Psychotic Disorders - Powerpoint 3 Flashcards

A set of 50 vocabulary flashcards covering key terms and concepts from the psychotic disorders notes.

Brief Psychotic Disorder

Transient psychotic symptoms triggered by severe psychological or social stress; acute onset; rapid decline; premorbid functioning typically good.

Brief Psychotic Disorder with Postpartum Onset

Brief psychotic disorder that begins within 4 weeks after childbirth.

Acute Onset

Sudden appearance of psychotic symptoms.

Transient Psychotic Symptoms

Psychotic symptoms that are temporary and self-limiting.

Premorbid Functioning

Level of functioning before illness onset; typically good in brief psychotic disorder.

Severe Life Stressor

External events (e.g., bereavement, immigration, natural disaster, combat) that can precipitate brief psychosis.

Culture Shock

Stress response to moving to a new country; example of a potential precipitant.

Natural Disaster (as a Stressor)

A significant life event that can precipitate brief psychotic episodes.

Combat/Military Activity

Stressful experience that can precipitate brief psychotic symptoms.

Delusional Disorder

Delusions without accompanying hallucinations, thought disorder, mood disorder, or significant flattening of affect.

Non-bizarre Delusions

Delusions that appear possible but are not wholly implausible; a key feature of delusional disorder.

Persecutory Type

Fixed paranoid delusions that others intend to harm the individual; may feel watched or followed.

Jealous Type

Delusions that a significant other is unfaithful.

Erotomanic Type (de Clerambault syndrome)

Delusion that a famous or higher-status person is in love with the individual.

Grandiose Type

Fixed beliefs of power, wealth, identity, or a special relationship with a deity.

Somatic Type

Fixed belief of a physical abnormality or illness; may resemble hypochondriasis.

Mixed Type

Delusions involving more than one category without a single dominant type.

Unspecified Type

Delusions that do not fit into any defined category.

Shared Psychotic Disorder (Folie à Deux)

Rare delusional disorder where a delusion is transmitted from one person to a closely related partner.

Folie à Deux

Another name for Shared Psychotic Disorder; delusion shared within two related individuals.

Schizophrenia

Chronic psychotic disorder with long duration (≥6 months) and impairment; typically includes delusions, hallucinations, disorganized thinking, and negative symptoms.

Schizophrenia: Criterion A

Core symptoms such as delusions, hallucinations, disorganized thinking, disorganized/gal? motor behavior, or negative symptoms.

Schizophrenia Duration (Diagnostic Threshold)

Symptoms persisting for 6 months or longer.

Schizophreniform Disorder

Between brief psychotic disorder (<1 month) and schizophrenia (≥6 months); duration 1–6 months; many progress to schizophrenia.

Schizophreniform Disorder: Outcome

Most individuals are in the early stages of what may become schizophrenia; some recover.

Schizophreniform Mood Symptoms

Mood symptoms tend to be more prominent; FHx of mood disorders common.

Psychological Testing in Schizophreniform

Pattern of symptoms more typical of schizophrenia; cognitive impairment less common; mood symptoms may be prominent.

Course of Illness in Schizophreniform

Follows schizophrenia trajectory; if symptoms persist >6 months, deterioration may occur without treatment.

Atypical Antipsychotics

Second-generation antipsychotics; may prevent deterioration or cognitive impairment in schizophrenia.

Typical Antipsychotics

First-generation antipsychotics (e.g., haloperidol); reduce symptoms but may not prevent deterioration if illness persists beyond 6 months.

ECT (Electroconvulsive Therapy)

Electrical stimulation used as treatment for some patients with severe psychosis.

Hospitalization (Acute Stages)

Often required in the acute stage due to overt psychotic symptoms.

Antipsychotics (Mainstay Treatment)

Primary pharmacologic treatment for managing psychotic symptoms.

Sedative Drugs (Benzodiazepines)

Used to manage agitation and help induce sleep during acute psychosis.

Psychotherapeutic Interventions

Three major goals: understand the problem related to the stressor, rapid reintegration, and coping skills to prevent recurrence.

Understanding the Stressor

Therapeutic goal to help the patient comprehend how the stressor relates to the problem.

Rapid Reintegration

Therapeutic goal to quickly reintegrate the patient into work, school, or social environment.

Coping Skills Development

Therapeutic goal to build skills to prevent future episodes.

Complications (Social Function)

Major complications related to disruptions of social functioning (e.g., employment).

Stepwise Reintegration

Gradual reintegration into social and occupational roles.

Prognosis: Schizophreniform Disorder

Most are in the early stages of a trajectory toward schizophrenia; good short-term outcomes possible for some.

Poor Outcomes in Schizoaffective Disorder

Poor prognosis linked to insidious onset, early onset, poor premorbid functioning, absence of clear stressor, prominent negative symptoms, and family history of schizophrenia.

Schizoaffective Disorder: Bipolar Type

Mood cycling with manic/depressive episodes plus psychotic symptoms.

Schizoaffective Disorder: Depressive Type

Prominent depressive episodes with psychotic features.

Schizoaffective Disorder: Mood + Psychosis

Psychotic symptoms present with mood disorder features; mood symptoms coexist with schizophrenia-like psychosis.

Psychological Testing in Schizoaffective Disorder

Results vary with illness state; patterns may resemble schizophrenia plus mood disorder features.

Mood Symptoms During Schizophrenia Spectrum

Mood episodes can occur during the course of a chronic psychotic disorder, as in schizoaffective disorder.

Differential Diagnosis: Mood Disorders with Psychotic Features

Distinguishing primary mood disorders with psychosis from primary psychotic disorders.

Differential Diagnosis: OCD vs Delusional Disorder

OCD has obsessions with insight; delusional disorder features fixed, unshared beliefs without such insight.

Paranoid Personality Disorder vs Delusions

Paranoid personality disorder shows pervasive mistrust; delusional disorder presents fixed, systematized delusions.

Somatic Delusions vs Hypochondriasis

Somatic delusions involve fixed physical abnormalities; may be hard to distinguish from hypochondriasis depending on belief context.

Complications: Incarceration or Hospitalization risk (SPD)

Delusional disorder can lead to legal or involuntary hospitalization if beliefs lead to risky behavior.

Management: SPD Separation

Separate the involved persons; separation commonly leads to resolution of the delusion in the submissive partner.

SPD Management: Avoid Medication if Possible

Nonpharmacologic approaches preferred when safe, with ongoing psychological and social support.

SPD Management: Social Support & Coping

Provide ongoing psychological and social support to maintain separation and coping.

SPD Prognosis: Separation Outcome

Healthier partner tends to abandon the fixed belief after separation; the sicker partner may retain or develop new delusions.

SPD Prognosis: Indefinite Delusion Risk

In some cases, delusional beliefs persist or spread despite separation.

Course of Illness: Delusional Disorder Overall

Many patients maintain the delusional disorder diagnosis with about half recovering and a third improving; roughly 20% may remain deluded indefinitely.