Psychosis Exam

Aka: Psychosis Exam, Examination Findings Suggestive of Psychosis, Schizophrenia Exam

1. See Also
   1. Psychosis
   2. Psychosis Symptoms
   3. Psychosis Exam
   4. Psychosis Types
   5. Psychosis Differential Diagnosis
   6. Drug Induced Psychosis
   7. Psychosis Diagnostic Testing
   8. Schizophrenia
   9. Schizophrenia Diagnosis
   10. Delirium
2. Precautions
   1. Interpret in the context of the patient's social history (e.g. cultural beliefs)
3. Findings: Appearance
   1. Unkempt clothing
   2. Poor grooming
   3. Bizarre dress
4. Findings: Behavior and Psychomotor Disorder
   1. Bizarre and inappropriate behavior
   2. Agitation,
   3. Social isolation or withdrawal
   4. Deterioration in functioning
   5. Lack of initiative and motivation
   6. Identity disturbances
   7. Catatonic stupor
      1. Lack or reduction in spontaneous movement
   8. Stereotyped behavior (repetition)
   9. Negativism (uncooperative)
   10. Impulsive unpredictable behavior
   11. Anhedonia
   12. Somatic complaints
   13. Emotional withdrawal
   14. Poor rapport
   15. Passive, apathetic or avolitional
   16. Anergia (lack of persistence at work or school)
5. Findings: Speech
   1. Word Salads
   2. Echolalia
   3. Perseveration
   4. Mutism
   5. Neologisms
   6. Lack of spontaneity and conversation flow
   7. Alogia (marked poverty of speech or content of speech)
6. Findings: Mood
   1. Anxiety
   2. Anger
   3. Fearfulness
   4. Depression
   5. Dysphoria
7. Findings: Affect
   1. Blunted
   2. Flat
   3. Inappropriate
8. Findings: Perception
   1. Auditory or command Hallucinations
   2. Depersonalization
   3. Derealization
9. Findings: Thought Process
   1. Disorganized
   2. Illogical
   3. Blocking
   4. Loosening of associations
   5. Circumstantiality
   6. Tangentiality
   7. Flight of ideas
   8. Verbigeration
   9. Stereotyped thinking
10. Findings: Thought Content
    1. Delusions of being controlled by an outside force
    2. Thought insertion
    3. Thought withdrawal
    4. Thought broadcasting
    5. Delusions of grandeur or persecution
    6. Religious, nihilistic and somatic Delusions
    7. Ideas of reference
11. Findings: Impaired judgment
    1. Acts on Delusions
    2. Obey command Hallucinations
12. Findings: Cognition
    1. Impaired
    2. Attentional Impairment
    3. Difficulty in abstract thinking
13. Findings: Premorbid
    1. Withdrawn
    2. Eccentric
    3. Passive
    4. Impulsive
    5. Schizotypal
    6. Schizoid
14. References
    1. (2000) DSM IV, APA, p. 297-343
    2. Freedman (2003) N Engl J Med 349:1738-49 [PubMed]
    3. Schultz (2007) Am Fam Physician 75:1821-9 [PubMed]