schizophrenia Adjuvants: benzos can provide short term relief for behaviour, antidepressants and lithium to augment antipsychotics ECT: if resistance to pharmacological agents, or have catatonic schizophrenia ``` PSYCHOLOGICAL CBT: reduces residual symptoms Family intervention: psychoeduction Art therapy: alleviates negative symptoms Social skills training ``` SOCIAL Support groups e.g. Rethink and SANE Peer support Supported employment programmes

Answer 3

Either agree choice of antipsychotic with patient and/or worker, or start second generation antipsychotic Titrate to minimum effective dose, adjust according to response and tolerability Assess over 2-3 weeks If effective - continue Not effective - change and restart If not tolerated - discuss poor compliance, consider early use of depot injection Still not effective - clozapine

Answer 4

Grandiose - special powers, wealth, talents etc. Persecutory - other people conspiring against them Reference - Random events or others behaviour have special significance Guilt - belief they have done something shameful Hypochondrial - belief they have illness Morbid jealousy - belief spouse is being unfaithful

Answer 5

Broadcasting - internal thoughts can be heard out loud by others Insertion - thoughts being put into your mind Withdrawal - thoughts are being removed

Answer 6

Impairment in ability to form thoughts from logically connected ideas

Answer 7

Loosening of associations - loss of normal structure of thought Tangential disorder - person divert from original thought but never return Circumstantiality - Thinking proceed slowly with many unnecessary details before getting to the point Neologisms - Words and phrases devised by patient Alogia - little information conveyed by speech Word salad - real words but linked incoherently i.e. talking nonsense

Answer 8

Symptoms of schizophrenia and a mood disorder in the same episode

Answer 9

No hallucinations or delusions Eccentric behaviour, suspiciousness and unusual speech

Answer 10

Patients show: - Loss of interest - Social withdrawal - Self-neglect - Depression and anxiety - Brief psychotic episodes

Answer 11

Visual release hallucinations Type of psychophysical visual disturbance - person with partial or severe blindness experiences visual hallucinations May see simple repeated patterns or complex images of people, objects or landscapes More likely to occur if vision loss affects both eyes, common in macular degeneration

Answer 12

Walking corpse syndrome Person holds delusional belief that they are dead, do not exist, putrefying (decomposing) lost their blood or internal organs.

Answer 13

Erotomania | Paranoid condition characterised by an individual's delusions of another person being infatuated with them

Answer 14

An involuntary sensory experience vivid enough to be regarded as a hallucination, but recognised by the person experiencing it as being subjective and unreal.

Answer 15

Schizophrenia Bipolar disorder - may have some of the first rank symptoms, but elation, erratic behaviour and grandiose delusions rather than persecutory Alcoholic hallucinations in withdrawal Drugs e.g. cannabis, steroids, cocaine, ecstasy, LSD Organic disorders - temporal lobe seizures in epilepsy, dementia, trauma, hypos Other mental health disorders e.g. brief psychotic, delusional, morbid jealousy, erotomania

Answer 16

Excess dopaminergic activity Thought the excitatory neurotransmitter glutamate is involved Neuroimaging may show increased size of lateral ventricles, reduced brain size usually in temporal lobes Reduced connections between different brain areas can often be deduced from EEGs

Answer 17

Bipolar type - manic or mixed episode occurs | Depressive type - illness mainly depressive episodes

Answer 18

``` Depressed Decreased pleasure Weight loss Insomnia or hypersomnia Fatigue Feelings of guilt or worthlessness Recurrent thoughts of death or suicidal notions ```

Answer 19

``` Inflated self esteem Grandiosity Reduced need for sleep Pressure of speech Flight of ideas Easily distracted Psychomotor agitation Increase in goal-directed activity Excessive involvement in high risk activities ```

Answer 20

Two or more during one month of the illness Delusions Hallucinations Speech abnormalities e.g. incoherent or derailment Behavioural abnormalities Negative symptoms e.g. apathy, lack of emotions

Answer 21

``` Substance misuse Organic e.g. hypothyroid, delirium, HIV Medication side-effects Depressive episode Dementia, delusional disorder ```

Psychotic Disorders Flashcards

(45 cards)