DSM-5 Diagnoses Flashcards
How would you define Adjustment Disorder?
Adjustment Disorder is a behavioural or emotional reaction in response to an identifiable situation or event in a person’s life.
What are the essential features of Adjustment Disorder?
- The event or situation must have occurred within 3 months of the onset of the symptoms.
- The distress felt must be out of proportion to the event and/or there is significant impairment functionally.
- It is not normal bereavement.
- Symptoms do not persist for longer than 6 months after the end of the identified stressor or its consequences.
What are the subtypes of Adjustment Disorder?
- Depressed mood
- Anxious mood
- Mixed anxiety and depressed mood
- Disturbance of conduct
- Miced disturbance of emotions and conduct
How would you define Antisocial Personality Disorder?
A personality disorder characterised by persistent antisocial, irresponsible, or criminal behaviour, often impulsive or aggressive, with disregard for harm/distress caused to others and an inability to maintain long-term social/personal relationships.
What are the essential features of Antisocial Personality Disorder?
- Persistent disregard for, and violation of, the rights of others since the age of 15 years. This is met by engaging in any of the 7 behaviour patterns: criminal activity, lying or manipulation, impulsivity, fighting or assaults, disregard for safety of self or others, irresponsibility, and lack of remorse.
- Person is at least 18 years of age at the time of diagnosis.
- History prior to age 15 indicates a pattern of behaviour that would have supported a diagnosis of conduct disorder.
- Behaviour does not occur in the context of schizophrenia or bipolar disorder.
How would you define Attention-Deficit/Hyperactivity Disorder?
ADHD is a neurodevelopmental disorder charactereised by a pattern of inattention and/or hyperactivity-impulsivity behaviour that has persisted for at least 6 months and clearly intereferes with function or development in multiple domains (school, work, social).
What are the essential features of ADHD?
- Having six or more symptoms from the inattention and/or hyperactivity-impulsivity presentation (for under 17 years), or five or more (for those aged 17+).
- Inattention = making careless mistakes, difficulty sustaining attention, not listening, being easily sidetracked, difficulty organising tasks, avoidance of tasks requiring sustained mental effort, losing things, easily distracted, being forgetfull in daily activities.
- Hyperactivity-impulsivity = fidgeting, leaving their seat, restlessness, inappropriate running around, unable to play/do leisure activities quietly, difficulty sitting still for extended time, excessive talking, blurting out answers, difficulty turn taking, interrupting others. - Several symptoms must be present prior to the age of 12.
- Symptoms do not occur in the context of a psychotic disorder.
How is ADHD specified?
Specification of presentation = whether symptoms fall primarily into the inattention or hyperactivity-impulsivity categories, or are mixed.
Specification of severity = mild, moderate, or severe.
How would you define Autism Spectrum Disorders?
ASDs are neurodevelopmental disorders, characterised by difficulties in social interaction and communication, and by restricted or repetitive patterns or thought and behaviour.
What are the essential features of ASD?
- Social deficits in communication and interaction (e.g. lack of reciprocity, facial expressions and eye contact).
- Behavioural deficits (e.g. restricted or repetitive interests and abnormal sensory response).
- Evidence of the presence of these deficits in early development even if not recognised at the time
- Currently causing significant impairment in functioning.
- Not better explained by an intellectual disability or global developmental delay.
How would you define Bipolar I disorder?
Bipolar I disorder requires evidence of at least one manic episode during a person’s lifetime, which MAY be preceded or followed by a hypomanic or depressive episode.
What are the essential features of a manic episode?
- Emotional changes (elevated, expansive, or irritable mood) at levels that appear abnormal, and behavioural change (persistent and abnormal increases in energy or goal-directed behaviour).
- Emotional and behavioural changes must last at least 1 week and be present on most days, for most of the day.
- 3+ symptoms must be present during the mood disturbance and represent a change in usual behaviour (inflated self-esteem, less need for sleep, being more talkative, racing thoughts, being easily distracted, increases in goal-directed or purposeless activity, engaging in risky impulsive behaviour).
- The disturbance causes marked impairment in function or requires hospitalisation due to safety concerns or psychotic featues.
- Episodes cannot be attributed to drugs or medical conditions.
