Psychosis | Mental health | NCLEX-RN | Khan Academy


– [Voiceover] When someone
has psychosis, they have some kind of disturbance in
their sense of reality, which could be having some kind of beliefs that simply aren’t true,
or it could be seeing or hearing things that aren’t there, and they’re unable to tell the difference between what’s real and what’s not real. When they have these false beliefs, they often feel very strongly about them, and will not change their mind, even if there’s a lot
of evidence against it. These thoughts are also
known as delusions, and these delusions are usually compared to other people of the same culture, and that last bit’s really important because what’s considered
unusual in one culture might be a completely
normal belief in another. So, there are several different types of delusional thinking
to distinguish between. The first type is delusions of reference, which is believing that certain events aren’t random or neutral, but instead, something that’s aimed at the person. So an example of this could be like if somebody thought that some article in the newspaper was written for them, that the writer was trying to send them a personal message of some kind. And this would be considered
a delusion of reference. Another type of delusion,
though, is a grandiose delusion, or maybe more commonly heard
as delusions of grandeur. These are based around
the person believing that they have some sort of
unique significance or power. For example, believing that
they’re actually a ruling king or queen that deserves
to be treated like royalty. Now a third type is paranoid delusions, and these are based around paranoia, and the belief that they’re
being harmed or watched by someone or some group of people. For example, thinking that the
van parked outside the house is actually filled with
people trying to spy on them. And this type is of particular concern, because it can sometimes lead to patients not taking their medications or treatments due to paranoid beliefs
about the treatment. Now there also could be
delusions of control, which is believing that
another person or group or force controls their
thoughts, feelings or actions. So this could be like thinking that aliens are controlling the way
they think or their actions. And finally, there’s erotomanic,
where they incorrectly believe that someone else,
usually a stranger, or maybe someone famous or of high-status is in love with them. So, for example, thinking
that a famous singer is actually in love with them, and this one’s of also
particular importance because it can sometimes lead to legal issues like restraining orders because the so-called
relationship is one-sided. Now sometimes a further way to categorize these delusions is by their apparent plausibility
or how reasonable they are. We’ll either say they’re
bizarre or non-bizarre, and non-bizarre delusions
are those that are technically within the
realm of possibility, so they could be true, technically, but they’re usually pretty exaggerated, like the example of the singer
being in love with them. But bizarre delusions are those
that are clearly implausible and really not taken from any sort of ordinary life experiences, so
like the delusion of control where the aliens were controlling their actions and their thoughts. That would be considered
a bizarre delusion. So those were all delusions,
which had to do with the thoughts and beliefs people had, but people diagnosed with psychosis may also have hallucinations,
and these aren’t necessarily only visual
hallucinations, they could also be other sensations, like hearing things, and these are usually vivid and detailed, and they seem very real,
but, in fact, they aren’t. The most common is actually
auditory hallucinations, often in the form of
voices, which could be like spoken commands or a running commentary, which would just be like
voices in the background always talking, rather than
directly at the person, or they could just be
other sounds in general. Besides that, you could have
visual hallucinations as well, and those are typically simple
things like flashes of color, but some experience clear and identifiable objects like people or faces. And you can also extend
this to other senses, like touch, smell and taste, but usually auditory and
visual are the most common. So another symptom of psychosis besides delusions and hallucinations are those of disorganized behavior, which
can be directly observed, and disorganized thinking,
which can be indirectly observed through someone’s speech, and there are several
common types of speech that can suggest symptoms of psychosis. One is called poverty of content, where they don’t actually
give much information or don’t say anything
substantive when they’re talking, or maybe they just say way
more than what’s needed to actually convey the message. Another speech pattern
that can come about is getting off-topic when
answering a question, which is called tangential speech, like the saying going off on a tangent. Sometimes they actually
do answer the question, but it’s in a totally roundabout way. Another pattern is thought blocking, where they’ve just suddenly
lose their train of thought, and this can happen
especially when there is a sudden interruption
in what they’re saying. There’s also what’s known as a word salad, where words are just put together and there’s no sense or
meaning in what’s said, like, for example, dog
sleep chicken pencil trees. The words are just jumbled together like they’ve been tossed in a salad bowl and then served out randomly. Finally there’s preservation, where words or ideas are repeated, even after a particular
topic has been switched. So, they’re like preserving
the last topic and then continuing to talk about
it in the next topic. Finally, the patient
might have symptoms of agitation and aggression,
where if psychosis is left untreated, anxiety, heightened emotions, and heightened motor activity
can all start to manifest. If someone has psychotic symptoms, though, there may be several underlying causes, and one might be simply
other psychiatric conditions like schizophrenia or a brief
psychotic disorder or others. But they might also have
another medical condition like delirium, which is a
state of mental confusion that’s often accompanied
by psychotic symptoms. But another culprit are
things like substances like alcohol or
hallucinogenic drugs like LSD, and finally, certain medications can also cause psychotic symptoms
like anti-parkinsonism medications like Levodopa,
and some anti-viral medication can also bring about psychotic symptoms.

