dsm5` Flashcards
caffeine withdrawal
headache, fatigue, decreased energy/activeness, decreased alertness, drowsiness, decreased contentedness, depressed mood, difficulty concentrating, irritability, and feeling foggy/not clearheaded
cannabis withdrawal
anxiety, irritability, anger or aggression, disturbed sleep/dreaming, depressed mood and loss of appetite.
impact of genetics on ID
5%
ID base rate
1%, 85% mild
1.5:1 male to female
language disorder after age of __ likely to persist in adulthood
4
child onset fluency disorder/stuttering
onset age 2-7
Base rate ASD
1%
Rett syndrome
mostly girls
5-48 months onset
de-accelerated head growth, stereotyped hand movements, loss of social engagement
social communication skills improve after a while
medications for ADHD
ritalin/concerta/methylphenidate, adderall/amphetamine, dexidrine/dextroamphetamine, strattera/atomoxetine
ADHD base rate
5% kids, 2.5% adults
DCD
deficits in activities requiring motor coord
Tourette’s
1+ vocal and multiple motor tics, 1 year
Persistent tic disorder
motor OR vocal tics, not both, 1 year
provisional tic disorder
tics <1 year
Tic medications
catapres/clonodine, haldol/haloperidol, SSRIs
Tourette’s base rate
0.5%, 2-4:1 males to females
Delusions
fixed, false beliefs, unchangeable
disorganized thinking
derailment, tangentiality
grossly disorganized behaviors
catatonia, agitation
neg symptoms of schizophrenia
diminished emotional expression, avolition, alogia (decreased speech output), anhedonia, asociality
catatonia
stupor, catalepsy, waxy flexibility, mutism, negativism, stereotyping, agitation, grimacing, echolalia, echopraxia
delusional disorder
1+ delusions for 1+ month, no other schizophrenia symptoms
types of delusions
erotomanic, grandiose, jealous, persecutory (most common), somatic, mixed, unspecified
brief psychotic disorder
1 day to 1 month
one of: delusions, hallucinations, disorganized speech/beh, catatonic beh
schizophreniform disorder
schizophrenia but 1 month - 6 months
schizophrenia
- 2+ for significant portion of 1 month - at least one (delusions, hallucinations, disorganized speech), grossly disorganized or catatonic beh, neg symptoms (avolition, diminished emotional expression, alogia, anhedonia, asociality)
- functioning below previous functioning
- continuous disturbance 6 months, active symptoms for 1 month
onset adolescence-30s
0.3-0.7% lifetime rate male female 1:1
novel and traditional antipsychotics
schizoaffetive disorder
major mood episode and symptoms of shizophrenia, delusions or hallucinations for at least 2 weeks without mood symptoms
bipolar or depressive type
substance induced psychotic disorder
alcohol, inhalants, etc.
Catatonic disorder due to another medical condition
neurological, metabolic
psychotic disorder due to another medical condition
neurological, endocrine, metabolic
Other specified/unspecified schizophrenia spectrum disorder
attenuated psychosis, auditory hallucinations and nothing else
Manic episode
abnormally elevated mood or irritable, goal-directed energy, lasts at least 1 week all day every day. 3+ of inflated self-esteem, decreased need for sleep, pressured speech, racing thoughts, distractibility, psychomotor agitation. Functional impairment or hospitalization (no minimum duration), or causes psychotic symptoms
hypomanic episode
at least 4 days, same symptoms as mania. Not severe enough for impairment or hospitalization or psychosis
depressive episode
5+ symptoms over 2 weeks
Depressed mood, loss of pleasure, and (weight gain, appetite change, sleep change, psychomotor agitation or retardation, fatigue, worthlessness or guilt, poor concentration, suicidal ideation)
Bipolar I
at least one manic episode
base rate 1%
Base rate for bipolar
1%, 1:1 for gender, more common in high income countries, highest rates of suicide and concordance (80% for identiical twins, 20-25% for siblings)
mean age of onset 18
90% of people who had an episode go on to have another one
suicide for bipolar
x15 regular person
might be 25% of all suicides
Bipolar II
1 hypomanic and 1 major depressive episode, NEVER been manic
cyclothymic disorder
symptoms of hypomania/depression over 2 years, periods of hypomania/depression persist more than half the time, and not without symptoms for more than 2 months at a time. episode criteria never met, functional impairment indicated
substance induced bipolar and related disorder
PCP, stimulants, steroids
bipolar and related due to medical condition
MS, cushing’s, TBI, stroke, hyperthyroidism
Disruptive Mood regulation disorder
3-4 temper outburst per week for 1+ years, in 2 settings, persistently angry/irritable between bursts. onset before age 10, but not before 6 or after 18. no more than a day of manic symptoms
Major Depressive Disorder
presence of MDE - 5+ symptoms over 2 weeks, at least one of (depressed mood, loss of pleasure) + (weight change, sleep change, appetite change, psychomotor agitation/retardation, fatigue, worthlessness/guilt, poor concentration, suicidal ideation/death thoughts)
Recovery within 3 months of onsent 40% of time, within 1 year for 80% of individuals
1:1.5-3 male to female
Grief vs MDE
Prevalent in grief - loss, emptiness, dysphoria in waves
MDE - inability to experience pleasure, persistent depresed mood, self-loathing/inadequacy/suicide
MDD with peripartum onset
10-15% of mothers, severe anxiety, insomnia, lack of interest in baby
Postpartum blues
50-80% of mothers, few weeks. Not dsm
postpartum psychosis
0.2%, brief psychotic disorder with postpartum onset
concordance rates for MDD
55-60% for twins, 20% for siblings
treatment for MDD
behavior activation just as effective as meds, more effective than cog therapy in severe
suicide rates
women attempt 3 times more,
men succeed 4 times more
90% have mental health disorder
highest 45-64
lowest 15-24
highest white and First Nations
Persistent Depressive Disorder
Depressed mood most of the day for 2+ years, (1+ for kids), at least 2 symptoms, not without symptoms for more than 2 months,
premenstrual dysphoric disorder
5+ symptoms week before menses, minimal or absent post-menses, present over most cycles over past year
substance-induced Depressive disorder
alcohol, hallucinogens, PCP, inhalants, opiods, sedatives, hypnotics and anxiolytics, stimulants
Panic attack
peak in 10 min, expected or unexpected, 4+ physical/cog symptoms (nausea, chest pain, shortness of breath, palpitations, dizzy, fear of dying, fear of loss of control)
limited symptom attacks if <4
separation anxiety
developmentally inappropriate anxiety about being away from home/someone, 3+ (distress, worry about harm to attachment figure, worry about getting lost/kidnapped, reluctance of going out/being alone) 4+ weeks
selective mutism
consistent failure to speak in specific situations, 1 month duration.
