CLASSIFICATION Flashcards

Question

**Subtypes bipolar** Rapid cycling Postpartum onset Seasonal pattern

Answer 1

When at least four episodes of bipolar disorder occur within a period of one year - 70-80% of rapid cyclers are women Postpartum onset refers to the onset of mania, hypomania or depression with 4 weeks of childbirth. Seasonal pattern refers to recurrences over several years with most episodes typically start (and end) at the same time each year

Answer 2

* Chronic, mildly depressed mood lasting for at least 2 years with symptoms like low energy, poor concentration, and hopelessness. - Double Depression* occurs when major depressive episodes occur on top of dysthymia, often with worse prognosis and treatment response. * Cyclothymia- Mild mood swings between depression and elation, not severe or prolonged enough to meet criteria for bipolar disorder or recurrent depressive disorder. The individual perceives these fluctuations as unrelated to life events. * SAD, ICD-10 specifies that 3 or more affective episodes must occur, with onset within 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. Seasonal episodes substantially outnumber any non-seasonal episodes that may occur. Tx 2 hrs daily 10,000 lux

Answer 3

ICD-10 requires duration of at least 6 months and at least 4 of the symptoms should have been present on most days during 6 months Panic- syx must be present for one month duration. severe = 4 attacks per week in 4 week period.

Answer 4

Most common and incapacitating phobic disorder, often starting in early adulthood, with fear of situations where escape is difficult (e.g., crowded places). Avoidance leads to symptom-free periods but can result in being housebound. It can be accompanied by panic attacks. ICD-10 views agoraphobia as the primary disorder, while DSM-IV places panic attacks first.

Answer 5

Social Phobia: Marked fear of social situations with scrutiny, often starting between 17-30 years. DSM emphasizes the fear of embarrassment or humiliation, distinguishing it from paranoia. The condition may be either discrete (e.g., fear of public speaking) or diffuse (e.g., fear of all social tasks). Diagnosis requires recognition of excessive fear. Specific Phobias: Typically begin in childhood (e.g., animal phobias at age 7). DSM-IV categorizes five types (e.g., animals, blood, situational). Blood-injection phobia differs with a fainting response rather than a sympathetic-driven reaction. DSM-V now requires a 6-month duration for all ages, and no subjective recognition of irrationality is needed for adults

Answer 6

Obsessional thoughts/images/ideas and compulsive behaviors, often linked to anxiety and depression. I CD-10 criteria: Must have: Obsessions/compulsions originating in the patient’s mind. Repetitive, unpleasant, and excessive/unreasonable. At least one is unsuccessfully resisted. Actions are not intrinsically pleasurable. Common symptoms: Checking, washing, contamination fears, doubting, counting, symmetry obsessions, aggressive thoughts. DSM-5 update: OCD and related disorders are now in a separate chapter, with new diagnoses: Hoarding Disorder and Excoriation (skin-picking) Disorder

Answer 7

reaction - within 1 hour, resolution 8 hours or 48 hours if prolonged event, dissociative symptoms, agitation. disorder- lasting at least 2 days, max 4 weeks. dissociation. adjustment-relation to adapting to new circumstances and occurs in someone who has been exposed to a psychosocial stressor. onset 1 month, ICD, 3 months dsm. last 6 months.

Answer 8

- Hyperarousal: Persistent anxiety, irritability, insomnia, poor concentration. - Hypervigilance & re-experiencing: Intrusive memories, flashbacks, recurrent distressing dreams, difficulty recalling the trauma. - Avoidance & emotional numbness: detachment, anhedonia, estrangement from others. Both ICD-10 and DSM-IV require 2+ persistent symptoms of heightened arousal post-trauma. Symptoms should emerge within 6 months, with chronic cases (>6 months) or delayed onset (probable PTSD).

Answer 9

Characterized by loss of integration among memories, identity, sensations, and movements, typically triggered by trauma. Symptoms start suddenly and end abruptly, but can be chronic (lasting >1 year). Amnesia: Partial, selective loss of recent memories, usually related to trauma; no anterograde deficits. Fugue: Amnesia with purposeful travel, often leading to the assumption of a new identity, with amnesia for past identity and the fugue episode

Answer 10

trance-Involuntary, narrow consciousness with repetitive movements; must disrupt life and occur outside cultural practices. possession trance- replced with another identity conversion-Motor or sensory dissociative symptoms without an organic cause, often with la belle indifference (not distressed despite serious syx) psuedoseziures- avoidance behvaiour resisting eyelid opening, emotional trigger, seizures occur only presence others

Answer 11

Al = characterized by the lack of a psychological appraisal on the patient’s part + a resistance to consider presenting problems as one of ‘mental’ origin 1. somatisation (a) at least 2 years of multiple and variable physical symptoms for which no adequate physical explanation has been found; (b) persistent refusal to accept the advice and reassurance of several doctors regarding the absence of a physical illness; (c) notable impairment of social and family functioning due to the symptoms and the illness behaviour. The term Briquet Syndrome or St. Louis Hysteria is sometimes applied to denote somatisation disorder

