Definitions Flashcards
Acute stress reaction definition
- Transient, develops in an individual w/o any other apparent mental disorder in response to exceptional mental/physical stress
- Subsides within hrs/days
- Features:
- initial DAZE
- constricted field of consciousness
- narrowed attention
- inability to comprehend stimuli
-disorientation - severe withdrawal may manifest as stupor
- can become agitated and over reactive
- may have autonomic signs of panic
- complete or partial amnesia
8 DSM-V: Sx at least 3d, if >1m consider PTSD
Adjustment disorder definition
Subjective distress and emotional disturbance
Interfering w/function
Arising in period of adaptation to life
Manifestations:
- Depressed mood
- anxiety
- worry
- unable to cope
- disability in performing daily routines
Conduct disorder association (adolescents)
Generalised anxiety disorder definition
Generalised and persistent but not restricted to one environment
>6m
Sx criteria (at least 4 including autonomic)
Common fears: self/relative illness
Doesnt meet panic/phobic anxiety, OCD or hypochondriacal dx
Not caused by organic health problem or substance
Key featues:
- apprehension
- motor tension
- autonomic overactivity
Sx criteria for GAD
at least 4 in total including 1 of:
Auto: palpitations, sweating, trembing, dry mouth
Others:
- Chest/abdo: dib, choking, pain, nausea
- Brain: dizzy, depersonalisation, fears
- General: hot/cold flushes, parasthesia
- Tension: muscle tension/ache, restless, mental tension
Other: exaggerated startle, difficulty concentrating, irritable, insomnia
OCD definition
Recurrent obsessional thoughts can be:
Ideas, Imaged, Impulses
Obsession thoughts distressing and patient tries to resist
Recognised as own thoughts despite involuntary
Compulsive rituals, not inherently enjoyable or useful
Behaviour is recognised as pointless and attempts made to resist
Anxiety almost always present and worsens if acts resisted
Body dysmorphic disorder definition
Appearance preoccupation (non-existent or slight flaw)
Repetitive behaviours (can be mental eg. comparison)
Clinical: causes distress/impairment
Specifiers:
- muscle dysmorphia (too much or too little)
- ?insight
Panic disorder definition
Recurrent attacks not restricted to any particular situation Are thus unpredictable Sx: - sudden onset palpitation - CP - choking sensation - dizziness - depersonalistion/derealisation - fear of death/going mad NB panic dx NOT main dx in pt w/depressive disorder at start of attacks (panic secondary)
Social phobia definition
Fear of scrutiny by others leading to avoidance of social situations
?a/w low esteem
Sx: blushing, hand tremor. nausea, urinary urgency in social situations
Can progress to panic attacks
Specific phobia definition
Restricted to highly specific situations
Can evoke panic attack
Agoraphobia definition
Cluster a/w fear of leaving home, entering crowds, travelling alone
Can have panic attacks
Avoidance prominent, so potentially can have relatively little anxiety
PTSD definition
Delayed or protracted response to exceptionally threatening/catastrophic event
Duration: >1m
RF: Hx neurotic illness or compulsive personality
Key Features
1. Re-experiencing
2. Avoidance
3. Autonomic hyperarousal
others: emotional blunting, detachment, anhedonia
?suicidal ideation
Reaction may take weeks/months
Recovery expected in most cases
Small percentage will result in enduring personality change
ADHD subtypes
- Predominantly inattentive
easily distracted, forgetful, poor concentration and completion of tasks - Predominantly hyperactive-impulsive: fidget, hyperactive, immature, ?destructive
- ADHD : combination
Sx must have appeared by age 6-12y, occur in >1 environment, cause issues, last >6m
ADHD how is it subdivided?
