Icd 10 Psych Diagnoses Flashcards
Substance dependence syndrome
1) strong desire or sense of compulsion
2) difficulties in controlling substance taking behaviour
3) physiological withdrawal state
4) evidence of tolerance
5) neglect of alternative pleasures or interests
6) persisting with substance despite harmful consequences
3 or more present during previous year
Narrowing of repertoire - characteristic but not diagnostic
Compulsion should be present
Dementia in Alzheimer’s disease
1) presence of dementia
2) insidious onset with slow deterioration
3) exclusion of other causes - hypothyroidism, hypercalcaemia, vit b12, deficiency, niacin deficiency, neurosyphilis, NPH, subdural haematoma
4) absence of sudden apoplectic onset of neurological signs of focal damage
Early onset Alzheimer’s
Alzheimer’s diagnostic criteria
Onset before 65, rapid progression
Vascular dementia
1) dementia - uneven cognitive impairment
2) stepwise deterioration or focal neurology
3) CT may confirm
4) CVD RFs - carotid bruits, emotional liability with transient depressive mood
Dementia - picks disease
1) progressive dementia
2) predominance of frontal lobe features, euphoria, emotional blunting, coarsening of social behaviours, disinhibition, apathy or restlessness
3) behavioural manifestations before frank memory impairment
Onset 50-60
Delirium
1) impairment of consciousness and attention
2) global disturbance of cognition
3) psychomotor disturbance
4) disturbance of sleep-wake cycle
5) emotional disturbance
Symptoms should be present in each one of the following areas
Onset rapid, fluctuating course, less than 6 months
Schizophrenia
1 of first rank symptoms
1) passivity
2) thought insertion, withdrawal, broadcast
3) auditory hallucinations - 3rd person, running commentary, thought echo
4) persistent delusions
2 of second rank symptoms
1) persistent hallucinations in any modalities when accompanied by fleeting delusions
2) thought block or interpolations resulting in incoherence
3) catatonic behaviours
4) negative symptoms
5) change in personal behaviour - social withdrawal (>1 year)
Must be present for 1 month or more
Paranoid schizophrenia
Relatively stable paranoid delusions, usually accompanied by hallucinations
- delusions of persecution, exalted birth, special mission, bodily change, jealousy
- hallucinatory voices, threaten the patient or give commands, or hallucinations without verbal form - whistling, humming etc
- hallucinations of smell or taste or of sexual or other bodily sensations
Thought disorder, blunted affect
Catatonic schizophrenia
- prominent psychomotor A) stupor B) excitement C) posturing D) negativism E) rigidity F) waxy flexibility G) command automatism, perseveration of words and phrases
Hebephrenic schizophrenia
- affective changes prominent
- delusions fleeting and fragmented, behaviour irresponsible and unpredictable, mannerisms common
- mood is shallow, inappropriate,
- thought is disorganised, rambling and incoherent
- 15-25 onset and poor prognosis
Acute and transient psychotic disorders
- an acute onset
- presence rapidly changing and variable state
- associated with acute stress
Residual Schizophrenia
clear progression from an early stage to a later stage characterised by long term, though not necessarily irreversible, “negative symptoms” -
- psychomotor slowing, underactivity, blunting of affect, passovoty and lack of initiative, poverty of quantitiy or content of speech
- poor self care and social performance
Simple Schizophrenia
insidious but progressive development of oddities of conduct, inability to meet demands of society and decline in total performance.
negative symptoms without overt psychotic symptoms
Persistent delusional disorders
delusions constitute the only, or the most conspicuous, clinical characteristic and which cannot be classified as organic, schizophrenic or affective.
Induced delusional disorder
delusional disorder shared by two or more people with close emotional links - inclu. folie a deux
Schizoaffective disorder
Does not justify a diagnosis of either schizophrenia or depressive or manic episodes.
- The depressive type of schizoaffective disorder is more common in older patients, whereas the bipolar type is more common in younger patients.
- Patients have a better prognosis than patients with schizophrenia but a worse prognosis than patients with mood disorder.
- Patients tend to have a non-deteriorating course and better response to mood stabiliser medications than patients with schizophrenia.
- Patients with schizoaffective disorder are a heterogeneous group with a variable predominance of schizophrenia and affective disorder symptoms.
Social phobia
fear of scrutiny, leading to avoidance of social situations. more pervasive social phobias are usually associated with fear of criticism and low delf esteem.
- complaint of blushing, hand tremor, nausea or urgency of micturition
- symptoms may progress to panic attacks
Panic disorder
recurrent attacks of severe anxiety which are not restrictd to any particular situation or set of circumstances and are therefore unpredictable.
Generalised anxiety disorder
anxiety that is generalised and persistent but not restricted to, or even strongly predominating in, any particular enviromental circumstances
OCD
obsessions and compulsions, anxiety almost invariably present
Acute stress reaction
transient disorder that develops in an individual without any other apparent mental disorder in response to exceptional physical and menal stress and that usually subsides within hours or days (<1 month). Identifiable trigger.
- daze
- fugue
- amnesia
PTSD
delayed or protracted response to a stressful event or situation
RF - personality traits or previous history of neurotic illness
- repeated reliving
- emotional blunting
- avoidance
- hyperarousal
latency period of a few weeks to months
Adjustment disorder
subjective distress and emotional disturbance, interfering with social functioning and performance, arising in the period of adaptation to significant life change or stressful life event. (<6months)
Mild learning disability
50-69 IQ
mental aged 9-12
