OCI bits Flashcards
What are some key terms that can describe mood? Draw pictures!
Euthymic Elevated, euphoric Depressed, dysphoric Irritable Anxious Apatheic - i.e. Flat with no evident mood
How does mood differ to affect?
Mood is a persons predominant internal emotional state. Affect is the external and dynamic manifestation of a persons emotional state.
Affect is described using which parameters?
Reactive vs non-reactive / blunted or flattened Congruent vs incongruent Mobility - labile vs stable Range - full vs restricted Intensity
How does blunted affect compare with flat affect?
In blunted affect there is minimal reactivity which is of superficial intensity. In flattened affect reactivity is absent
What is alexithymia?
The inability of a patient to recognise and describe mood states.
What is an expansive mood?
Relaxed, talkative, extroverted
3 ways to categorise tremors
Postural - benign essential, anxiety, thyroid, withdrawal states, Li TOXICITYIntention - cerebellar lesion, intoxication, Wernikes encephalopathyResting - parkinsons/ism
What is the difference between athetoid and choreiform?What are choreoathetoid movements?
1) Snake like writhing vs. typically discrete coarse jerky movement2) a combination of the 2 seen in Huntingtons, Wilsons, tardive dyskinesia, dopamine agonists
Blepharospasm - what is it?
Repeated spasmodic closure of the eye lids - probably localised tardive dyskinesia
How does tardive dystonia differ to tardive dyskinesia?
Movements are less jerky and are more sustained, e.g. Grimmacing for at least several seconds
How do automatisms, stereotyped behaviours and mannerisms differ?
Mannerisms are largely under conscious control. They appear purposeful and are consistent distinctive ways of doing things, e.g. Pirouetting before sitting down.Automisms and stereotypies are both involuntary and apparently purposeless. Automisms occurring in the context of altered conscious level and are not remembered by the patient. They can be simple or complex.Stereotypies are complex involuntary behaviour that occur without conscious impairment. E.g. Rocking in PDD
What are tics?
Tics are recurrent motor activities or vocalisations which are difficult to voluntarily control. Attempts to resist tics are met with increasing psychomotor tension which is relieved when the tic occurs.Associated tic disorder, tourettes, ocd, stimulants
You have 2 patients who turn anti-clockwise before sitting. 1 manifests a mannerism, the other a compulsion. How do mannerisms and compulsions differ?
The compulsion is performed to relieve anxiety. The need to perform the action is (or has been) recognised to be unreasonable.A compulsion is often linked to an obsession.
3 ways to categorise tremors
Postural - benign essential, anxiety, thyroid, withdrawal states, Li TOXICITYIntention - cerebellar lesion, intoxication, Wernikes encephalopathyResting - parkinsons/ism
What is the difference between athetoid and choreiform?What are choreoathetoid movements?
1) Snake like writhing vs. typically discrete coarse jerky movement2) a combination of the 2 seen in Huntingtons, Wilsons, tardive dyskinesia, dopamine agonists
Blepharospasm - what is it?
Repeated spasmodic closure of the eye lids - probably localised tardive dyskinesia
How does tardive dystonia differ to tardive dyskinesia?
Movements are less jerky and are more sustained, e.g. Grimmacing for at least several seconds
How do automatisms, stereotyped behaviours and mannerisms differ?
Mannerisms are largely under conscious control. They appear purposeful and are consistent distinctive ways of doing things, e.g. Pirouetting before sitting down.Automisms and stereotypies are both involuntary and apparently purposeless. Automisms occurring in the context of altered conscious level and are not remembered by the patient. They can be simple or complex.Stereotypies are complex involuntary behaviour that occur without conscious impairment. E.g. Rocking in PDD
What are tics?
Tics are recurrent motor activities or vocalisations which are difficult to voluntarily control. Attempts to resist tics are met with increasing psychomotor tension which is relieved when the tic occurs.Associated tic disorder, tourettes, ocd, stimulants
You have 2 patients who turn anti-clockwise before sitting. 1 manifests a mannerism, the other a compulsion. How do mannerisms and compulsions differ?
The compulsion is performed to relieve anxiety. The need to perform the action is (or has been) recognised to be unreasonable.A compulsion is often linked to an obsession.
How do verbigeration and perseveration differ?Bonus point for palilalia
Verbigeration is the repetition of words or phrases that are inappropriate to the conversation.Perseveration is the inappropriate repetition of words or phrases which were initially appropriate in conversation
List several thought disorders and rank them in terms of severity.
Circumstantiality - understandable connection between phrases, goal of speech is achieved but speech is digressive and overly detailed.Tangentiality - understandable connection between phrases but the goal of speech is lostFlight of ideas - frequent tangentiality, pathonomonic of mania - as is clanning, punningLoosening of association / derailment - understandable connection between phrases is lostWord salad - no meaningful connection between words expressedThought blocking - thought content is lost mid sentence. Lack of awareness that this has occurred and no recollection of preceeding thoughts.Neologisms
What is a referential delusion?
The attribution of special individual meaning to a neutral stimulus.
What is Magical thinking?
Illogical ideas in which an unrealistic outcome is ascribed to an event. E.g. Wear my Lions cap whilst watching the game on TV, otherwise they will lose.Can be developmentally normal, otherwise seen in OCD and schizotypal PD
How does a delusion differ from an over valued idea?
Delusions are fixed false beliefs that are not in keeping with a persons cultural or social experience.Over valued ideas are also false beliefs that are firmly held, but not with the fixed intensity of a delusion.
How do obsessions differ from pre-occupation
Recurrent, intrusive egodystonic vs recurrent egosyntonic
Hallucination vs illusion
The experience of a sensory stimulus is the absence of an external stimuli, vs the misinterpretation of an external stimulus.
How do kinesthetic hallucinations differ from cenesthetic hallucinations?
Kinesthetic hallucinations describe the sensation of movement in a body part that is not movingCenesthetic hallucinations are somatic hallucinations which cause physically implausible visceral sensations such as burning in the brain.
Vermification vs formication
Worms vs insects
How do capgras delusions differ from fregoli delusions?
Both describe delusions of misidentification.In Capgras familiar persons and believed to have been replaced with imposters.In fregoli’s unfamiliar persons are believe to be a familiar person in disguise
How does derealisation differ from depersonalisation?
Depersonalisation describes the sense that a persons body is unfamiliar, e.g. Like looking down from above and watching the events take placeDerealisation describes the sense that the environment surrounding a person is unreal.Can occur in dissociative disorder, personality disorder, high levels of anxiety, psychosis/prodrome, drug intoxication/withdrawal
Deja vu vs jamais vu
Sense of overfamiliarity with a novel experience as if it had been experienced beforeVsA sense of non-familiarity with an experience to which an individual has been previously exposedSuspect TLE
What is an autoscopic hallucination?
A hallucinatory experience in which an individual sees them self, as if looking in the mirror.Think CVA, TLE
How does clanging differ to punning?
Clanging is association by rhythmingPunning is association by double meaning
What is an extracampine hallucination?
A false perception which occurs beyond the normal range of perception of the sensory organs
What did the ECA say?
Epidemiological Catchment Area Survey
What did the Sweedish Conscript Study teach us?
50,000 18yr old recruits… 15yrs later…
THC increases the risk of hospitalisation for schizophrenia. 6x risk, but nearer 2x once adjusted.