Subdivision based on presence of 6+/9 Sx of inattention, hyperactivity or both lasting at least 6m
ADHD Sx clusters Inattention
Difficulty paying close attention to details
Trouble holding attention
Trouble organising tasks
Loses necessary items
Appears forgetful
Short attention span and easily distracted
Difficulty with structured school work or tasks that are complex/time consuming
ADHD Sx clusters Hyperactivity-Impulsivity
Unable to sit still Fidget Leaves seat inappropriately Takes risk w/little thought 'on the go' talking more than others Answers quickly Difficulty waiting turn Interrupts/Intrudes
Autistic spectrum disorder
Pervasive developmental dx develops <3y 3 areas: reciprocal social interaction communication restricted stereotyped repetitive behaviour
Aspergers syndrome definition
Uncertain nosological validity
Abnormalities of social interaction that typify autism
Restricted, stereotyped, repetitive repertoire of interests
NO general delay in language or cognition
Marked clumsiness
Strong tendency to persist into adult life
Psychotic episodes can occur in adult life
Baby blues definition
Tearfulness, irritability, low mood occurring within a few days of childbirth
Lasts days
Labile mood sometimes
Post natal depression
Depressive disorder w/peripartum onset (during pregnancy to 1y post)
Criteria same as non child birth depression
Most recover within a month
Peurperal psychosis
not defined by DSM-V or ICD-10
Onset of psychostic Sx after childbirth (usually around 2w)
3 Patterns:
1. Delirium
2. Affective (psychotic depression/mania)
3. Schizophreniform
Sx will deteriorate and fluctuate rapidly
Recovery 6-12w
Bipolar affective Dx
2+ episodes in which mood and activity significantly disturbed
Some occasions are (hypo)manic, some depressive
Types:
I: 1+ manic, depressive episodes common but NOT necessary
II: At least 1 hypomanic, at least 1 major depressive
Cyclothymia: Hx of hypomania w/periods of depression that are not major
Hypomanic episode definition
Persistent mild elevation of mood, increased energy and activity, usually marked feelings of well being Increased sociability Increased sexual energy Decreased need for sleep NOT severe disruption of work Can manifest as irritable NO hallucinations/delusions
Mania w/o psychotic Sx definition
Mood elevated out of keeping w/circumstances (from carefree to uncontrollable excitement)
Increased energy -> overactivity, insomnia
Distractable
Inflated self esteem
Grandiose ideas
Loss of inhibition
Conduct disorder definition
Repetitive persistent dissocial/aggressive/defiant conduct
Violates age appropriate expectations
>6m
Subtypes:
- family context only
- unsocialised vs socialised (well integrated into peer group)
Oppositional-defiant disorder:
Related condition in younger children
Specific of ODD is defiance vs others (parent), NOT delinquency/aggressive
Delusional Disorder
1+ delusion that are usually persistent and sometimes lifelong
NOT any auditory hall., delusions of control, blunting or any other schizo sx
NB. occasional or transient auditory hallucination does not rule out DD as long as it is a small part of picture
Depressive disorder ICD-10
Symptoms
- core: low mood, anhedonia, anergia
- bio: sleep/appetite disturbance, low libido, agitation
- cognitive: impaired memory/concentration, guilt and worthlessness, low self esteem, bleak future
MILD: 2 or 3 core, 2+ other, pt distressed but able to continue most activities
MOD: 2/3 core, 3+ other, pt. reports considerable difficulty
Sev: All 3 core, 4+ other, major impact on life, distress/agitation possible
DURATION: >2 weeks to be major depressive episode
Depressive disorder definition DSM-IV
1.Depressed most of the day, nearly everyday
2.Diminished interest/pleasure in activities
3.Significant wt change or appetite change daily
4.Sleep disturbance nearly daily
5. Psychomotor agitation/retardation
6. Fatigue or low energy
7. Feeling worthless/guilty nearly daily
8. Diminished concentration ability
9. Recurrent thoughts of death
SUBTHRESHOLD: <5 sx
MILD: >5 Sx, minor functional impairment
Moderate: symptoms and impairment mild-severe
SEVERE: Most Sx, marked impairment, can present w/psychosis too
Dissociative disorders definition
Partial/complete loss of integration between:
- memories of past, awareness of identity, control of body
Tend to remit after weeks/months (particularly if a/w traumatic event)
Chronic dx (paralyses) possible if a/w insoluble problems
NO underlying dx
NB. ONLY dx of physical function under voluntary control/loss of sensation are dissociative (pain and other ANS functions are somatisation dx)
Dissociative amnesia
Dissociative amnesia (loss of memory) often recent important events
Dissociative stupor (pro
Dissociative fugue
(same features as dissociative amnesia) plus purposeful travel beyond everyday range
behaviour may appear normal to outside observer who is unaware of amnesia
Dissociative stupor
Diminution or absence of vountary movement and normal responsiveness to external stimuli
No physical cause
Evidence of psychgenic causation from recent trauma/stress
Trance and possession disorders
Temporary loss of sense of personal identity
Full awareness of surroundings
ONLY trances that are involuntary and unwanted, occurring outside religion or cultural situations
