Exam 2: Psychosis

The word psychosis means to have \_ state of mind.

disordered

In psychiatry, the defining feature of psychosis is a loss of contact with \_, meaning those without psychosis dont percieve what the patient is perceiving. Psychosis in psychiatry is defined by \_ + \_ symptoms.

positive; negative

Positive symptoms are called positive because they are \_ or considered to be added to the normal range of beliefs, perceptions + behaviors that individuals without psychosis would experience. Positive symptoms include \_, hallucinations, disorganized \_ (SPEECH), and grossly disorganized \_ which can include \_.

extra, delusions, hallucinations, thinking, behavior, catatonia

\_ symptoms are called negative because they represent a reduction of the quantity of behaviors below a normal range of expression. Negative symptoms include a reduction in emotional expression called \____, decreased motivation known as \__, a reduction in the quantity of speech called \_, a reduction in the experience of pleasure known as \_, and a lack of social interest and connection known as \_.

Negative; Affective flatening/Alexithymia; Avolitron; Alegia; Anhedonia; Asociality

A lack of \_into having a mental illness along with limited insight into the symptoms + consequences of the disease and the need for treatment is highly associated with psychotic disorders. Limited insight is a barrier to treatment \_ and the ability to complete \_, \_ and maintain \_.

insight; engagement; ADLs, work, relationships

Psychosis is an \_ term that describes the state of being out of touch with reality that can occur in a variety of different mental health disorders and stem from a variety of causes. Psychosis manifests differently in different people depending on the unique mixture of \_ + \_ symptoms, motor + speech manifestations, and even \_ traits, gender, \_ history, and a patient’s \_ background.

umbrella; positive; negative; personality; trauma; cultural

Even though there can be great variability in how psychotic episodes manifest, there are often commonalities based on \_ category.

diagnostic

Patients with Bipolar disorder experiencing a manic episode are more likely to have \_ delusions, \_ psychomotor behavior, and rapid disorganized thinking manifested as \_ speech. They may be more likely to have \_ hallucinations that may have a \_ theme, such as hearing the voice of God.

grandiose; agitated; tangential; auditory; religious

Patients with chronic Schizophrenia are more likely to have \_ delusions, \_ symptoms such as a \_ affect, poor \_, and a \_ quantity of speech. They are also more likely to have both auditory + visual \_.

paranoid; negative; flat; motivation; seduced; hallucination

Patients experiencing a major depressive episode with psychotic features are more likely to have \_ delusions, \_ symptoms such as a \_ affect, poor \_, and a \_ quality of speech. They are also more likely to have both auditory + visual \_.

guilty, niihilistic, slowing

\_ are one of the \_ symptoms of psychosis. Hallucinations are \_ perceptual experiences that occur without an external \_ and can be experienced as coming from any of the \_.

Hallucinations, positive, involuntary, stimulus, 5 senses

\_ hallucinations involve hearing things without an external stimulus. Auditory hallucinations are experienced by about 65-85% of patient with primary psychotic disorders like \_and are the most common type of hallucination experienced by patients with \_ disorder. One of the most troubling forms of auditory hallucinations for patients to do things like \_ themselves or others, Assessing for auditory \_ hallucinations is important as it can be a significant risk for \_.

Auditory, schizophrenia, Bipolar, auditory command, hurt, command, suicide

\_ hallucinations are also common in psychotic disorders and can involve visual \_ or seeing complete \_, _, _.

visual; distortions; animal; objects; people

\_ hallucinations are a form of \_ hallucination that may involve the sensation of having bugs crawling on or under the skin (fornimation). This type of hallucination may occur in varied types of psychosis, but it is common during \_use, such as .abuse where it commonly called having /_

Delusions are \_ that an individual in psychosis holds that resist change despite evidence the beliefs are not \_.

