Disorders Flashcards
DEPRESSIVE DISORDERS
Major Depressive Disorder
5 “SIG E CAPSS” symptoms for at least 2 weeks [Sadness, Interest loss, Guilt or worthlessness, Energy loss, Concentration loss, Appetite change, Psychomotor agitation or retardation, Sleep change, Suicidal thoughts]
Persistent Depressive Disorder (Dysthymia)
- Sad most days for 2 years
– 2 or more of: sleep change, hopelessness, appetite change, low self-esteem, concentration loss
– Never 2 months symptom free in first 2 years – Significant distress or impairment
Disruptive Mood Dysregulation Disorder
– Severe recurrent temper outbursts (verbal or physical)
– Out of proportion to context
– 3 or more per week; persists more than a year; began as child (6-18)
– Persistent irritability
– (not better explained by mania, depression, autism, substance abuse, etc)
Premenstrual Dysphoric Disorder
– Symptoms present one week prior to menses – At least 1 of the 4 following: mood swings, irritability/ anger, sadness, anxiety/ tension
– At least 5 total: mood swings, irritability/ anger, sadness, anxiety/ tension, loss of interest, poor concentration, fatigue, appetite change, sleep change, overwhelmed, physical symptoms (breast tenderness, bloating, pain, weight gain)
– Significant distress or impairment
BIPOLAR DISORDERS
Bipolar I Disorder
– Euphoric or irritable mood and increased energy or activity for 1 week
– 3 out of 7: grandiose, decreased sleep, talkative, racing thoughts, distractibility, increased goal-directed activity, impulsive)
– Social or work impairment
Bipolar II Disorder
– At least 1 Hypomanic episode and at least 1 Major Depressive episode
– No full Manic episodes
Hypomanic Episode
– Same as Bipolar I Manic episode except: at least 4 days duration (instead of 7)
– And NO marked impairment in social or occupational functioning
Cyclothymic Disorder
– Numerous hypomania and depression symptoms for most of the time for 2 years – Never reaches full diagnosis for either hypomanic, manic or depressive episodes – Not without symptoms for 2 months in 1st 2 years. – Clinically significant distress or impairment
May Add Specifiers:
with Anxious Distress with Mixed Features (mania and depression) with Rapid Cycling (for Bipolar I and II: > 4 episodes per year) with Melancholic Features (loss of pleasure, lack of reactivity, despair, worse in a.m., early morning awakening) with Atypical Features (weight gain, increased sleep, leaden paralysis, interpersonal rejection sensitivity, mood reactivity) with Psychotic Features, with Catatonia, with Peripartum Onset, with Seasonal Pattern
PSYCHOTIC DISORDERS
Schizophrenia
– Must have 1 positive symptom (hallucinations, delusions or disorganized speech) for 1 month – 2 of the following: hallucinations, delusions, disorganized speech, disorganized behavior, or negative symptoms (low emotion, low motivation)
– Prior or residual poor functioning for at least 6 months
– Social or work impairment
Schizophreniform Disorder
– Schizophrenic symptoms between 1-6 months duration
Schizoaffective Disorder, Bipolar type
– Schizophrenic symptoms and Bipolar I symptoms present most of the time.
– At least 2 weeks of delusions or hallucinations without Bipolar symptoms – Must have Bipolar symptoms for the majority of time.
Schizoaffective Disorder, Depressive type
– Schizophrenic symptoms and Depression symptoms present most of the time.
– At least 2 weeks of delusions or hallucinations without Depression symptoms – Must have Depression symptoms for the majority of time.
Delusional Disorder
– Moderate delusions at least 1 month, not Schizophrenic level – Otherwise good functioning; no bizarre behavior • Erotomanic type • Grandiose type • Jealous type • Persecutory type • Somatic type • Mixed type • Unspecified type
Brief Psychotic Disorder
– Schizophrenic symptoms for less than 1 month
– Full return to premorbid level.
