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differential diagnosis of psychosis
psychiatry
21
Medical
Professional
02/10/2010

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Term
brief psychotic disorder
Definition
1. sudden onset of psychotic symptoms
2. lasting between 1 and 30 days
3. return to previous level of functioning
->specify with or without stressor
Term
schizophreniform disorder
Definition
1. full criteria are met for schizophrenia for >1 month but <6months
2. does not require impairment in social or occupational functioning
3. can be 'provisional' diagnosis in someone who eventually is diagnosed with schizophrenia (60-80%)
4. good prognosis, rapid onset, confusion, good premorbid functioning, normal affect
Term
Delusional Disorder
Definition
1. one or more non-bizarre delusions that persist for a month or more
2. cannot be in someone who has been diagnosed with schizophrenia
3. hallucinations not prominent
4. psychosocial functioning not impaired
->types: erotomanic, grandiose, jealous, persecutory, somatic
Term
risk factors for delusional disorder
Definition
1. increased age
2. sensory impairment
3. family history
4. social isolation
5. recent immigration
Term
neurologic conditions associated with delusions
Definition
1. head trauma
2. encephalopathy
3. migraine
4. MS
5. temporal arteritis
Term
metabolic/endocrine conditions associated with delusions
Definition
1. acute intermittent porphyria
2. vitamin deficiency - folate, thiamin, B12
3. electrolyte imbalance
4. PKU
5. thyroid disorders
Term
sex chromosome disorders associated with delusions
Definition
klinefelter's
turner's syndrome
Term
infections associated with delusions
Definition
1. AIDS
2. Cruetzfeld-Jacob
3. Malaria
4. Syphilis
5. Typhus
Term
toxic agents associated with delusions
Definition
1. arsenic
2. carbon monoxide
3. manganese
4. mercury
5. thallium
Term
schizoaffective disorder
Definition
1. chronic illness characterized by concurrent symptoms of schizophrenia as well as a major mood disorder
2. at least 2 weeks when delusions or hallucinations are present without prominent mood symptoms, but mood symptoms present for substantial portion of illness
3. high rates of mood disorders in family
4. negative symptoms less severe than schizophrenia
5. better prognosis if mood symptoms predominate
Term
psychosis in dementia
Definition
30% have hallucinations, usually visual
30-40% have delusional thinking, usually persecutory
can have delirium superimposed on dementia
Term
psychosis in personality disorders
Definition
may have transient psychotic symptoms lasting minutes to hours, especially in paranoid, schizotypal, and borderline personalities
Term
delirium tremens (DTs)
Definition
1. delirium superimposed on withdrawal symptoms
2. often severe confusion
3. tactile and visual hallucinations are common
4. may have seizures (rum fits)
Term
uremia
Definition
fatigue, decreased cognitive functioning, confusion, may get delirium and psychosis
Term
hepatic encephalopathy
Definition
get impairment in consciousness, often delirium with hallucinations (usually visual)
Term
thyroid disorders
Definition
hyperthyroidism may cause mania with psychosis
Term
delirium
Definition
disturbance of consciousness, reduced ability to focus/sustain/shift attention, change in cognition or perceptual disturbance
Term
confabulation
Definition
-filling in gaps in memory with imaginary events
-often trying to please interviewer or hide memory loss
Term
illusions
Definition
misinterpretation of actual objects, commonly seen in delirium, substance abuse
Term
agnosias
Definition
inability to understand sensory stimuli, impaired recognition of objects
Term
psuedodementia
Definition
seen commonly in elderly
severe psychomotor retardation, events don't register so appears to have poor memory, may actually have cognitive failure secondary to depression
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