fixed false beliefs, true

Delusions can take a wide \_ of forms that often overlap. For example, a person with \_ delusion believes that are extra special because God send them messages in the newspaper that only they will understand (a delusion of \_), and that their job is to explain these messages to the world in order to save it (a delusion with religious and special talent components).

variety, grandiose, reference

\_ delusions are common in primary psychotic disorders like \_ and usually involve belief that some person (my neighborhood) or group (hospital staff) are watching, following, surveilling them.

paranoid; schizophrenia

Delusions may be categorized by whether they are possibly true vs surely false. Delusions that essentially could not be true are called \_ delusions. Delusions that are improbable, but not totally impossible, are considered \_. Believing one was born on the Krypton and are related to superman is an example of a \_ delusion because it can’t be true. A patient that believes their spouse is watching them with cameras in the home is an example of a \_ delusion because it is possibly true.

Bizarre; non-bizarre; bizarre; non-bizarre

Another positive symptoms of psychosis is have grossly \__ (speech). We assess a patient’s thought process by paying attention to how much what they are \_ makes sense.

disorganized thinking; saying

Patients in psychosis may add a lot of extra \_ and talk in \_ before getting to the point. The is known as \_ speech. Patients may veer “off the tracks” and never answer the question. This commonly known as \_ speech or \_.

details; circles; circumstantial; tangential; derailment.

When patients patient jump from topic or theme in ways that are only loosely connected and hard to follow, they are said to have to have a thought process characterized by \__.

neologisms; clang

Sometimes, pts will make new words, called \_, or talk/respond in a way that rhymes, called \_ associations.

neologisms; clang

Another positive symptom of psychosis that is common in patients with primary psychotic disorders like schizophrenia or \_ disorder is grossly disorganized \__. This may manifest as having \_ affect where one laughs at serious issues, such as someone’s loss, or random, odd gesturing which might accompany responding to \__ like hallucinations. Finally, it can manifest in poor \_ and \_ dress for the weather or circumstance.

schizoaffective; motor behavior; inappropriate; internal stimuli; hygiene; inappropriate

\_ is considered a \_ syndrome usually driven the patient’s mental state.

Catatonia; psychomotor

Catatonia can occur in a variety of mental health conditions, but is very common in \_ and \_ disorders, especially among those are experiencing severe enough symptoms to be \_.

schizophrenia; bipolar; hospitalized

Catatonia can manifest as either psychomotor \_ or psychomotor \_.

slowing; agitation

Psychomotor slowing in catatonia can, in some cases, progress severe immobility and stupor leading to \_, \_, \_ imbalances and risk for falls, as well as \_ breakdown, and \_ that could could cause pulmonary embolism.

dehydration, malnutrition, electrolyte; skin; DVTs

Psychomotor agitation in catatonia can result in excessive, ongoing, purposeless movement that can progress to pose a risk of \_ collapse.

Cardiovascular

Catatonia can become a life-threatening condition. The two most commonly used treatments are high dose \_ and \_. Benzodiazepines are effective in up to 80% of patients with catatonia. ECT is commonly used in patients where Benzo have not effective. ECT is effective in 80-100% of those who have not been responsive to benzos.

Benzos; ECT

The \_ symptoms of psychosis are usually more proposed and persistent in the chronic psychotic disorders like \_ and are usually more transient in disorders like \_ or \_ disorder where psychosis can occur.

negative; MDD; bipolar

\_ symptoms are not considered diagnostic of psychotic disorders but are very common and often \_ the development of the more obvious positive and negative symptoms, especially in the primary psychotic disorders.

Cognitive ; precede

Negative + cognitive symptoms may be more \_ for patient with psychotic disorders over the long-term given their impact on \_.

debilaritating; relationship,work +ADLs

Traditional antipsychotic medications tend to have limited efficacy on the negative and cognitive symptoms, but some medication like \_ and \_ have shown some efficacy in treating these symptoms.

Clozapine(Clozaril); Cariprazine(Vraylar)