• with marked stressors
• without marked stressors • with postpartum onset
• with Catatonia
ANXIETY DISORDERS
Panic Disorder
– Recurrent, abrupt, unexpected intense fear or discomfort
– Persistent worry of additional attacks for 1 month
– 4 out of 13 symptoms: (palpitations, sweating, trembling, shortness of breath, choking, chest pain, nausea, dizziness, derealization, fear of “going crazy”, fear of dying, numbness/ tingling, hot/ cold flashes)
– “Panic Attack” can also be a specifier for other diagnoses (i.e. “PTSD with Panic Attacks”)
- When accompanied by agoraphobia, this diagnosis is manifested by a fear of having panic attacks when leaving home, particularly when having to be in crowded places.
Agoraphobia
– Intense fear of 2 or more of: public transportation, open spaces (markets, bridges), enclosed spaced (theaters, shops), crowds, being away from home.
– Avoids these areas
– Greater than 6 months; interferes with
Generalized Anxiety Disorder
– Excessive worry most days for 6 months
– 3 out of 6: (restless, fatigue, decreased concentration, irritability, tense, insomnia)
– Interferes with work / social functioning
Specific Phobia
– Intense unreasonable fear
– Interferes with work / social functioning
Social Anxiety Disorder
– Formerly “Social Phobia”
– Persistent fear of social interaction or performance
– Interferes with work / social functioning
Separation Anxiety Disorder
– Excessive anxiety over separation from home or parents
Selective Mutism
– Mute in some settings but not others
OBSESSIVE-COMPULSIVE DISORDERS
Obsessive-Compulsive Disorder
– Obsessions: persistent intrusive, inappropriate non-psychotic thoughts
– Compulsions: repetitive behaviors compelled to reduce distress
– Patient sees as excessive / unreasonable
– Marked distress / interference
Body Dysmorphic Disorder
– Preoccupation with imagined defect in physical appearance
– Repetitive checking, grooming, picking, comparing, or reassurance seeking
– Work / social impairment
Trichotillomania
– Recurrent hair pulling and hair loss
– Failed attempts to stop hair pulling
– Marked distress or impairment
Hoarding Disorder
– Can’t discard possessions regardless of value
– Possessions accumulate, cluttering living space
– Marked distress or impairment
Excoriation (Skin-Picking) Disorder
– Persistent skin picking causing lesions or infections
– Failed attempts to stop skin picking
– Marked distress or impairment
SUBSTANCE ABUSE DISORDERS
Alcohol Use Disorder
Alcohol Use Disorder MILD = 2-3 symptoms MOD = 4-5 symptoms SEV = 6 or more symptoms
Symptom List:
– Uses more than intended
– Failed attempts to cut back
– Excessive time spent in obtaining, using, or recovering from substance
– Cravings for substance
– Substance use leads to problems at work, school or home
– Important work, social or recreational activities are given up due to substance use
– Uses in dangerous situations
– Persistent use despite awareness of problem – Tolerance (needs more substance for same effect)
– Withdrawals school or home
Gambling Disorder
– Continued gambling despite distress or impairment
– 4 of the following: increasing amounts of money gambled, irritable when cuts back on gambling, failed attempts to cut back, preoccupied with gambling, gambles to feel better, “chases their losses” (gambles later to make their money back), lies about gambling, relationship / work / or school problems, others give them money to help desperate need caused by losses.
