Schizoaffective disorder Has both features of Schizophrenic and mood disorders Schizoaffective disorder [Bipolar or manic type] Schizoaffective disorder [Depressive type] Management Mood Stabilizers, Antipsychotics and Antidepressants
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Other antipsychotics Long Acting Injectable [Depot] Antipsychotics used in patients with poor compliance Available for Fluphenthixol Fluphenazine Haloperidol Pipotiazine Risperidone Zuclopenthixol Olanzapine Paliperidone Aripiprazole Thioridazine can cause irreversible retinal pigmentation, QT Prolongation but Less EPM side effect Chlorpromazine with corneal and lenticular deposits Penfluridol is the longest acting antipsychotic Ziprasidone can cause QT Prolongation
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Delusional disorder Delusional disorder: Development of a single or a set of related delusion which are persistent Hallucination, disorganization and negative symptoms are absent Persecutory Type, Jealous Type, Erotomania Type, Grandiose Type Somatic Type – Delusional parasitosis, Delusional dysmorphophobia, Delusion of Halitosis Capgras Syndrome – Familiar person has been replaced by an imposter Fregoli
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Clozapine First Atypical antipsychotic and is Drug of Choice in RESISTANT Schizophrenia Low D2 Affinity [Lack of Extrapyramidal S/E]and Strong D4 Affinity Antagonist of 5HT2A, D1, D3 and Alpha-adrenergic receptor Preferred Antipsychotic in patient who with EPM side effects including tardive dyskinesia S/E – Sedation, Syncope, hypotension, tachycardia, Nausea & Vomiting, Weight Gain [Highest],
Acute psychotic disorder Delusion, hallucination and disorganization symptoms like schizophrenia Does not meet the duration criteria for diagnosis of schizophrenia Preceded by STRESSOR [Stressful Life Event] and may be precipitated by Fever ICD -10 [Acute & Transient Psychotic Ds] DSM5 [ if Duration < 1 Month Brief Psychotic Disorder Duration 1-6 Months – Schizophreniform Disorder]
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MSE-Perception Perception is receiving information using one of the sensory modalities The perception of a person during MSE can be diagnosed into: Illusion- False perception of real object Example of Illusion – A man mistakes a rope for a snake Hallucination- In absence of object or stimulus Are Vivid [Clear or detailed] Experienced in Outer
Hallucinations The different types of hallucinations are: Auditory Hallucinations are the most common hallucinations Visual Hallucinations are the most common hallucinations in Organic Psy. Ds [Delirium] In temporal Lobe Epilepsy all kinds of hallucinations can be present [Like tactile & Olfactory] Tactile Hallucinations are typical feature of cocaine intoxication Hypnagogic Hallucinations – While Falling
MSE-Thought Thought – An idea or opinion produced by thinking or occurring spontaneously Cognition – Mental process of acquiring knowledge [Thoughts + Experiences + Sensations] The diagnosis of thoughts of a patient in MSE is made by: Stream of thought Form of thought Content of thought Possession of thought
MSE-Basics Morbid Psychological Processes used for diagnosis are: History: Symptoms Duration Dysfunction Mental status Examination: General appearance & behavior Speech Mood & Affect Perception Thought Higher mental functions
Autism-Signs, Symptoms & Management Autistic signs & symptoms: Interacting with others- Little interest in interacting with other people or children of same age group (Lack of social reciprocity) Preferring to play alone Lack social smile. Avoiding eye contact Being unusually intolerant of people entering their own personal space Rarely using gestures or facial expressions when
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