Paranoid Disorders

University:
Stanford University
Course:
PEDS 282 | Pregnancy, Birth, and Infancy
Academic year:

2023
Views:

420

Pages:

2
Author:

Pierre BERNARD

Paranoid Disorders Psychosis – inability to distinguish between subjective experiences & reality as evidenced by hallucinations & delusions Delusions – unshakeable, false beliefs, out of keeping with the subject’s personal, cultural, social and intellectual background. Hallucinations – false sensory perceptions NOT associated with real external stimuli Content of delusions Paranoid – just means self referral Persecutory – bad Guilt Love Hypochondriacal – obsession with body & illness Nilhilistic Jealousy Reference – everyone & everything relates to the patient Hallucinations Auditory Visual Olfactory Tactile Gustatory Differential of Psychosis Delerium (MSU, Temp) Dementia Hypothyroidism, anaemia Intra/Extracranial lesions (often in temporal lobe) Epilepsy Alcohol Other drugs (digoxin, prednisolone, cimetidine) Depression (? Are the psychosis mood congruent) Paranoid personality disorder (patient knows its them that’s ill) Persistent delusional disorder (knows its bizarre but doesn’t think its them, not confused, just deluded, more common in elderly) Paranoid schizophenia (usually past history Risk Factors Male:Female = 1:7 Deafness (or some visual & hearing impairment) Lives alone, Social isolation, unmarried & childless (often referred by neighbours) Pre-morbid personality (paranoid schizoid traits) Genetics / FH Ventricular size, pattern of cognitive impairment Presentation Delusions with persecutory themes, well formed, persistent and consistent Partitional delusions Hallucinations during clear conciousness, often auditory persecutory (tactile & olfactory may occur, visual rare – suspect Charles Bonnet Syn) Occasional thought insertion, withdrawl & broadcast (as in schizophrenia) NO intellectual impairment Assessment Should ideally be at home Involves aspects from relatives, carers, neighbours etc MMSE Exclude physical, treatable causes Management Treat any other co-existing conditions Hearing aid, sight test to reality orientate Attempt to relieve social isolation (get to day hospital / lunch group) Medication (antipsychotic) can be difficult as often no insight Follow up with MDT