NEURODEVELOPMENTAL DISORDERS
Attention-Deficit / Hyperactivity Disorder (ADHD)
ADHD, Combined
ADHD, Inattentive
ADHD, Hyperactive / Impulsive
– Persistent inattention or hyperactivity interfering with functioning for 6 months, began before age of 12
– Inattention- 6 or more of the following: inattention to details, difficulty sustaining attention, doesn’t listen well, poor follow through on tasks, poor organization, avoids homework or large projects, often loses things, distractible, forgetful
– Hyperactivity - 6 or more of the following: fidgets or squirms, leaves seat often, runs around inappropriately, can’t play quietly, driven, always moving, overly talkative, blurts out answers, difficulty waiting or taking turns, interrupts frequently
Autism Spectrum Disorder:
Problems with social communication and social interaction Repetitive behaviors; 2 of the following:
– Repetitive actions or speech
– Insistence on sameness
– Restricted fixated interests
– Increased or decreased sensitivity to sensory stimulation 3 Levels:
Level 1 - requiring support
Level 2 - requiring substantial support
Level 3 - requiring very substantial support
Communication Disorders
Language Disorder - difficulty using language
Speech Sound Disorder - difficulty speaking Childhood Onset Fluency Disorder - stuttering issues
Social (Pragmatic) Communication Disorder - speaking difficulties in social context
Specific Learning Disorders
Learning Disorder in Reading
Learning Disorder in Writing
Learning Disorder in Mathematics
Intellectual Disability
– Decreased intellectual functioning
– Decreased developmental and social functioning
– Begins in childhood
Motor Disorders
Developmental Coordination Disorder
– Coordination impairment, clumsy, slow, inaccurate
– Marked distress / interference
Stereotypic movement Disorder
– Repetitive purposeless movement (head banging, rocking, biting, picking, hitting, etc.)
– Interferes with functioning or self-injurious
Tourette’s Disorder – Multiple motor tics + 1 vocal tic – Persistent for 1 year – Marked distress or impairment – Onset before 18 years old
Persistent Motor or Vocal Tic Disorder – Motor only or vocal only tics – Persistent for 1 year – Marked distress or impairment – Onset before 18 years old
Provisional Tic Disorder
– Tics, 4 weeks to 1 year
– Marked distress or impairment
– Onset before 18 years old
TRAUMA & STRESS DISORDERS
Post Traumatic Stress Disorder (PTSD)
– Severe Trauma
- experienced trauma, witnessed trauma, or learned about violent trauma to loved one
– Intrusive memories, nightmares, flashbacks
– Avoidance
- (avoid memories, thoughts, feelings, reminders)
– Negative thoughts & feelings: amnesia to the event, exaggerated negative beliefs, self (or other) blame, persistent fear / anger / horror / shame, low interest in activities, feeling detached, feeling numb
– Hyperarousal (insomnia, poor concentration, emotional lability, hypervigilance, exaggerated startle, reckless or self destructive behavior)
– Symptoms present for 1 month and work / social impairment
Acute Stress Disorder
– PTSD, but less than one month since trauma.
Adjustment Disorders
– Stressor leading to excessive distress or work / social impairment
– Symptoms do not last greater than 6 months after resolution of stress
– Specify stress as acute or chronic (greater than 6 months)
Adjustment Disorders with depressed mood Adjustment Disorders with anxiety
Adjustment Disorders with mixed anxiety and depressed mood
Adjustment Disorders with disturbance of conduct
Adjustment Disorders with mixed disturbance of emotions and conduct
Reactive Attachment Disorder
– Poor care-giving at early age (neglected, deprived, too numerous care-givers, or orphanage)
– Emotionally withdrawn behavior towards care-givers (doesn’t seek or respond to comfort)
– Socially and emotionally unresponsive, inappropriately irritable / sad / or fearful
Disinhibited Social Engagement Disorder
– Poor care-giving at early age (neglected, deprived, too numerous care-givers, or orphanage)
– Child inappropriately approaches or is overly familiar with unknown adult.
DISSOCIATIVE DISORDERS
Dissociative Identity Disorder (Multiple Personality)
– 2 or more distinct personalities recurrently take control
– Compartmentalization of information.
