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Psychotic Disorders and Co-occurring Substance Use Disorders
Published in Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews, Co-occurring Mental Illness and Substance Use Disorders, 2022
Tricia L. Chandler, Fredrick Dombrowski
The symptoms associated with brief psychotic disorder may seem self-explanatory. The observation of positive and negative symptoms associated with schizophrenia are present. However, the symptoms have lasted one day but have often lasted less than a month (pp. 94–95). Those living with brief psychotic disorder can be misdiagnosed in the presence of substance use as many symptoms associated with substance use intoxication may look like psychosis (Steeds et al., 2015). When the effects of the substance dissipate within a day to a few weeks, this can be interpreted as the individual recovering from the effects of substances. Appropriately diagnosing this disorder is needed in the absence of substance use. See Figure 3.1 for the Psychotic Disorder Matrix. This matrix breaks down the difference between brief psychotic disorder, schizophreniform disorder, and schizophrenia. While the positive symptoms and negative symptoms remain similar across diagnoses, the diagnoses differ in presentation time and duration of symptoms.
Psychiatric Terminology
Published in Michael Farrell, Psychosis Under Discussion, 2017
Brief psychotic disorder (American Psychiatric Association, 2013, pp. 94–96) involves the presence of one or more of four symptoms. The first three are delusions, hallucinations and disorganised speech, and the individual must experience at least one of these. Behaviour that is ‘grossly disorganised or catatonic’ is the fourth criterion (Ibid., p. 94). It is specified that episodes last at least a day but less than a month before the person resumes his or her previous levels of functioning.
MRCPsych Paper A1 Mock Examination 3: Answers
Published in Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri, Get Through, 2016
Melvyn WB Zhang, Cyrus SH Ho, Roger CM Ho, Ian H Treasaden, Basant K Puri
Explanation: The DSM-IV-TR criteria specify that the duration of a brief psychotic disorder is at least 1 day but less than 1 month. The ICD-10 criteria specify that the presentation of the fully developed acute and transient psychotic disorder should not exceed 2 weeks. DSM-IV-TR further specifies that brief psychotic disorder may not include a symptom if it is culturally sanctioned response pattern.
The burden of disease in early schizophrenia – a systematic literature review
Published in Current Medical Research and Opinion, 2021
Benedicto Crespo-Facorro, Pedro Such, Anna-Greta Nylander, Jessica Madera, Henrike K. Resemann, Emma Worthington, Molly O’Connor, Emma Drane, Sara Steeves, Richard Newton
Twelve publications reported social functioning outcomes in early schizophrenia versus healthy controls, chronic schizophrenia, and other psychiatric disorders (Table 2)28,34,39,42,44,54–60. Patients with early schizophrenia showed significantly poorer social functioning compared with healthy controls (p < .05)54–56,59. On the other hand, studies comparing with chronic schizophrenia did not conduct statistical comparisons or found no significant differences35,39,57,58. Two studies found that patients with first-episode schizophrenia experienced significantly poorer social functioning when compared with psychotic mania and brief psychotic disorder (p < .05)34,44,60 while further studies found no significant difference versus delusional disorder28, or other psychiatric disorders with psychosis58.
A case of Wilson’s disease presenting only with somatic preoccupation, suicidal tendencies and auditory hallucinations
Published in Psychiatry and Clinical Psychopharmacology, 2019
Jung An Lee, Nae-Yun Heo, Bong Ju Lee, Gyung-Mee Kim, Jung Goo Lee, Seon-Cheol Park
Under the initial diagnosis of brief psychotic disorder, based on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) [9], the patient was medicated with olanzapine 20 mg, valproate 600 mg, and clonazepam 0.5 mg per day. The avoidance of valoproate was usually recommended in hepatic dysfunction [10]. However, since the level of her hepatic injury was minimal and her suicidal behaviours and impulsivity were prominent, valproate was used. There was a mild improvement in the occurrence of auditory hallucinations, suicidal behaviour, and impulsivity, while the regressed behaviour and somatic concerns were sustained under the psychiatric treatment. Due to the high signal intensities detected in the basal ganglia, midbrain, and pons during fluid-attenuated inversion-recovery (FLAIR) imaging (Figure 1), encephalopathy, because of metabolic or autoimmune abnormalities, was presumed as putative diagnosis. Despite the absence of Kayser-Fleischer rings, abnormal results from the 24 h urine copper test (80.6 μg/day [16.0–60.0 μg/day]) and the serum ceruloplasmin test (< 4.0 mg/dL [17.9–53.3 mg/dL]) were identified, along with the existence of the ATP7B mutation that leads to impaired copper excretion into the bile. Hence, the patient’s diagnosis of Wilson’s disease was confirmed by a hepatologist.
Treating hallucinations in Parkinson’s disease
Published in Expert Review of Neurotherapeutics, 2022
Alice Powell, Elie Matar, Simon J. G. Lewis
Hallucinations are defined as abnormal perceptions without a physical stimulus that can involve any sensory modality and may be simple or complex in form [1]. They represent part of the Parkinson’s disease (PD) psychosis spectrum and to fulfil current diagnostic criteria, should occur after disease onset and be present for at least one month having excluded other medical, neurological or psychiatric causes [1]. Patients with PD are also at an increased risk of delirium which can involve hallucinations developing or worsening acutely alongside disturbances in attention and awareness [2]. The requirement for symptoms to be present for at least one month reflects the need to distinguish PD psychosis from a brief psychotic disorder or most cases of delirium [1].