Psychosis 101
What is a hallucination, and how does it differ from an illusion?
A hallucination is a perception without an external stimulus (e.g., hearing voices that aren't there), while an illusion is a misinterpretation of a real external stimulus.
What symptom duration is required to diagnose schizophrenia?
At least 6 months of symptoms (including 1 month of active-phase symptoms).
At what age does schizophrenia typically present in men?
Late teens to early 20s.
What is the Baker Act used for in the state of Florida?
To allow involuntary psychiatric evaluation and treatment if someone is a danger to self/others.
Name one common antipsychotic used to treat schizophrenia.
Aripiprazole, risperidone, olanzapine, etc.
Define a delusion. Provide an example based on Thomas’ case.
A delusion is a fixed, false belief not shared by others. Example: Thomas believes “Evil Thomas” lives in the walls and his parents are conspiring with him.
What’s the key difference between schizophreniform disorder and schizophrenia?
Duration: Schizophreniform lasts 1–6 months; schizophrenia lasts >6 months.
Name one genetic and one environmental risk factor for schizophrenia.
Genetic: family history (e.g., maternal uncles). Environmental: cannabis use.
What are the basic criteria for Baker Act involuntary commitment?
Presence of mental illness, danger to self/others, and refusal of voluntary treatment.
What are side effects that led Thomas to stop taking risperidone?
Sexual dysfunction and increased appetite.
Name two negative and two positive symptoms of schizophrenia.
Positive: hallucinations, delusions. Negative: flat affect, avolition.
What is brief psychotic disorder, and how long does it last?
A psychotic disorder lasting >1 day but <1 month, with full return to premorbid function.
Explain the “social drift” theory and how it applies to Thomas.
The theory that illness causes decline in socioeconomic status. Thomas lost his job and relies on parents.
What is the Marchman Act, and when is it used instead of the Baker Act?
It allows involuntary treatment for substance abuse; used when addiction, not mental illness, is primary.
What is Assertive Community Treatment (ACT), and how does it help patients like Thomas?
A team-based care model providing 24/7 support to reduce hospitalizations and improve outcomes.
What is formal thought disorder, and give an example seen in Thomas.
A disturbance in the form of thought, such as looseness of associations. Example: Thomas interjects odd, unrelated comments at dinner.
What is the core difference between delusional disorder and schizophrenia?
Delusional disorder lacks other psychotic symptoms like hallucinations or disorganized behavior; functioning is mostly preserved.
List three medical or substance-related causes of psychosis.
Examples: hyperthyroidism, corticosteroids, methamphetamine use.
Can a patient be committed for substance-induced psychosis under the Baker Act?
Yes, if they meet criteria for danger and have impaired judgment from substance-related psychosis.
What is the focus of “Housing First” programs for people with mental illness?
Providing stable housing without requiring sobriety or treatment compliance first.
Define catatonia and list two clinical signs.
Catatonia is a psychomotor disturbance that can include stupor, mutism, or waxy flexibility. Signs: immobility, echolalia.
Describe shared psychotic disorder and give a possible example from Thomas’ family history.
A delusion shared by two or more people. Example: Thomas’ grandmother believed neighbors poisoned her dog, and the grandfather came to believe it too.
How can cannabis use contribute to the development of schizophrenia?
Heavy early use increases risk of triggering psychosis in vulnerable individuals. Thomas’ first episode was after marijuana use and he has a family history of psychosis/schizophrenia
Apply the Baker Act to Thomas: Does he meet criteria currently?
Yes — he has active hallucinations and delusions, poor insight, and responds to internal stimuli that may endanger him.
How do First Episode Psychosis Programs differ from standard outpatient care?
They offer early, intensive, multidisciplinary intervention targeting young people with a first psychotic episode.