Psychotic Disorders

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Psychiatry First Aid p21-35
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5 criteria of psychosis 5 criteria of psychosis (1) Delusions (2) Hallucinations (3) Disorganized thoughts (thought process) (4) Negative Symptoms (5) Disorganized Behavior
What are some negative symptoms? Apathy, social withdrawal, low energy -flat, constricted, inappropriate affect -poor eye contact -poorly or oddly relatable
2 Diagnostic criteria for Delusional Disorder Delusional Disorder (1) presence of one or more nonbizarre delusions for at least 1 mo. (2) doesn't meet the criteria for schizophrenia (doesn't have meet another criteria of psychosis besides delusions) -functioning in life not significantly impaired Basically: one or more delusions w/o any of the other 4 criteria of psychosis (no hallucinations, disorganized thought or behavior, or negative symptoms)
Typical pt profile for delusional disorder Older pt (> 40 yoa), immigrant, hearing impaired
Prognosis of delusional disorder, what percent (a) Fully recover (b) Have decrease in symptoms (c) No change Delusional Disorder prognosis (a) 50% fully recover (b) 20% have a decrease in symptoms (c) 30% no change
Treatment for delusional disorder Basically: psychotherapy/CBT -antipsychotics should be tried, but often are ineffective -very difficult to treat
Differentiate the types of delusions (a) Persecutory (b) Jealous (c) Somatic (d) Grandoise (e) Erotomanic (f) Mixed (g) NOS Types of delusions (a) Persecutory- delusions of being persecuted (b) Jealous- delusions of unfaithfulness (c) Somatic- physical delusions (d) Grandoise- inflated self-worth (e) Erotomanic- delusion that someone is in love w/ you (usually someone higher up like Obama etc) (f) Mixed- have characteristics of multiple (g) Not otherwise specified- doesn't nicely fit one of the categories
3 main distinctions btwn delusional disorder and schizophrenia (1) Bizarre illusion (or nonbizarre) = schizophrenia, only nonbizarre for DD (2) Schizophrenics have more than delusions in the criteria of psychosis (also have disorganized thoughts or behaviors, negative symptoms, and/or hallucinations (3) Daily functioning sig. impaired in schizophrenia, but not sig. impaired in DD
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