Psychotic disorders Flashcards Preview

Psychiatry > Psychotic disorders > Flashcards

Flashcards in Psychotic disorders Deck (13):
1

Definition

Mental state in which reality is grossly distorted

2

Interrelated parameters in psychosis

1. Perception
2. Abnormal beliefs
3. Thought disorder
4. Negative symptoms
5. Psychomotor

3

Define perception

Making sense of physical information from our senses

4

Difference between hallucination and illusion, pseudohallucination

Hallucination occurs without external stimulus
Illusion is misperception of stimulus
Pseudohallucination is an experience in the inner world->minds eye

5

Components of thought disorder

1. Abnormal beliefs
Delusions
Overvalued ideas
2. Disorganised thinking
Circumstantial
Tangential
LOA
Neologisms
FOI
Thought blocking
Perseveration
Echolalia
Irrelevant answers

6

Negative symptoms

Poverty of speech
Apathy
Social isolation
Poor self care
Blunted affect
Cognitive deficits

7

Psychomotor->catatonia

Rigidity
Posturing
Flexibility
Excitement
Stupor
Echopraxia
Mannerisms
Sterotypes

8

Differential diagnosis

1. Psychotic disorders
SchizoPF
SchizoP
SchizoA
Brief psychotic episode
Delusional disorder
2. Mood disorders with psychotic features
3. Personality
Schizotypal
BPD
4. Secondary GMC or substance

9

GMC associated with psychosis

1. Neurology
Stroke
Dementia
Delirium
Infection
Injury
2. Endocrinology
3. Epilepsy
4. Huntington
5. SLE
6. Vitamine B12
7. Wernickes

10

Substances associated with psychosis

Alcohol
Cannabis
Amphetamine
Antipsychotics
Antiparkinsons
Cocaine
Steroids
Hallucinogens
PCP
Organophosphates

11

History

1. Psychosis
Duration, onset
Hallucinations: Noises, thoughts out loud, talking about you, commanding
Delusions: Afraid someone harming, references, special powers, being controlled, thoughts don't belong to you
Functional impairment
Suicidal, homicidal
Anxiety, depression, substance
2. Head trauma
3. Seizures
4. Blurred vision, speech, movement, HA, motor/sensory
5. Features of endoC
6. Medications
7. Heavy metals, organophosphates
8. DIet
9. Surgery
10. FHx->neurological, metabolic, autoimmune
11. Travel, sexual, social

12

Physical examination

1. Vitals->tachy/hyperT: drugs
2. MSE
3. Fluctuating LOC
4. Fever, rash: menin/encephalitis
5. Hyper/hypothyroid
6. Malnourished
7. Dysmorphic
8. Complete neurological examination
Aphasia
Haemianopia
Haemiparesis
Ataxia
Brisk tendon reflexes
Babinski's sign
Cranial nerve deficits
Tremors
Myoclonus
Paraesthesias
Neuropathy with weakness and
decreased vibrational and
position sense: may be seen
in vitamin B deficiencies
Signs of raised intracranial pressure

13

Investigations

CBC
UEC
LFTs
Creatinine
UDS
Vitamin B12
TFTs
Consider ANA, ESR
Glucose
Urinalysis
Febrile->BC, CXR

Depending on presentation
Urinary 24 hour cortisol, Ca, PTH, ceruloplasmin, HIV
CT/MRI->head injury, focal neurological signs, headache