MH&W Exam 1 Other Psychotic Disorders

signs and sx of brief psychotic disorder

sx occur for less than one month with complete resolution. Triggered after significant external stressor, sx can mimic delirium. recurrence can happen if stressor is ongoing or if other conditions are present

how to diagnose brief psychotic disorder

get more info from another person. pts are completely fine within 30 days. if duration is longer than dz might be schizo or other psych d/o

how do you manage a pt with brief psychotic disorder

hospitalization needed, antipsychotics and sedatives relieve sx esp by inducing sleep. tx is only 1-3 mo. if recurrent give long term antipsychotics. psychotherapeutic intervention has the goals of helping pt understand how the stress leads to their sx, how they should reintegrate into society, and what coping skills they can develop to prevent more episodes.

what are complications of brief psychotic disorder

disruptions of social function, can’t get employed. long term adverse outcomes are related to other predisposing variables and not disorder itself

what is schizophreniform disorder

positioned between brief psychotic disorder (<1mo) and schizophrenia (>6mo)

what are the signs and sx of schizophreniform disorder

sx similar to criterion A of schizo but duration is b/w 1-6 months. mood sx prominent and fhx of mood disorders. psych test shows similar to schizo, cognitive impairment (memory issues) less common, mood sx more common

how to tx schizophreniform

hospitalization needed in acute stages. typical antipsychotics (haloperidol) reduce sx but not prevent deterioration if more than 6mo. sedative drugs like benzodiazepines needed to manage acute agitation. atypical antipsychotics prevent psychological deterioration or cog impairment. ECT can be used too

what is schizoaffective disorder

mood sx like mania/depression that occur at the same time as a chronic psychotic disorder. middle ground b/w mood d/o and chronic psych conditions.

sx of schizoaffective disorder

criterion A of schizophrenia AND superimposed episodes of depressive/manic episodes. can be diagnosed as depressed or manic type schizoaffective disorder. psychotic sx similar to schizo need to be present for at least 2 weeks.

cycling of mania, depression, or mixed states consistent with bipolar along with sx of schizophrenia. this psychotic disorder is

schizoaffective disorder, bipolar type

repeated episodes of major depression along with sx of schizophrenia. this psychotic disorder is

schizoaffective disorder, depressive type

how to diagnose schizoaffective disorder

typical schizo sx but also sx of mood disorders, whether that be depression or bipolar. pt isn’t diagnosed on first encounter, there needs to be proof of long term mood/psych disorder first.

which schizoaffective d/o has better functioning between episodes compared to the other types

schizoaffective bipolar type

from most to least severe, rank schizophrenia, schizoaffective bipolar type, and schizoaffective depressive type.

most severe is schizophrenia, then schizoaff depressive, then schizoaff bipolar type is least severe

how to tx schizoaffective disorder

antipsychotics, antidepressant, mood stabilizers

what is delusional disorder

pt has delusions with no hallucinations thought d/o mood d/o or flat affect. “the ultimate conspiracy theorist” where pts think nothing is true

sx of delusional disorder

possible but far fetched delusions, delusions of being in a relationship with a celebrity, watched by the CIA. other than that they are completely normal.

persecutory type delusional disorder

fixed paranoia that another person is trying to harm them, they’re being watched/followed.

jealous type delusional disorder

significant other is being unfaithful. hard to distinguish b/w it being a normal fear or real experience

Erotomanic type delusional disorder

aka Clerambault syndrome. someone famous is in love with the pt. don’t usually make contact with person but are a stalker.

grandiose type delusional disorder

false beliefs of power, money, identity, a special relationship w god. usually presented by authorities b/c they tried to contact a government organization. they think they can come to the white house bc they believe they’re the president or someone special

somatic type delusional disorder

some physical abnormality or condition is happening. tough to distinguish from hypochondriasis, depends on context of belief and degree its held. unusual beliefs like contaminated toxic substances, insect infestation, body odor.

what is the course of illness of pt with delusional disorder

some pts develop schizophrenia. most will keep their diagnosis with half recovering and 1/3 improving

how to diagnose delusional disorder

delusional thinking happens in many d/o, but delusional d/o will not have the other sx characteristic of other psych problems. can be seen as OCD but in OCD pt might now why their thoughts are like that. hypochondriasis can be similar but delusions are more far fetched. can be seen as paranoid personality d/o but not bc no hostility and doesn’t infiltrate many parts of a person’s life. pts with delusional d/o have a stable but false belief system for long time.

how to tx delusional disorder

atypical antipsychotic drugs even tho pts will resist tx bc they believe they’re right. “this med will help you w how you’re feeling” not “this will help your delusions”

complications of delusional disorder

if the person will act on their delusions. pts live quiet lives. unexpected event can intervene like stalking which can lead to incarceration or hospitalization

what is shared psychotic disorder

aka folie a deux. delusion occurs in a person who has a relationship with another person who has that fixed delusion. Other person has delusion in context of another psychotic illness. can occur in cults or family members. person with delusional d/o believes the earth is flat, pt with shared psychotic disorder eventually believes what they’re saying.

how to tx shared psychotic disorder

separate pts. healthier of 2 people will give up belief, sicker may keep false fixed belief. try to avoid meds, just go on psych and social support. developing coping skills and social independence. intervention needed if pt returns to same environment