– Marked distress or impairment
Dissociative Amnesia
Dissociative Fugue (travel)
– Trauma leading to inability to remember personal information
– Marked distress or impairment
– Specify if it includes
Depersonalization / Derealization Disorder
– Recurrent subjective detachment (as if an “outside observer” or in a dream)
– Intact reality testing (not psychotic)
– Marked distress or impairment
EATING DISORDERS
Anorexia Nervosa
– Reducing food intake and refusal to maintain minimally healthy weight
– Strong fear of gaining weight or being “fat”
– Disturbance in body image (usually perceiving self as much heavier)
Anorexia Nervosa
Restricting Type
- no binge eating or purging (purely uses fasting and exercising)
Anorexia Nervosa
Binge / Purge type
- some binges or purging (vomiting, laxatives, etc)
Bulimia Nervosa
– Binge eating with minimal sense of control
– Purging or over exercising
Binge Eating Disorder
– Binge eating with minimal sense of control – No purging or over exercising to try to compensate
FEEDING DISORDERS
Avoidant / Restrictive Food Intake Disorder
– Extreme food preferences leading to substantial psychosocial or nutritional problems
Pica
– Eating non-food items for 1 month or more
– Inappropriate for age
Rumination Disorder
– Persistent regurgitation of food (may be re-chewed or spit out)
ELIMINATION DISORDERS
Enuresis
- Loss of control of urine (day or night)
Encopresis
- Loss of control of stool (with or without constipation)
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NEUROCOGNITIVE DISORDERS
Delirium
– Quick onset disturbance in attention, orientation, and cognition (memory, language & perception)
– Evidence of a medical cause (substance intoxication or withdrawal, toxin, medication reaction, or other physical illness)
– May also be more specific in coding to specific cause
Major Neurocognitive Disorder
– Significant cognitive decline in one or more areas (learning and memory, language, executive functioning, complex attention, perceptual-motor, or social cognition)
– Interferes to the point of needing assistance
– Specify (and code) subtypes when possible: Alzheimer’s, Vascular, Substance Induced, Traumatic Brain Injury,HIV Infection, Parkinson’s Disease, Lewy Bodies, Prion Disease, and Huntington’s Disease.
Mild Neurocognitive Disorders
– Modest cognitive decline in one or more areas (learning and memory, language, executive functioning, complex attention, perceptual-motor, or social cognition)
– Does not interfere with functioning or independence
– Specify (and code) subtypes when possible: Alzheimer’s, Vascular, Substance Induced, Traumatic Brain Injury, HIV Infection, Parkinson’s Disease, Lewy Bodies, Prion Disease, and Huntington’s Disease.
DISRUPTIVE IMPULSE-CONTROL DISORDERS
Oppositional Defiant Disorder
– Angry, argumentative, vindictive or defiant behavior for 6 months
– Marked distress or impairment
Conduct Disorder
– Persistently violates other’s rights or societal rules (hurting people or animals, property destruction, lying, theft, illegal activity)
– May code more specifically for Childhood or Adolescent onset
Intermittent Explosive Disorder
– Recurrent verbal or physical outbursts out of character for the person and disproportionate to the stress.
Kleptomania
– Recurrent impulsive stealing of un-needed items
– Build up of tension prior to the act and relief following it
Pyromania
– Recurrent fire setting and attraction to fire
– Build up of tension prior to the act and relief following it
SOMATIC DISORDERS
Somatic Symptom Disorder
– Disproportionately excessive response (thoughts, feelings or behaviors) to a distressing physical symptom
– Usually persists at least 6 months
- Excessive time devoted to symptoms (2a. doctor shopping), (scenario-frequent trips to the hospital)
Somatization symptom disorder clients usually have long and complicated medical histories and symptoms that are often vague, imprecise, and inconsistent and may include gastrointestinal problems, shortness of breath and various complaints of pain. These clients typically suffer psychological problems including anxiety; depression and personality disorders related to past emotional traumas and childhood sexual abuse but her symptoms of somatization have primarily superseded emotional manifestations of past traumas.
