Classification Flashcards
Where is schizotypal disorder classified in ICD-11?
WIth Schizophrenia and related disorders
Where is schizotypal disorder classified in DSM-V?
Cluster A personality disorders
What level of support might somebody with moderate learning disability need?
Can manage basic self care but need significant support to live independently and maintain employment as adults
Level of support required for severe learning disability
Daily support in supervised environment usually required
Some may develop basic self care skills with intensive support and training
Level of support required for profound LD
Limited communication ability
Daily support in supervised environments usually required
How long does it take to recover from most cases of delirium?
4 weeks
What is Ganser syndrome?
Approximate answers, disorientation, clouding of consciousness, hallucinations, motor disturbance, anxiety/apathy with then sudden resolution with amnesia for period of illness
Where is Ganser syndrome classified in ICD-11?
Other specified dissociative disorders
Who described the three-syndrome model of schizophrenia?
Liddle
Clinical features of avoidant personality disorder
Fear of criticism or rejection
Unwillingness to get involved unless certain they will be liked
Social inhibition due to feelings of inadequacy
View self as inferior
What is De Clerambault syndrome?
Form of delusion of love
Whats % of children with ADHD have a comorbid disorder?
50-80%
What are some common comorbid conditions with ADHD?
Specific learning disorders - 70% ASD - 59% Tics/Tourette's - 55% Oppositional defiant disorder - 30-50% Depression - 12-50% Bipolar - 5-47% Conduct disorder - 3.5-10%
What was Angst’s work in?
Bipolarity of mood disorders
Core symptoms of Schizophrenia in ICD-11
Delusions
Hallucinations
Experiences of passivity, influence or control
Disorganised thinking - formal thought disorder
What is Windigo?
Person developing the delusion of transforming into a cannablistic monster and craving human flesh under the threat of starvation in severely cold weather
When should schizophrenia, continuous be diagnosed?
If symptoms fulfilling criteria for schizophrenia have been present for almost all of the illness course over the period of at least 1 year with periods of subthreshold symptoms being brief
What are some characteristics of a paranoid personality disorder?
- Suspicions that others are harming them
- Holding long-standing grudges
- Increased sensitivity to criticism and setbacks
- Believing others are not trustworthy
- Feeling that others are attacking their character
What are some characteristics of delirium tremens?
- Clouding of consciousness
- Disorientation
- Amnesia of recent events
- Agitation
- Hallucinations - characteristically lilliputian
- Sweating, fear, cardiovascular collapse
Features required for diagnosis of schizoaffective disorder
Schizophrenic and affective symptoms simultaneously present for at least 1 month with both being equally prominent
Where is schizoaffective disorder classified?
Schizophrenia or other primary psychotic disorders
What are the negative symptoms of schizophrenia?
- Flattened affect
- Alogia - poverty of speech
- Anhedonia
- Social withdrawal
- Avolition
- Lethargy
- Attentional impairment
How many axes did the ICD-10 use and what were they?
3
1 - the mental disorder
2 - the degree of disability
3 - current psychosocial problems
When does schizophrenia following brain injury tend to occur?
1-5 years after injury
Who coined the term simple schizophrenia?
Bleuler
What % of people with MCI go on to develop AD?
10-15%
When do PTSD symptoms arise?
Within 6 months of the trauma
What are the 3 common clinical presentations of postpartum psychosis?
- Prominent affective symptoms
- Schizophreniform disorder
- Acute organic psychosis
How is postpartum psychosis classified in ICD-11?
Mental disorder associated with the puerperium with psychotic symptoms - use this code for significant mental disorders occurring about 6 weeks after delivery that include delusions, hallucinations and other psychotic symptoms
When do you see kinaesthetic hallucinations?
Benzo withdrawal
Schizophrenia
Alcohol intoxication
Who introduced the term Schizoaffective psychosis?
Kasanin
Is there any association between social class and anorexia?
No
What is the genetic concordance of anorexia nervose MZ and DZ?
MZ - 65%
DZ - 32%
What is fregoli syndrome?
Type of delusional misidentification in which patient believes that strangers have been replaced with familiar people
According to DSM-V, the core symptoms of ADHD must appear before what age?
12
What is a conduct disorder characterised by?
