PSYCHOTIC DISORDERS

Psychotic Disorder Psychosis Rule out psychotic disorder due to substances and/or general medical condition Prominent mood syndrome (major depression, mania) present for significant portion of illnessDuration of illness <= 1 month Duration of illness1-6 months Duration of illness >= 6 months Non-bizarre delusions >= 1 month, no decline in functioning, behaviour is not odd Delusions developed in context of close relationship with a person with already established similar delusion Mood syndromes absent (or brief relative to duration of psychotic symptomsPsychotic symptoms present exclusively during major mood syndrome Psychotic symptoms not limited to delusionsPsychotic symptoms limited to non-bizarre delusions only 1 or more: 1) Delusions 2) Hallucinations 3) Disorganized speech 4) Grossly disorganized or catatonic behaviour Mood disorder with psychotic features Brief psychotic disorder Schizoaffective disorder (bipolar & depressive) Schizophrenia Schizophreniform disorder Shared psychotic disorder (Folie a Deux) Suicide = 10%Neuroleptic Malignant Syndrome: Side effects of anti-psychotics Sx: Hyperpyrexia (>38.5°C), muscle rigidity and mental status changes 20% mortalityPsychotic symptoms also present outside of mood episodes Delusional disorder2 or more (1 must be 1-3):1) Delusions 2) Hallucinations 3) Disorganized speech 4) Grossly disorganized or catatonic behaviour 5) Negative sx (affective flattening, alogia, avolition) Criteria: see schizophreniform disorderMedical Conditions: Para/Neoplastic Brain tumour Stroke Parkinson's AIDS, syphilis EpilepsyInfectious Cushing's MS, SLEDegenerative Endocrine Vascular Drugs of Abuse:Cocaine Alcohol (rare) Cannabis Amphetamines Opiates (rare) PCPHallucinogensMedications: Amphetamines Methylphenidate Steroids Dopamine Agonist Anticholinergic L-Dopa PSYCHOTIC DISORDERS