Onset usually before age 5
specific phobias
out of proportion to actual danger, 6+ months, common to have multiple.
Invivo exposure usually best resuluts
social anxiety disorder
fear of situations with potential scrutiny of others, 6+ months
panic disorder
recurrent panic attacks, at least 1 followed by 1+ month of persistent concern about another attack or change in beh
20-30% for twins, 0-10% for siblings
Agoraphobia
anxiety about 2+ situations: using public transport, being in open/enclosed spaces, standing in line/being in crowd, being ouside home. Thoughts of not being able to get help or escape being difficult. 6+ months
GAD
excessive worries 6+ months, 3+ of (restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbance), only 1 for children
median age of onset for GAD
- chronic usually, fluctuates
OCD
obsessions (recurrent intrusive thoughts/urges) or compulsions (repetitive behaviors to deal with obsessions), time-consuming and functional impairment
body dysmorphic disorder
preoccupied with perceived flaw, excessively engage in behaviors to manage
hoarding
can’t get rid of things regardless of value
Reactive attachment disorder
inhibited, withdrawn behavior toward caregiver, rarely seeks commfort, present before age 5, after 9 months of developmental age
disinhibited social engagement disorder
lack of hesitation in going with strangers
PTSD
intrusive symptoms, avoidance of stimulus associated with trauma, neg changes in mood/cognition, increased arousal, 1+ month
50% recover in 3 months
treatment for PTSD
PE, EMDR, CPT, seeking safety
acute stress disorder
9 symptoms from any 5 PTSD symptom categories upto 1 month
Adjustment disorder
symptoms in resposne to stressor, within 3 months of stressor presence and remits within 6 months of stressor termination
DID
2+ identities, discontinuation in sense of self, inability to recall everday events, traumas
Drugs for MDD
SSRI (
SNRIs
Bupoprion
Mertazopine
Bipolar meds
Mood stabilizers
Atypical Antipsychotics (abilify, codiapinr)
Anti convilsants
Panic disorder meds
SSRI
Meds for ocd
Fluvoxamine (SSRI)
Clamipromine (trycyclic)
Isotalopram
dissociative amnesia
inability to remember important info beyond forgetfulness
depersonalization/derealization
persistent/recurrent depersonalization episodes, reality testing intact
somatic symptom disorder
1+ distressing symptoms, or disrupts dsaily life, persistent thoughts/anxiety about symptoms, excessive time/energy spent on symptoms, worries persist 6+ months
illness anxiety
preoccupation with getting seriously ill, 6+ months
conversion disorder
1+ symptoms affecting voluntary motor or sensory function
2-3 times more common in women
psychological factors affecting medical conditions
medical condition present, and psych factors adversely impact by exacerbating, or delay recovery, adherence, create additional health risks
factitious disorder (Munchausen most severe)
intentional feigning symptoms or creating injuries, absence of external incentives for injury
pseudocyesis
false belief of being pregnant with physical symptoms of pregnancy
pica
eating non-food 1+ month
rumination disorder
regurgitating food 1+ month
avoidant/restrictive food intake disorder
failure to eat adequately resulting in failure to gain weight/weight loss, nutritioual deficiency, reliance on feeding tube/supplements, psychosocial functioning interference, “failure to thrive”,
anorexia nervosa
fear of weight gain, restricting type/binging-purging type.
bulimia nervosa
binge purge once per week for 3+ months
enuresis
bed wetting twice a week for 3+ months, age 5 and up, 99% remit by adulthood
urine alarm
treatment for enuresis, classical conditioning
encopresis
pooping in inappropriate places, intentional OR voluntary
insomnia disorder
3+ nights each week
3+ months
hypersomnolescence disorder
excessive sleepiness
narcolepsy
recurrent periods of irresistible need to sleep + hypocretin deficiency, cataploxy, REM <15 min
hypnogogic hallucinations at onset of sleep
hypnopompic hallucinations at waking
sleep paralysis during
non-rapid EM sleep arousal
sleep walking type vs sleep terror type
total amnesia
nightmare disorder
repeateed nightmares, usually during REM sleep
REM sleep behavior disorder
vocalizing or moving during sleep
restless leg syndrome
urge to move legs, 3+ times per week over 3+ months
