Psychotic Disorder
Terms
| Types of Hallucinations | Auditory Visual Tactile Olfactory/gustatory |
| Auditory Hallucinations | Often psychiatric Voices very common Indistinguishable sounds |
| Visual Hallucinations | Poorly defined/symbolic: Usually psychiatric Well formed (people, animals): Usually medical |
| Tactile hallucinations | Often medical/delirium Bugs, picking, phantom |
| Olfactory/gustatory | often neurological |
| Delusion | A false belief: Based on an incorrect inference of external reality. Firmly held despite clear evidence to the contrary. Not accepted by other members of the person’s culture. |
| loose associations | disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts |
| Blocking | A failure to retrieve information that is available in memory even though you are trying to produce it |
| Ideas of reference | often seen in paranoid patients; they personalize unrelated events EXAMPLE: see the nurse talking to the therapist and think they are talking about him/her. |
| Thought Broadcasting | Feeling that one’s thoughts are being broadcast or projected into the environment |
| Neologism | new word or expression |
| Echolalia | an autistic symptom in which the person “echoes” or repeats what has just been said |
| Clang association | association of words similar in sound but not in meaning; words have no logical connection; may include rhyming and punning |
| Echopraxia | The meaningless imitation of another person’s movement |
| catatonia | a state of unresponsiveness to one’s outside environment, usually including muscle rigidity, staring, and inability to communicate |
| negativism | Doing the opposite of what others want |
| stereotypical | repetitive speech or action |
| mutism | Inability or refusal to speak |
Brief Psychotic Disorder
- Presentation:
- 1 day up to <1 month
- The episode lasts at least one day but less than one month, and the individual eventually has a full return to the premorbid level of functioning.
- A disturbance that involves the sudden onset of at least one of the following positive psychotic symptoms:
- delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior.
Schizophreniform Disorder
- Presentation:
- Same criteria for Schizophrenia, but total duration is > 1 month, but < 6 months.
- Often rapid onset.
- Prognosis is better.
- Treatment:
- Treated with antipsychotics, but may not need long term.
- Tx: similar to bipolar or major depression
Schizophrenia
- Presentation:
- Causes:
- Diagnosis:
- Treatments:
Schizoaffective Disorder
- Presentation:
- Primary schizophrenia symptoms, with significant mood episodes during psychosis
- Elements of schizophrenia combined with elements of either bipolar disorder or major depression.
- The mood Sx (mania and/or depression) must account for a substantial portion of the total duration of the illness.
- Bipolar/Depressive Types.
- With catatonia
- Diagnosis:
- Patient has periods (2 weeks or more) of psychosis occurring during times when they are not manic or depressed.
Delusional Disorder
- Presentation:
- 1+ Non-bizarre delusion for 1 month or more
- Delusions of at least 1 month duration.
- If hallucinations present, they are not prominent and are related to delusion.
- Specify whether delusion is bizarre.
- might seem normal or lack of negative symptoms
- Types:
- Erotomanic (someone else loves them)
- Grandiose
- Jealous (partner unfaithful)
- Persecutory
- Somatic (has illness/defect)
- Mixed or unspecified
- Treatment:
- often not effective; can be chronic
Shared psychotic disorder / Folie a deux
- AKA: Delusional Symptoms in Partner of Individual of With Delusional Disorder
- Presentation:
- Delusion as a result of a close relationship with someone delusional
- A delusion (usually persecutory) develops in the context of a close relationship with a person who has an already-established delusion.
- Most cases involve dependent female family members; one submissive, one dominant.
- Can be suicidal or homicidal.
- Treatment:
Dementia/Delirium
- Presentation:
- New onset psychosis in an older person with no history of a primary psychotic disorder is strongly suggestive of dementia and/or delirium
- Delirium: Visual+tactile hallucinations.
- Dementia: Visual hallucinations+delusions.
- Common causes of delirium-related psychosis:
- –Infection (UTI, pneumonia)
- –Medication side effect
- –Stroke
- –Any change in medical status
Post-Partum Psychosis
- Presentation:
