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41 Cards in this Set

  • Front
  • Back
First rank symptoms
thought insertion, withdrawl, broadcasting
delusions of control (belief's that one's thoughts/actions are controlled by some external source)
Perceptions
hallucinations
illusions
depersonlization
derealization
hallucination
sensory perception in absence of external stim that is similar in quality to a true perception
Delusions
persecutory
delusions of reference
Erotomania
grandiose
religious
somatic
Persecutory delusions
belief others trying to cause you harm
Delusions of reference
interpreting publically known events/celebrities as having direct reference to oneself
Erotomania
belief another is in love with you
Religious delusions
belief of receiving instructions/powers from higher being
Somatic delusions
belief one has a physical disorder/defect
Cognition
LOC
orientation
memory
intellectual functions
- attention
- concentration
- calculation
- abstraction (proverb interpretation)
- language
- communication
Insight
ability to realize that has physical/mental illness and to understand its implications
Judgement
ability to understand relationships between facts and draw conclusions that determines one's actions
Axis I
DDx of DSM IV clinical disorders
Axis II
personality disorders
mental retardation
Axis III
general medical conditions potentially relevant to understanding/managing mental disorder
Axis IV
psychological and environmental issues
Axis V
global asessment of functioning incorporating effects of Axes I-IV
61-70 - some mild symp, generally functioning well
31-40 - some impairment in reality testing/communication, impairment in several areas
21-30 - behaviour influenced by delusions/hallucinations or serious impairment in communication/judgement
11-20 - some danger of hurting self/others
1-10 - persistent danger of severely hurting self/others
DDx of psychosis
"GASPP"
GMC
Affective disorder
Substance induced
Primary psychotic disorder
Personality disorder
Primary psychotic disorders
schizophrenia
schizoaffective disorder
delusional disorder
brief psychotic disorder
Mood disorders in DDx of psychosis
depression w psychotic features
bipolar (manic episode with psychotic features)
schizophreniform
Personality disorders in DDx of psychosis
schizotypal
schizoid
borderline
paranoid
obsessive compulsive
Schizophrenia Dx criteria
A. In 1m ≥2 of
delusions
hallucinations
disorganized speech
grossly disorganized/catatonic behaviour
negative symptoms
1 "A" symp if - delusions bizarre or hallucinations are running commentary/≥2 voices conversing w each other
B. ≥1 area of dysfunction
C. continuous signs of disturbance for ≥6m including ≥1m active symptoms
First rank psychotic symptoms
"ABCD's"
Auditory hallucinations
Broadcasting of thoughts
Controlled thoughts
Delusional perceptions
Subtypes of schizophrenia
paranoid
catatonic
disorganized
undifferentiated
residual
Rx of schizophrenia
acute - antipsychotics +/- anticonvulsants, anxiolytics
manage S/E
Ψsocial
CBT
ACT
social skills, employment programs
housing
Prognosis of schizophrenia
⅓ imrpome
⅓ same
⅓ worse
Schizophreniform disorder criteria
Criteria A, D, E of schizophrenia
- symptoms last 1-6m
Px better than schizophrenia
Rx similar to schizophrenia
Brief Psychotic disorder
Dx - acute psychosis ≥1 +ve symptoms from 1d-1m with eventual return of premorbid level of fxn
Non-bizarre delusions
involve situations that could occure in real life (eg being followed, poisoned, loved at a distance)
Negative Symptoms
affective flattening
alogia
avolition
Dx criteria for depression
"MSIGECAPS"
≥5 symptoms in 2wks, representing ∆ from previous fxn, ≥1 of depressed mood or anhedonia
depressed Mood
↑/↓ Sleep
↓ Interest
↓ Energy
↓ Concentration
↑/↓ Appetite
Psychomotor agitation/retardation
Suicidal ideation
Criteria for Mania
"GST PAID"
≥1wk (or any duration if hospitalization necessary) off Elevated/Expansive/Irritable mood & ≥3 of (4 if mood only irritable)
Grandiosity
↓ need for Sleep
Talkative (pressure speech)
Pleasurable activities w Painful consequences
↑ goal directed Activity/Psychomotor agitation
flight of Ideas/racing thoughts
Distractable
Depressive Disorders
1. psychotic (with hallucinations/delusions - can be mood congruent)
2. chronic ≥2yrs
3. melancholic (Ψm retardation, EMA, mood worse in am, +++ guilt, ↓↓wt)
4. atypical (↑sleep, ↑wt, rejection hypersensitivity)
5. post-partum
6. seasonal
Dysthymic disorder
depressed mood most of day, most days for ≥2yrs
≥2 of
poor appetite/overeating
↓/↑ sleep
↓energy/fatigue
↓self-esteem
poor concentration, or difficulty making decisions
feelings of hopelessness
No MDE during 1st 2 years of disturbance (1yr for kids or adolescents)
Postpartum "Blues"
Normal emotional ∆'s of puerperium
50-80% mom's @2-4d post-partum, lasts ~48h (≤10d)
transient period of mild depression, mood instability, anxiety, ↓concentration, ↑concern over own health and baby's
Post-Partum Depression
Dx MDE, onset within 4wks post-partum
lasts 2-6m, residual symp ≤1yr
must ask about suicidal/infanticidal ideation
RF
PHx mood disorder
Ψsocial factors
Rx
no evidence meds superior to ΨRx in non-psychotic PPD
established short term safety of SSRIs - long term unknown
Bipolar I vs II
I - ≥1 manic/mixed episode
MDE not required for Dx
II - ≥1 MDE, ≥1 hypomanic and NO past manic/mixed
Cyclothymia
numerous pds of hypomania and depressive symptoms NOT meeting criteria for MDE
- No MDE, manic/mixed episodes
DDx of anxiety disorders
Endocrine
- ↓/↑thyroid, pheo, hypoglycemia, hyperadrenalism, hyperPTH
CVS
- CHF, PE, arrhythmia, MVP
Respiratory
asthma, pneumonia, hyperventilation
Metabolic
Vit B12↓, porphyria
Neuro
neoplasm, vestibular dysfunction, encephalitis
Substance induced
Medical w/u of anxiety
Routine
P/E
CBC
Thyroid fxn
lytes
U/A
+/- as indicated
neuro consult, CXR, ECG, CT scan
Criteria for Panic disorder
"STUDENTS FEAR the 3C's"
Sweating
Trembling
Unsteadiness, dizziness
Depersonalization/
Derealization
Excessive HR, palpitations
Nausea
Tingling
SOB
FEAR of dying, going crazy, losing control
3C's
Chest pain
Chills
Choking