Psychosis

Definition
1. A syndrome characterized by a loss of touch with reality
Causes
1. Organic Causes
  1. VITAMIN C DIP
    1. Neurological Causes
      1. Temporal Lobe Epiilepsy
    2. Infection
      1. Encephalitis
    3. Alcohol and Drugs
    4. Metabolic
      1. Wilson's Disease
    5. Endocrine
    6. Autoimmune
2. Functional
  1. Schizophrenia
  2. Bipolar
  3. Delusional Disorders
Aetiology
1. Predisposing
  1. Genetic
  2. Emvironmental
    1. Maternal infections
    2. Winter birth
    3. Maternal malnutrition
2. Precipitating
  1. Substance abuse
  2. Life events
  3. High expressed emotion in families
3. Maintaining
  1. Substance misuse
  2. Expressed emotion
Epidemiology
1. Prevalence 7-9/1000 for schizophrenia
2. Lifetime risk of 1% for bipolar
Treatment
1. Psycholoical
  1. CBT
  2. Bahvioural family therapy
  3. Psychoeducation
2. Pharmacological
  1. Antipsychotics
    1. Typical
      1. haliperidol
    2. Atypical
      1. chlozapine
Diagnosis
1. Schizophrenia
  1. Positive symptoms
  2. Negative symptoms
    1. apathy
    2. anhedonia
    3. avolition
  3. Disorganised thinkin
    1. disorganised writing and speech
    2. disoragnised behaviour
Symptoms
1. Delusions
2. Hallucinations
3. Lack of Insight
4. Disorganized thinking
5. Loss of touch with reality
Prognosis
1. quarter of schizophrenia cases show good recovery
  1. poor outcomes
    1. illness
      1. early onset
      2. negative symptoms
      3. previous psychiatric history
      4. insidious onset
    2. patient related
      1. male
      2. single relationship
      3. poor compliance
      4. substance misuse
      5. social isolation
2. bipolar
  1. 90% have further episodes
  2. warning signs of relapse
    1. reduced need for sleep
    2. racing thoughts
    3. elated mood
    4. increased physical activity
    5. overspending

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	Created by Zainab B over 10 years ago