Illness Anxiety Disorder
– Excessive worry over having a serious illness, despite minimal medical evidence
– High anxiety around health overall
– Excessive health-related activities (symptom checking, tests, doctor visits, etc), or avoids medical care
Factitious Disorder
– Intentional faking to achieve a sick role
– No clear economic or legal motivators
Conversion Disorder
– Abnormal voluntary motor or sensory functioning
– Symptoms are incompatible with recognized neurologic or medical conditions – Marked distress or impairment
SLEEP-WAKE DISORDERS
Insomnia Disorder
– Difficulty initiating or maintaining sleep, 3 nights a week for at least 3 months
– Marked distress or impairment
Hypersomnolence Disorder
– Excessive sleepiness despite sleeping at least 7 hours per night
– One of the following: non-restorative sleep lasting 9 hours or more, recurrent lapsing into sleep through the day, or difficulty awakening – Occurs 3 times a week for at least 3 months – Marked distress or impairment
– Not better explained by: sleep apnea, narcolepsy, parasomnias etc
Narcolepsy
– Irresistible sleep attacks, at least 3 times a week for 3 months
– At least one of the following:
• Cataplexy: sudden loss of muscle tone after laughing
• Hypocretin deficiency on spinal tap
• Sleep study showing reduced REM sleep latency
PARASOMNIAS
Nightmare Disorder
– Repeated terrifying awakenings with vivid recall and alertness
– Marked distress or impairment
Rapid Eye Movement Sleep Behavior Disorder
– Repeated sleep arousals with speaking or complex movements (walking, etc)
– Quickly awakens, fairly alert and not disoriented
PERSONALITY DISORDERS
Cluster A: “Odd” Group
Paranoid Personality Disorder
– Distrust since early adulthood
– 4 out of 7 symptoms: suspects deception, doubts loyalty of friends, reluctant to confide, reads hidden meanings, bears grudges, perceives personal attacks on character, unwarranted suspicions of partner
Schizoid Personality Disorder
– Detached social relationships
– 4 out of 7 symptoms: doesn’t desire close relationships, solitary activities, no interest in a sex partner, few close friends, little pleasure in activities, indifferent to praise or criticism, emotional coldness or flat affect
Schizotypal Personality Disorder
– Eccentricities and few close relationships
– 5 out of 9 symptoms: odd behavior, magical thinking (ESP, superstitions), ideas of reference, illusions, odd thinking and speech, paranoia, inappropriate or constricted affect, few close friends, excessive social anxiety
PERSONALITY DISORDERS
Cluster B “Dramatic Group”
Borderline Personality Disorder
– Unstable relationships, unstable self image, unstable affects and impulsivity
– 5 out of 9 symptoms: frantically avoids abandonment, idealizes then devalues relationships, identity disturbance, dangerous impulsivity, recurrent suicidal thoughts or self-mutilation, affective instability, chronic empty feeling, anger control problems, transient dissociation or paranoia
Histrionic Personality Disorder
– Excessive emotions and attention seeking
– 5 out of 8 symptoms: center of attention, sexually seductive, shallow and unstable emotions, dresses to draw attention, emotional speech without substance, theatrical, suggestible and easily influenced, feels relationships are more intimate then they really are
Narcissistic Personality Disorder
– Grandiosity, need for admiration and lack of empathy since early adulthood
– 5 out of 9 symptoms: grandiosity, fantasies of unlimited power and success, sees self as “special” and only associates with others of high status, needs admiration, sense of entitlement, interpersonally exploitative, lacks empathy, envious of others, arrogant
Antisocial Personality Disorder
– Evidence of conduct disorder before age 15
– Disregards other’s rights since age 15
– 3 out of 7 symptoms: repeated unlawful acts, deceitfulness, impulsivity, repeated physical fights, disregard for safety, consistent irresponsibility, lack of remorse
PERSONALITY DISORDERS
Cluster C “Withdrawn Group”
Avoidant Personality Disorder
– Inhibited, inadequate and hypersensitive
– 4 out of 7 symptoms: avoids occupations dealing with people, avoids people unless they’ll be liked, restrained in close relationships, fears social rejection, social inhibition, feels socially inept, few new activities or risks
Dependent Personality Disorder
– Excessive need to be taken care of
– Submissive and clingy behavior
– Fears of separation
– 5 out of 8 symptoms: difficulty making decisions, doesn’t take responsibility, avoids conflict, poor initiation of projects, craves nurturance, helpless when alone, urgently seeks out relationships when one ends, fears being left to
Obsessive-Compulsive Personality Disorder
– Orderly, perfectionistic and in control
– 4 out of 8 symptoms: overly preoccupied by details; interfering perfectionism, workaholic, overly strict values, pack rat, micromanages others, miserly, rigid and stubborn
