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25 Cards in this Set
- Front
- Back
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How do you distinguish Brief psychotic d/o v schizophreniform d/o v schizophrenia
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Durtation of sx (criterion A). BPD < 1 mo sx; schizphreniform is 1-6 months (including prodrome sx); schizophrenia is > 6 mo sx (including prodrome + at least 1 month of active sx)
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Distinguish MDD w/ psychotic features v schizoaffective d/o.
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In a patient with concurrent depression and psychosis. MDD psychotic sx occur ONLY in context of depression. SAD, look for psychotic sx for 2 weeks in ABSENCE of depression and pt should meet criteria for BOTH MDD and schizophrenia.
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How do you distinguish Brief psychotic d/o v schizophreniform d/o v schizophrenia
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Durtation of sx (criterion A). BPD < 1 mo sx; schizphreniform is 1-6 months (including prodrome sx); schizophrenia is > 6 mo sx (including prodrome + at least 1 month of active sx)
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Distinguish MDD w/ psychotic features v schizoaffective d/o.
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In a patient with concurrent depression and psychosis. MDD psychotic sx occur ONLY in context of depression. SAD, look for psychotic sx for 2 weeks in ABSENCE of depression and pt should meet criteria for BOTH MDD and schizophrenia.
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PTSD v Acute stress d/o
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Major difference is duration of sx. PTSD req sx > 1month. ASD requires sx for less than 4 weeks. Both occur w/in 4 weeks of index trauma. Both require 3 symptom clusters: re-experiencing, hyperarousal and avoidance/numbing. ASD also requires 3 sx of dissociation.
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Social phobia v panic d/o
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social phobia is specific to an uncomfortable social situation and panic attacks may be present (triggered by situation). Panic d/o requires h/o recurrent, unexpectected/untriggered panic attacks and after at least one of these there must be a period of > 1 month where pt has significant anxiety about having another attack (2/2 unexpected nature)
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OCD v GAD
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OCD - presence of obsessions or compulsions that don't respond to simple re-assurance. GAD = anxiety regarding many things (the "worry wart") but can usually recognize irrational nature of worries (better insight)
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T/F: panic attacks are pathognomic for panic d/o
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False. Panic attacks can exist in nearly any anxiety d/o and even be substance induced or d/t general medical condition. First distinction is if they are triggered --> insight into specific anxiety d/o.
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BP I v BP II v Cyclothymic d/o
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BP1: h/o manic or mixed episode; BP2: requires h/o hypomanic episode AND MDD episode. Cyclothymia: persistent mood episodes on most days > 2 yrs straight! (w/o euthymia for over 2 months)
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MDD v dysthymic d/o
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MDD: depression or anhedonia + 4 sx from SIGECAPS x 2 weeks. Dysthymic d/o: depression + 2 of ACHEWS (allergic to happiness - Appetite changes, dec concentrations, hopeless, dec energy, worthless, sleep) x 2 years w/o 2 mon euthymia
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MDD v Bereavment
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Time and functioning. Bereavement can last up to a year, but MDD is reserved for significant sx that last > 2 months AFTER LOSS. If pt is not functioning w/in the 2month a dx of MDD can be made(sx to suggest MDD are guilt, SI, worthlessness).
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T/F: VH can occur in individuals suffering from bereavement
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True. 30%
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MDD v adjustment d/o
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SEVERITY. sx meet criteria for MDD, then mood disorder (BP or MDD). If there is functional impairment w/ MDD criteria NOT met, then adjustment d/o.
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somatoform d/o (somatization /do, hypchondriasis, etc.) v factitious d/o v malingering
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somatoform = doesn't understand and does know why; factitious (munchausen's or M by proxy) = knows whats going on but doesn't appreciate why they're doing it (no clear secondary gain); malingering = secondary gain is clear
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Body dysmorphic d/o v delusion d/o
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BDD = excessive, strong beliefs about body's imperfections (45x increase in suicide!); Delusional d/o = single, isolated, non-bizarre (FBI following you)
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primary d/o v. substance d/o v. d/o due to general medical condition
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If you get a question where patient is taking a substance known to cause a particular syndrome (e.g interferon for depression) then its usually substance induced. Same goes for general medical condition (e.g. L frontal CVA or pancreatic CA --> depression). Primary means that it can't be due to the other two
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T/F: Personality disorders are generally ego-dystonic.
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False. They are egosyntonic, which means patient thinks that their sx are reasonable and appropriate (e.g schzoid perfers to be left alone and OCPD thinks its okay to be aperfectionist)
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Differentiate Schizoid/typal vs schizophrenia
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Schizoid = loner; odd interactions with others; Schizotypal = odd, eccentric personality; may have magical thoughts. BOTH LACK frank delusions, hallucinations and disorganization although they may display negative sx.
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Avoidant v panic d/o with agoraphobia/social phobia
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Difficult to differentiate. avoidant PD = egosyntonic to have thoughts of inadequancy and pervasive fear of not being accepted (drive to avoid contact). Panic d/o w/ agoraphobia/social phobia pts are driven BY ANXIETY. avoid contact in order to avoid having a panic attack.
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Antisocial v intermittent explosive d/o
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IED is characterized by discrete episodes of violent/aggressive behavior interspersed by much longer periods of remorse and non-aggressive behavior. They have significant regret v antisocial, who rarely express remorse.
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OCPD v OCD
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OCPD = perfectionistic & rule driven, come off as cold toward others. OCD = defined by presence of either obsessions and/or compulsions > 1 hr/day
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borderline/histrionic v cyclothymic/bipolar d/o
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borderlines can't see shades of fray (splitting). They also evoke strong emotion from care providers (usually frustrations), and they routinely cause drama (parasuicidal thoughts/actions). Histrionics make extravagant shows and can be seductive. Cyclothymic is hypomanic and depressive sx for at least 2 years w/o 2month consecutive interval of sx free
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What else goes on Axis II other than personality d/o?
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MR (soon to be called intellectual disability).
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What else goes on in Axis I besides psychotic, mood and anxiety d/o?
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borderline intellectual functioning (IQ 71-84).
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what is the 15/20/20/15 rule?
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IQ < 15 is profound MR, 16-35 (15+20) severe MR, 36-55 (35+20) moderate MR, 56-70 (55+15) mild MR.
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