Repetitive and persistent pattern of antisocial, aggressive or defiant behaviours that defy age-appropriate societal norms or rules
What is bipolar I?
At least one past or present manic or mixed episode
What is bipolar II?
At least one hypomanic and one depressive episode
Features of delusional disorder
Delusions without hallucinations and thought disorder along with preserved family and work functioning
3 core features of ADHD
Inattention
Hyperactivity
Impulsiveness
What is an adjustment disorder?
Maladaptive reaction of an identifiable psychosocial stressor or multiple stressors that usually emerges within one month of the stressor
In which type of personality disorder might people have difficulty making decisions
Obsessive compulsive personality disorder
What does an operationalised approach involve?
Clearly defined clinical descriptions of disorders with explicit inclusion and exclusion criteria
What is classed as a significantly low body weight?
BMI 14-18.5
What is classed as a dangerously low body weight?
BMI less than 14
How long does the natural course of an episode of untreated mania last?
4 months
How long does the natural course of an episode of untreated depression last?
6 months
What is the classic triad of wernicke’s encephalopathy?
Confusion
Ataxia
Nystagmus/ophthalmoplegia
What does Wernicke’s encephalopathy develop secondary to?
Thamine (vitamin B1) deficiency
First rank symptoms of schizophrenia
- Auditory hallucinations
- Delusions of thought interference
- Delusions of control
- Delusions of perception
According to ICD-11, what is the minimum duration of drinking to make a diagnosis of alcohol dependence disorder?
1 month if drinking almost everyday
Usually evident over 12 months
Which dimensional descriptors have been introduced for schizophrenia in ICD-11?
Positive symptoms Negative symptoms Depressive mood symptoms Manic mood symptoms Psychomotor symptoms Cognitive symptoms
Cluster A personality disorders
Mad
Schizotypal, paranoid, schizoid
Cluster B personality disorders
Bad
Antisocial, histrionic, narcissistic, borderline
Cluster C personality disorders
Sad
Avoidant, Dependent, Obsessive-Compulsive
Time frame in ICD-11 for diagnosing personality disorders
Over 2 years
What is La Belle Indifference?
Surprising lack of concern for or denial of apparently severe functional disability
What is the most vocationally impairing personality disorder?
Borderline
What is bipolar III?
Hypomania or mania precipitated by taking antidepressant drugs
What is the best test to differentiate delirium from dementia?
With delirium, attention and level of consciousness are reduced and fluctuating - with dementia these domains tend to remain intact until advanced stages
Most children with selective mutism also meet diagnostic criteria for which disorder?
Social anxiety disorder
How much does smoking cannabis as an adolescent increase your risk of schizophrenia by?
2-4x
Features of dissociative amnesia with dissociative fugue
Loss of personal identity and sudden travel away from home, work or significant others for an extended period of time
A new identity may be assumed
When do symptoms of adjustment disorder resolve?
6 months of termination of the stressor
In PTSD, what is associated with a poor prognosis?
Emotional numbing
The global assessment of functioning forms which axis in the DSM-V?
Five
What % of non-schizophrenic patients exhibit first rank symptoms of schizophrenia?
10-20%
What % of patients with schizophrenia present with at least 1 first rank symptom?
58%
Minimum symptom duration in ICD-11 to make diagnosis of schizophrenia
1 month
ASD typically becomes evident at what age?
Less than 2 years old
What is the time frame for acute and transient psychotic disorder?
Acute onset of a clear psychotic state from a non-psychotic state within a period of 2 weeks
How long does acute and transient psychotic disorder last?
3 months
What has happened to subtypes of schizophrenia in ICD-11?
They have been eliminated due to lack of predictive validity or utility in treatment
How does acute stress disorder differ from PTSD?
Acute stress disorder is similar to PTSD in that symptoms are similar but acute stress disorder generally resolves after 4 weeks
What treatment may be trialled in cyclothymia?
Mood stabiliser
Is narcissistic personality disorder included in ICD?
No only in DSM-V
Where in the world is this diagnosis mainly made?
North America
Who is often referred to as the founding father of neuropsychiatry?