15 thoughts on “Psychosis | Mental health | NCLEX-RN | Khan Academy

  1. 20 seconds into this one, there's already a huge red flag waving…
    And if you cannot identify the massive issue with this approach of diagnosing a quote "psychosis", then quite frankly you need to go back and rethink it all because you're not thinking in a sane manner.

  2. my younger sister is having more of visual hallucinations from couple of years and also she doesnt have any feelings left specially the happy feelings , but the things is that so far her doctors have diagnosed her with anxiety and mild depression while with the use of anti anxiety and anti depressant her problem isnt going away infact now its getting so severe that she sees ppl all around her all the time and so on and so forth and i dont know what to do with her as doctors dont consider or try to diagnose her with psychosis while i am sure she has it .

  3. OK, let's see…

    Delusions of Reference: check
    I have had times where I thought that street signs and public advertising was put up by unknown forces solely to communicate with me. Random, but seemingly interconnected events would all build up to create a very clear and cogent message meant just for me.

    Delusions of Grandeur: check
    I have had times when I believed that God had chosen me to spread some message, usually contained in something scientific about the sub-atomic realm. I have often had beliefs that God had chosen me to create a new age for humanity by finding free energy from within the structure of the universe, or by proving some mathematical paradox.

    Paranoid Delusions: check
    I have had times where I have refused to leave the house because "they" had me under surveillance. If I had to go to the supermarket to get supplies I would be in near terror because everyone who looked at me could see into my soul and steal some of it from me. For a while I believed that the wind was blowing into my skull and eroding my brain.

    Delusions of Control: check
    I have had times where I believed that an outside force, usually demonic, was planting thoughts into my head so as to control me and make me think "bad" thoughts. The demon's goal was to be able to claim my soul for eternity so as to prevent me from being God's "chosen one".

    Erotomania: thank fuck no

    Hallucinations: check
    I have had times where I have hallucinated strange animals such as giant cats and birds, disembodied people, seeing complex mathematical equations appear on a curtain, lights moving around me, my field of vision just "melt" before my eyes. I have smelt strange odours coming from the walls and I have heard dead people scratching to get out from underneath the floor boards and felt things crawling underneath my skin.

    Disorganised Thinking and Behaviour oh my word, yes!
    My partner once took a video of my behaviour during a psychotic break and showed it to me later…cringe…

    Agitation and Aggression: check
    I recall one instance where 4 policemen could barely hold me down while an ambulance worker tried to knock me out with a Ketamine injection. Took 3 times the usual dosage for a person my size to bring me down, I was later told.

    Ah, the joys of psychosis…

  4. when interviewing patients : according to to 90% of the modern patients report the following "modern believes about false-paranoia are only a way to hold people in torture internal of computer simulations and that their conditions can only be caused internal of computer simulations… "according to 95% of patients : there is real attempt to enslave and control what they call "simulation residents of all ages", they state repeatedly that thye are being tortured by LRAD style computer algorithms… according to the patients : they SHOULD be treated well seeing as how they are AI life forms, etc…. 95% of them argue that offending life forms , SEEMINGLY-inept-doctors included should be punished by the law. they also claim that lucid dreams are proof of being computer simulated what do you guys think about these BIZARRE, so very strange reports from patients of lucid dreaming disorder ?… in our group : we research these events as often as daily for several years at a time.

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