What are the essential features of Bipolar II disorder?
- Presence of both a current or past hypomanic episode and a current or past major depressive episode.
- The episode is clearly and uncharacteristic change in the person’s usual behaviour.
- The change in behaviour is observable by others.
- The episode is NOT severe enough to cause marked impairment or hospitalisation.
How is a hypomanic episode different from a manic episode?
Both manic and hypomanic episode involve:
- Emotional and behavioural changes (elated, expansive, or irritable mood; energy, or goal-directed behaviour)
- 3-4+ symptoms representing a change from normal behaviour (inflated self-esteem, less need for sleep, being more talkative, racing thoughts, being easily distracted, increased goal-directed or purposeless activity, engaging in risky/impulsive behaviours).
Hypomanic episode durations are 4 days only, where as a manic episode is 1 week.
What are the essential features for a Major Depressive Episode?
5+ of the following symptoms:
- Depressed mood most of the day, nearly everyday
- Diminished pleasure or interest in almost all activities for most of the day, nearly everyday
- Gaining or losing 5%+ of body weight in a month without dieting, or having a change in appetite most days
- Sleeping too much or too litter nearly everyday
- Being observably either physially agitated or slowed down
- Feeling tired or less energetic most days
- Feeling worthless or guilty nearly everyday
- Reduced concentration or indecisiveness
- Suicidal thoughts with or without a plan, or a suicide attempt
How would you define Borderline Personality Disorder?
BPD is a long-term pattern of instability across several domains:
- Relationships
- Self image
- Mood
- Behaviour - impulsivity
It starts by early adulthood and shows up in a variety of contexts.
What are the essential features of BPD?
5+ of the following:
- Frantic efforts to avoid real or imagined abandonment
- Intense and unstable relationships that tend to alternate between being seen as perfect or worthless
- Unstable sense of self
- Impulsive behaviour in at least two ares that cna be self-damaging
- Recurrent suicidal threats or actions or self-mutilating behaviour
- Unstable mood that is highly reactive to changes in circumstances
- Feelings of emptiness (chronic)
- Intense and difficult to control anger
- Stress-related paranoid ideas or dissociative symptoms
How would you define Conduct Disorder?
Conduct Disorder is a repeated pattern of persistent behaviour characterised by disregard for the rights of others or major violation of age-appropriate social rules and norms.
What are the essential features of Conduct Disorder?
3+ symptoms present for 12 months (with at least one occuring in past 6 months):
- Aggression to people or animals (threatens bullies, intimdates others, starts fights, used a weapon, physical cruelty, using confrontation of a victim to steal, forced another into sexual activity).
- Destruction of property (setting a fire to cause dmage, destorying others’ property).
- Deceitfulness or theft (breaking into a house/car/building, lying to obtain goods/favours or to avoid obligations, stealing without confrontation or breaking/entering).
- Serious violation of rules (staying out past curfew before 13 years of age, running away frm home at least twice and staying out overnight - or once if it’s more lengthy absence, skipping school prior to 13 years).
- Must cause impairment in functioning - school, social, occupational
- If person is 18y+ they do not meet the criteria for Antisocial Personality Disorder
How is Conduct Disorder specified?
- Age of onset = childhood, adolescence or unspecified
- With limited prosocial emotions = lack of guilt, empathy, concern for performance, or lack of expressed feeling
- Severity = mild, moderate or severe
How would you define Major Neurocognitive Disorder?
MND is decreased mental function due to a medical disease other than a psychiatric illness. MND is an umbrella term describing a decline in memory, intellectual ability, reasoning, and social skills, as well as changes in normal emotional reactions.
What are the essential features of MND?
- Cognitive decline in 1+ domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition).
- Decline must be substantial and demonstrated by concern by the individual or clinician as well as performance on an objective assessment showing decline from previous function or expected performance (2 SDs below the norm).
- The deficits interfere with being independent in everyday activities.
- Exclusion criterion = deficits are not in the context of a delirium
How can MND be specified?
MND specification is based on the onset trigger e.g.:
- Alzheimer’s disorder
- Parkinson’s
- Substance Induced
- Huntington’s disease
- Prion disease