Wilheim Griesinger
Poor prognostic factors in schizophrenia
Male Insidious onset Young onset Enlarged ventricles Negative symptoms (not mood symptoms, these are a positive factor)
What are some organic causes of catatonia?
- Post-encephalitis states
- Parkinsonism
- Seizures
- Bilateral globus pallidus disease
- Lesions of the thalamus or parietal lobe
- Frontal lobe disease
- General paresis
- CO poisoning
What adverse drug effect can catatonia occur as a result of?
Neuroleptic medication or phencyclidine
Who coined the term schizophrenia?
Bleuler
Who was associated with hierarchical organisation?
Jaspers
5As in alzheimer’s dementia
Amnesia - impaired ability to learn new information
Aphasia - problems with langue
Agnosia - failure of recognition
Apraxia - inability to carry out purposeful movements
Associated disturbance - behavioural changes, delusions, hallucinations
When do emotional and personailty changes occur in vascular dementia?
Early followed by cognitive deficits that are often fluctuating in severity
When would you give diagnosis of Parkinson’s disease dementia?
If Parkinsonian symptoms have existed for more than 12 months before dementia develops
WHat diagnosis would you give if motor symptoms and cognitive symptoms develop within 12 months?
Lewy body dementia
What % of people with schizophrenia never exhibit a first rank symptom?
20%
Features of schizotypal disorder
Eccentric manners, social withdrawal, magical thinking, suspiciousness, suspiciousness and obsessive ruminations without resistance
How long must symptoms be present for in schizotypal disorder to diagnose?
2 years without a diagnosis of schizophrenia
In which group of people is schizotypal disorder more common in?
First degree relatives of schizophrenics
What happens to the risk of schizophrenia in family of people with schizotypal disorder?
Their risk is increased for developing schizophrenia
Where is induced delusional disorder classified in ICD-10?
F24
Which group is schizoaffective disorder classified with in ICD10?
F20 - psychoses
What is bouffee delirante?
Psychosis of sudden onset
Clouded consciousness with absence of physical signs
Rapid return to premorbid level of functioning
What did Langfeldt describe?
Process schizophrenia - 2 groups of psychoses 1- a group with poor prognosis labelled genuine and group with good prognosis labelled schizophreniform
What did Leonhard describe?
Cycloid psychoses
According to ICD-10 when can diagnosis of recurrent major depressive disorder be given?
If there has been at least one previous major depressive episode separated by the current episode by at least 2 months
What does ICD-10 need to satisfy before diagnosis of bipolar can be given?
Needs to have been at least 2 episodes with complete recovery in between the episodes
How long must the mania be present for?
7 days (less if hospitalised)
How many days must hypomania be present for?
4 days
What is rapid cycling?
at least 4 episodes of bipolar disorder occur within a period of 1 year
What % of rapid cyclers are women?
70-80%
What are some of the factors associated with rapid cycling?
- Use of TCA
- Low thyroxine
- Female
- Bipolar II
- Presence of neurological disease
What is secondary mania?
Can occur as a result of misuse of alcohol or illicit drugs and can also occur with some prescribed drugs such as levodopa and corticosteroids
What is dysthymia?
Chronic, mildly depressed mood and diminished enjoyment not severe enough to be considered a depressive illness
What is cyclothymia?
Oscillating high and low moods without ever having a significant manic or depressive episode
When can you diagnose SAD?
3 or more affective episodes must occur with onset in the same 90 day period of the year for 3 or more consecutive years
Remissions should occur within a defined 90 day period of the year
When would a panic disorder be graded as severe?
More than 4 attacks per week in a 4 week period
How long does a typical grief reaction last?
12 months with average duration of 6 months
4 phases of grief?
Phase I - shock and protest
Phase II - preoccupation
Phase III - disorganisation
Phase IV - resolution
Mild LD IQ
50-69
Moderate LD IQ
35-49
Severe LD IQ
20-34
Profound LD IQ
<20
What is Heller’s syndrome?
Childhood disintegrative disorder whic is said to resemble dementia
What is Landau-Kleffner syndrome also called?
Acquired aphasia with epilepsy
What is Landau-Kleffner syndrome?
Despite previous normal progress in language development, loses both receptive and expressive language skills but retains intelligence
Temporal lobe epilepsy on EEG