Answer 12

(1) persistent belief of harboring at least one serious physical illness even though repeated investigations and examinations have identified none or a persistent preoccupation with a presumed deformity or disfigurement (body dysmorphic type); (2) persistent refusal to accept the advice and reassurance of several doctors regarding the absence of a physical illness patient looks for diagnosis, not symptom relief;

Answer 13

‘subjective description of ugliness and physical defect which the patient feels is noticeable to others' Overvalued idea - trivial or non existent physical abnormalities

Answer 14

ICD- describes the presence of low body weight as being 15% or more below the expected norm and BMI as 17.5 or less + syx DSM - now removed amenorrhea as a requirement. endocrine-Amenorrhoea, reduced sexual interest, abnormal thyroid, raised GH/cortisol, and insulin secretion abnormalities due to HPA axis dysfunction. atypyical- often older age onset, numerous somatic complaints, recurrent depression

Answer 15

Includes preoccupation with eating, binge episodes, attempts to counteract food effects (vomiting, purging, starvation, appetite suppressants), and morbid fear of fatness. Atypical bulimia may have missing features. purging and non purging types. BED involves binge eating without extreme weight-control behaviours, often associated with obesity. men in 40s.

Answer 16

Periodic episodes of hyper somnolence and hyperphagia + mood changes. Often presents in adolescent males + precipitated by fever or resp infections. Narcolepsy -excessive daytime drowsiness accompanied by a sudden onset of REM sleep (sleep seizure or narco lepsy) and sudden loss of muscle tone, provoked by strong emotions (cataplexy).

Answer 17

Inability to move occuring between wakefulness and sleep usually auditory in nature but may be visual or tactile, occur in about 25% of patients.

Answer 18

A- paranoid (suspicious) schizoid (avoid others), schizotypal (tin hat, magical) B- Antisocial (lack remorse, disregard rules), (self harm, impulsive), Histrionic (dramatic, attention seek, sexually provocative) Narcissistic (grandiose, self centred) C- Avoidant- (socially withdrawn) Dependent- (passive, lacks confidence) Obsessive- Compulsive - (anakastic) (perfectionist, rigid attention to detail, workaholic)

Answer 19

kleptomania (steal things) - pyromania (set fire) -Trichotillomania (pull hair out) - Intermittent explosive disorder (violent outbursts) - Pathological gambling

Answer 20

3 = transsexualism, dual role transvestism, and gender identity disorders of childhood. Gender dysphoria refers to incongruence between one's gender identity and phenotypic appearance, with varying degrees of severity.

Answer 21

Transsexualism: Persistent discomfort with one's sex, strong cross-gender identification, desire for sex-change surgery, and significant distress or impairment. Has to be present for 2 years Dual Role Transvestism: \ Wearing the opposite sex’s clothing temporarily, without sexual motivation or desire for permanent gender change. Differentiates from fetishistic transvestism, which involves sexual arousal and is classified as a paraphilia.

Answer 22

r should last at least 6 months, with a focus on ruling out chromosomal and endocrine issues. Management involves supporting tolerance of uncertainty, with surgery not justified until adulthood. Gender identity is separate from sexual orientation; most children with gender dysphoria do not persist as adult transsexuals.

Answer 23

Klismaphilia - enemas to achieve sexual arousal Necrophilia - arousal from death Exhibitionism - exposing for arousal Fetishism- inanimate objects Paedophilia - under 13 Masochism- being humiliated for arousal Sadism- real, not simulated act of inflicting suffering tans- crossdressing in male to achieve arousal Voyerusm- peeping tom Frotteurism- rubbing against non-consenting individual

Answer 24

profound iq <20, nursing care constant severe- speech minimal, iq 20-34 moderate - moderate supervision- iq 35-49 mild - can be guided towards social conformity. iq 50-69

Answer 25

Presence of abnormal and/or impaired development evident before the age of 3 years, with abnormal functioning in all three areas of social interaction, communication, and restricted, repetitive behaviour. Unlike children with autism, children with Asperger’s syndrome have normal language functions before the age of 3

Answer 26

Retts-apparently normal or near-normal early development is followed by partial or complete loss of acquired hand skills and of speech, together with deceleration in head growth, usually with an onset between 7 and 24 months of age Hellers- dementia of childhood. normal development up til 2, then loss of skills. LK - child loses reception and expressive skills from 3-7 but retains IQ. epilepsy temporally.

Answer 27

hyperkinetic- must have some symptoms before 7 years old. present in 2 settings and interfere 6m+ (dsm 5 now before 12 yrs) conduct= aggression, theft, destruction pf property, truant Op-negative, hostile, disobedient and defiant behaviour, without serious violations of societal norms or the rights of others (less severe than conduct)

Answer 28

selective mutism - mute is specific situations, onset before 5 years, social anxiety disorder- less common under 10, fear being negatively valued separation anxiety disorder - recurrent nightmares of separation