Most Commons Flashcards
Schizophrenia criteria:
must have at least 1 of these and it has to interfere w/ daily living
Delusions, hallucinations, disorganized speech x 6 months
*If >1 month and <6 months: Schizophreniform disorder!!
NOT Schizophrenia!!
Atypical antipsychotics for schizophrenia
Better for neg sx and cog dysfxn
Clozaril - reduces depression! :D
ADR: agranulocytosis, sz!
Monitor: WBC every week for 1st 6 months and every 2 wks forever :[
Schizoaffective disorder criteria
Schizophrenia + major mood disorder x 2 wks
Brief psychotic disorder
Delusions/hallucinations/ disorganized speech or behavior that returns to previous level of fxn x 1 day and < 1 month
Delusional disorder criteria
Delusion + no other sx of schizophrenia x 1 month
Substance/Med Induced Psychotic Disorder
Psychosis sx during or soon after substance intoxication or as part of w/drawal sx
Major Depressive Disorder Criteria
*most resolve spontaneously in 6 months w/o tx
At least 5 of 9 sx x 2 wks
+ one must be Depressed mood or Anhedonia
+ exclude other medical conditions or substance abuse
+ no evidence of mania, hypomania or mixed episode
+ must cause sig stress and disturb normal fxn
*If >2 yrs: Persistent Depressive d/o
Insomnia types
Initial: difficulty falling asleep
Middle: wake up in middle of night
Terminal: cannot make it through the night → *sign of severe depression!
Manic Episode Criteria
DIGFAST
3 listed sx or 4 if mood is irritable
+ Abnml persistent elevated, expansive or irritable mood x 1 wk [Any duration of elevated mood if hospitalization is required] + exclude other medical conditions and substance abuse + causes sig distress
Bipolar I Criteria
*more severe than Bipolar II
1 manic episode or mixed episode
Bipolar II Criteria
1+ major depressive episode + 1 hypomanic episode
*no full blown manic episode - if it does occur, they are now Bipolar I
Rapid cycling: 4+ episodes/yr
Mood disorder Criteria
Episodic + switch to opposite state or 2+ months of partial or full remission after an episode
Most common elderly complaint of MDD
New somatic complaint, loss of interest, panic attack
*⅕ of severely depressed will have psychotic sx!
MDD Rx regimen
Rx x 4-8 wks before inc dose or changing to different antidepressants
Once recovered: therapeutic dose x16-36 wks
*always check half lives to know how to taper!
If [+] psychotic sx: + antipsychotic
Hypomanic Episode Criteria
Abnml persistent elevated, expansive or irritable mood x 4 days but < 7 days
Similar sx to manic but less severe and briefer
No delusions, hallucinations, hospitalizations, and doesn’t impair social fxn
Cyclothymic Disorder Criteria
Mild swings b/w mild depression and hypomania x 2 yrs and not w/o sx for > 2 mths
No evidence of psychotic sx, no sig stress or social impairment
Persistent Depressive Disorder Criteria
2 of 6 sx + Depressed mood x 2 yrs most days than not
When to do full workup before referring to psych
No previous hx, lower SES, elderly
Alcohol Use D/o
Indirect tests [long term damage]
CBC, CMP carbohydrate deficient transferrin [low after excessive consumption] Thiamine [Wernike!] Folate [anemia, HA, fatigue, glossitis]
Alcohol use
Direct Test to evaluate for alcoholism BAC > 300 mg/dL: abuse d/o! > 150 mg/dL w/o gross evidence of intoxication > 100 mg/dL upon routine exam
Most common sx for alcohol withdrawal
delirium
Confusion and autonomic hyperarousal
Alcohol use d/o tx
Disulfiram - for committed pts who want to stop drinking
Naltrexone - not for liver dz!
Acamprostate: reduces craving
Substance-related Disorders Criteria
2 of 11 behaviors x 12 mths + interfering w/ life
Assessment: PHQ-9 and CAGE questions, complete MSE, social hx, hx from fam/friends,
EARLY Physical exam for alcohol use
rosacea palmar erythema palpable liver from fatty liver dz resp infxn Easy bruising
Late Physical exam for alcohol use
caput medusae
ascites
jaundice
esophageal varices/hemoptysis/hematochezia
What is the CIWA
what is the max score
clinical institute withdrawal assessment of alcohol
Max score of 67
Most common time of relapse
During 1st 6 mths following initial tx
Somatic Sx D/O Criteria
Somatic sx: any sx that disrupts life + excessive thoughts + disproportionate & persistent thoughts about seriousness of one’s sx x 6 mths
Conversion disorder criteria
Pop: Women, lower income, lower educational level, rural areas
Voluntary motor or sensory fxn loss and not consistent w/ any known illness
x 6 mths [acute is < 6, chronic is > 6]
If pt’s main complaint is limited to PAIN: Somatic Symptom D/O!
Illness Anxiety Disorder Criteria
Preoccupation w/ having or acquiring a serious illness
Disrupts life x 6 mths
Factitious disorder
Falsification of physical or psychological s/sx or induction of injury or dz
Get psych consult!
If [+] external gain: malingering
Dissociative identity d/o
2+ distinct personality states, marked discontinuity in sense of self, memory gaps, disrupts life
Pop: women, childhood, sex abuse
Dissociative amnesia
Can’t recall important info usually hx traumatic event
Depersonalization/
derealization d/o
Cut off from own thoughts, “outside observer” of their life
