DSM-V Flashcards
The presence, while depressed, of two (or more) of the following:
1. Poor appetite or overeating.
2. Insomnia/hypersomnia
3. Low energy or fatigue
4. Low self-esteem
5. Poor concentration or difficulty making decisions.
6. Feeling hopeless.
Persistent Depressive Disorder
The presence of 5, or more, of 9 criteria to be present over a two week period and present a change in the individual’s behavior or functioning form baseline.
1. Depressive Symptoms
2. loss of interest/pleasure
3. Weigh loss/gain or decrease in appetite.
4. insomnia/hypersomnia
5. psychomotor excitement/delay
6. Constant fatigue
7. Excessive sense of guilt/worthlessness.
8. Inability to concentrate
9. SI
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effectws of a substance or other medical condition.
Major Depressive Disorder
A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months in duration, as manifested by at least 6 of the following.
1. A strong desire to be of the other gender or insists that he/she is the other gender.
2. In boys, a strong preference for cross-dressing or simulating female attire. Or in girls a desire to wear masculine attire.
3. A strong preference for cross-gender roles in make-believe play or fantasy play.
4. A strong desire for the toys, games, or activities stereotypical of other gender.
5. A preference for playmates of other gender.
6. In boys, rejection of masculine toys, games, and avoidance of rough play. In girls, rejection of feminine toys, games, etc.
7. A strong dislike for one’s sexual anatomy.
8. Desire for the primary and/or secondary sex characteristics of one’s experienced gender.
Gender Dysphoria in Children
A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months in duration, as manifested by at least 2 of the following.
1. A marked incongruence between one’s experienced/expressed gender and primary/and/or secondary sex characteristics.
2. A strong desire to be rid of one’s primary and/or secondary sex characteristics.
3. A strong desire for primary and secondary sex characteristics of other gender..
4. A strong desire to be of other gender..
5. A strong desire to be treated as the other gender.
6. A strong conviction that one has the typical feelings and reactions of the other gender.
Gender Dysphoria in Adults
Cluster A Personality Disorders
Paranoid
Schizoid
Schizotypal
Often exhibit odd or eccentric behavior.
Cluster B Personality Disorders
Borderline
Histrionic
Antisocial
Narcissistic
Can be described as dramatic, emotional or erratic.
Cluster C Personality Disorders
Avoidant
Dependent
Obsessive-Compulsive
Characterized as anxious or fearful.
Brief Psychotic Disorder
What is a potential comorbid diagnosis?
Borderline Personality Disorder
38% of of BPD clients experience psychosis.
Cluster B
Low self-esteem, self-efficacy, and feelings of unworthiness could indicate this.
Self-stigma
This can reduce hope, increase psychiatric symptoms, difficulties in relationships, treatment issues and difficulties at work.
What are the key symptoms of Persistent Depressive Disorder?
Interpersonal Fears and Avoidance
What two core symptoms do the majority of people with Persistent Depressive Disorder have?
Wiersma
Childhood Maltreatment
Interpersonal Deficits
A. Depressed mood most of the day, for more days than not, for more than 2 years.
B. Presence, while depressed of the following (min. 2)
1. Poor appetite or overeating
2. Insomnia or hypersomnia
3. Low energy/fatigue
4. Low self-esteem
5. Poor concentraiton, difficult decision making
6. Hopelessness
C. During 2-year period, pt. has never been w/o symptoms longer than two months.
Persistent Depressive DIsorder (Dysthymia)
A. The development of emotional/behavioral symptoms in response to an identifiable stressor(s) occuring within 3 months of the onset of the stressor.
B. These symptoms or behaviors are clinically significant, as evidenced by 1 or both of the following:
1. Disress that is out of proportion to the severity of the stressor, taking into account the external context and cultural factors that might influence symptoms severity and presentation.
2. Significant impairment in social, occupational, or other important areas of functioning.
C. Distrubance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder.
D. Symptoms do not represent normal breavement.
E. Once stressor has terminatd, the symptoms do not persist for more than 6 months.
Adjustment Disorders
Common accompaniments of medical illness.
Differential Dx. of Adjustment Disorder
MDD
PTSD
Acute Stress Disorder
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.
B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though a a significantly low weight.
C. Distrubance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognigtiion of seriousness of the current low body weight.
Severeity based on BMI:
**Mild **: >17
Moderate : 16-16.99
Severe: 15-15.99
Extreme: <15
Anorexia Nervosa
Gold Standard Treatment: CBT and motivational strategies.
Group Therapy too!
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day.
B. During the period of mood disturbance adn increased energy or activity, three (or more) of the following symptoms (4 if the mood is only irritable) are present to a signicant decree and represent a noticeable change from usual behavior.
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g. feels rested after 3 hours of sleep.)
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or idea that thoughts are racing.
5. Distractibility, reported or observed.
6. Increase in goal-directed behavior (socially, vocation/school or sexually)
7. Excessive involvement in activities that have a high potential for painful consequences.
C. The mood disturbance is sufficiently severe to cause marked impariment in social r occupational functioning or necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
D. No attributable to physiological effects of substance abuse or another medical condition.
Manic Episode
At least one lifetime manic episode is required for the diagnosis of Bipolar I Disorder
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 days and present most of the day, nearly every day.
B. During the period of mood disturbance adn increased energy or activity, three (or more) of the following symptoms (4 if the mood is only irritable) are present to a signicant decree and represent a noticeable change from usual behavior.
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep (e.g. feels rested after 3 hours of sleep.)
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or idea that thoughts are racing.
5. Distractibility, reported or observed.
6. Increase in goal-directed behavior (socially, vocation/school or sexually)
7. Excessive involvement in activities that have a high potential for painful consequences.
C. The episode is associated with an unequivocal chnage in functioniong that is uncharacteristic of the individual when not symptomatic.
D. No attributable to physiological effects of substance abuse or another medical condition.
E. The episode is not severe enough to cause marked impariment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, teh episode is, by definition, manic.
F. The mood disturbance is sufficiently severe to cause marked impariment in social r occupational functioning or necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
Hypomanic Episode
Hypomanic episodes are common in Bipolar I disorder but are not required for the dx. of BPI.
A. Criteria have been met for at least one manic episode.
B. The occurence of the manic and major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorer, delusional disorder, or other specified or unspecified schizophrenia specturm and other psychotic disorder.
Bipolar I Disorder
What distinguishes grief from a major depressive episode (MDE)?
In grief, the predominant affect is feelings of emptiness and loss, while in MDE it is persistent depressed mood and the inability to anticipate happiness or pleasure.
Feelings of worthlessness or excessive/inappropriate guilt are most closely associated with ___.
Major Depression
MDD/Bipolar I & II
What is the core complex feature of Bipolar II?
Mood fluctuations without psychosocial triggers.
