Psychosis

Front 1

Define psychosis.

Back 1

A mental state in which reality is distorted, characterised by symptoms such as delusions, hallucinations & thought disorder.
Often features other symptoms e.g. psychomotor abnormalities, mood/affect disturbance, cognitive deficits & disorganised behaviour

Front 2

What are the 5 parameters used to simplify symptoms seen in schizophrenia & psychosis?

Back 2

Perception
Abnormal beliefs
Thought disorder
Negative symptoms
Psychomotor function

Front 3

Define perception.

Back 3

Process of making sense of physical information we receive from our 5 sensory modalities.

Front 4

Define hallucination.

Back 4

Perception occuring in the absene of an external physical stimulus.

Front 5

Define illusion.

Back 5

Misperception of real external stimuli (often in healthy individuals, associated with inattention or strong emotion)

Front 6

Define pseudohallucination. (Also give psychiatrists definition).

Back 6

Perceptual experience appearing to arise in the subjective inner space of the mind, not through one of the sensory organs, but not under conscious control.

(Psychiatrists definition = hallucinations that patients recognise as fake perceptions)

Front 7

Outline the 3 important characteristics which hallucinations must have.

Back 7

1) same as normal sensory experiences

2) external sensations from any of the sensory modalities, distinguishable from ideas/thoughts etc. originating in the patient's own mind

3) occur without external stimulus

Front 8

Name the 5 classes of hallucination.

Back 8

Auditory - hear
Visual - see
Somatic - touch
Olfactory - smell
Gustatory - taste

Front 9

Define elementary auditory hallucination.

Back 9

simple, unstructured sounds (common in organic states)

Front 10

Define complex auditory hallucination & explain the classification.

Back 10

spoken phrases, sentences or dialogue classified as
- first person (audible thoughts)
- second person (persecutory/command)
- third person (running commentary)

Front 11

Define thought echo

Back 11

patient experiences their thoughts as echoed by a voice after they have thought them

Front 12

What are 2ns person auditory hallucinations most commonly associated with?

Back 12

Mood disorders with psychotic features (can be mood-congruent hallucinations)

Front 13

Define autoscopic hallucination

Back 13

visual hallucination where patient's sees an image of self in external space

Front 14

What is Charles Bonnet syndrome?

Back 14

Condition where patients experience complex visual hallucinations associated with no other psychiatric symptoms or impairment in consciousness (usually in older adults associated with vision loss)

Front 15

Define Lilliputian hallucinations

Back 15

visual hallucinations of miniature people or animals

Front 16

Define superficial somatic hallucination & the 3 types

Back 16

Sensations on or just below the skin which may be
- tactile (haptic) - touch/prick/pinch
- thermal - heat/cold
- hygric - fluid perception

Front 17

Define formincation.

Back 17

Sensation of insects crawling on or just below the skin (associated with long-term cocaine use & alcohol withdrawal)

Front 18

Define kinaesthetic hallucinations.

Back 18

false perceptions of joint/muscle sense e.g. twisting or 'free falling' just below sleep (hypnagogic)

Front 19

Define hypnagogic & hypnopompic hallucinations.

Back 19

False perceptions in any modality that occur as one goes to sleep. Hypnopompic = as one awakens

Front 20

Define extracampine hallucinations.

Back 20

False perceptions that occur outside the limits of a person's normal sensory field, with patients often giving delusional explanations for this phenomenon

Front 21

Define a functional hallucination.

Back 21

When a normal sensory stimulus is required to precipitate a hallucination in the same sensory modality

Front 22

Define a reflex hallucination

Back 22

when a normal sensory stimulus in one modality precipitate a hallucination in another

Front 23

Define delusion.

Back 23

A false, fixed belief that is not accepted by other members of the patient's culture

Front 24

What are the 3 characteristics of delusional thinking?

Back 24

1) patient feels no differenec between a delusional & a true belief

2) delusion is false because of faulty reasoning

3) it is out of keeping with the social & cultural background

Front 25

How are delusions classified?

Back 25

- primary or secondary
- mood congruent or incongruent
- bizarre or non-bizarre
- according ot the content of the delusion

Front 26

How do you distinguish a primary from a secondary delusion? In what cases are each typical?

Back 26

Primary delusions do not occur in response to any previous psychopathological state - typical in scz & primary psychotic disorders.

Secondary delusions are consequences of pre-existing psychopathological states, usually mood disorders

Front 27

What are systematised delusions?

Back 27

many interrelated delusions centred on a common theme.

Front 28

Define persecutory delusion.

Back 28

A false belief that one is being harmed, threatened, cheated, harassed or is a victim of conspiracy

Front 29

Explain delusions of reference

Back 29

Certain objects, people or events have intense personal significance & refer specifically to oneself

Front 30

Describe erotomania & Clérambault syndrome

Back 30

A delusion of love - false belief that another person is in love with one
Clerambault sydrome = a woman (usually) believes that a man, frequently older & of higher staus, is in love with her

Front 31

What is Othello syndrome?

Back 31

Delusion of infidelity where there is a false belief that one's lover has been unfaithful (also morbid jealousy, but can be an overvalued idea)

Front 32

What are the 2 syndromes of delusions of misidentification?

Back 32

Capgras syndrome = familiar person has been replaced by an imposter

Fregoli syndrome = complete stranger is a familiar person already known

Front 33

Define nihilistic delusion.

Back 33

False belief that oneself, others or the world is non-existent or about to end

Front 34

Outline Cotard's syndrome

Back 34

presence of nihilistic & hypochondriacal delusions as part of a depressive psychosis, typically seen in older adults

Front 35

What is Ekbom's syndrome?

Back 35

Delusion of infestation with a false belief that one is infested with small but visible organisms – may occur secondary to tactile hallucinations

Front 36

Define delusions of control (passivity)

Back 36

Thoughts, feelings, actions or impulses are controlled or ‘made’ by an external agency.

Front 37

Outline the 3 delusions of thought control

Back 37

• Thought insertion = thoughts/ideas are being implanted in one’s head by an external agency

• Thought withdrawal = thoughts/ideas are being extracted

• Thought broadcasting = thoughts are being diffused or broadcast to others such that they know what one is thinking

Front 38

Define partial delusions.

Back 38

beliefs that were previously held with delusional intensity but then become held with less conviction (during recovery after treatment)

Front 39

What delusions/ideas does 'paranoid' refer to?

Back 39

refers to delusions/ideas that are unduly self-referent (typically delusions of ideas of persecution, grandeur or reference)

Front 40

Define 'overvalued idea'.

Back 40

plausible belief that a patient becomes preoccupied with to an unreasonable extent, with the pursuit of this idea causing considerable distress to the patient or those living around them.

Front 41

How does an overvalued idea differ from a delusion or an obsession?

Back 41

- lacks gross abnormality in reasoning (delusion)
- is not a recurrent intrusion (obsession)