Psych Flashcards
Cluster A
Schizoid
Schizotypal
Paranoid
Cluster B
Anti-Social
Borderline
Histrionic
Narcissistic
Cluster C
Avoidant
Dependent
OCPD
Schizoid Personality Disorder
Prefer to be alone or Isolated
Hermit, Loner, Introverts
prefer to be alone
Male>female
CBT first line
2nd line Short-term low-dose anti-psychs
Cluster A
Schizotypal Personality Disorder
Magical thinking
Odd eccentric, bizarre behavior or thinking
DX requires 5 of the criteria
-Ideas of reference (excluding delusions of reference), suspiciousness
-Odd beliefs or magical thinking or speech (eg, belief in clairvoyance, telepathy, superstition, bizarre
fantasies etc.)
-May talk to self in public.
-Unusual perceptual experiences; distorted cognition and reasoning.
-Inappropriate or restricted affect
-Pervasive discomfort with close relationships (increased social anxiety, may have few close friends)
CBT first line
2nd line Short-term low-dose anti-psychs
Cluster A
Paranoid Personality Disorder
Distrust, Suspiciousness
Unjust doubts about the loyalty
Taking things the wrong way
holds grudges, Doesn’t forgive
Suspicion of spouse
CBT first line
2nd line Short-term low-dose anti-psychs
Cluster A
Bipolar 1
Must have 1 Manic episode
(MDD not required but usual)
Mania must persist for 1 week and affect daily function
Mood, Thinking, Behavior
Lithium is first line
Depakote / carbamazepine for rapid cycling/mixed
2nd gen
CBT
Use of SSRI or Antidepressant may induce mania
Bipolar 2
Must have MDD (at least 1 episode)
Must have at least 1 hypomanic episode
Can be anytime in hx
Hypomania: less than a week, does not require hospitalization or impair daily function
Lithium is first line
Depakote / carbamazepine for rapid cycling/mixed
2nd gen
CBT
Cyclothymic disorder
Similar to bipolar 2 (less Severe)
Common with borderline personality disorder
at least 2 years of prolonged mild depression
and mild hypomania
(don’t meet bipolar 1/2 criteria)
no symptom free period for longer than 2 months
in the 2 year period
Tx: mood stabilizers like lithium / depakote, 2nd gen anti-psychs
Major Depressive Disorder
At least 2 episodes of 5 Symptoms for at least 2 weeks
Symptoms must cause distress or impairment
S/S all the PHQ 9 stuff
CBT
SSRI first line pharm therapy
If no effect in 4 weeks, switch SSRI’s
SNRI, Welbutrin, TCA, MAOI
ECT
Other depression sub-types
(SAD, Atypical, Melancholia, Catatonic)
Generalized Anxiety Disorder
Excessive Anxiety or worry most days for at east 6 months
Anxiety out of proportion
Generalized Anxiety Disorder
Excessive Anxiety or worry most days for at east 6 months
Anxiety out of proportion
At least 3 symptoms
Not episodic, situational or focal
Cause social impairment
SSRI first line
Buspar as adjunct to SSRI
CBT
Benzos (short term)
BB or TCA
Panic Disorder
Recurrent Panic Attacks (at least 2)
May or may not have trigger
Attack after persistent worry for attack, worry about implications, impairment (must occur for 1 month)
Agoraphobia
Over 60% have MDD
Long term SSRI first line (Sertraline, Citalopram, Fluoxetine)
Can use benzos short term and taper
SNRI, TCA
CBT
Benzos for acute attacks
Panic Attack
Sudden abrupt intense
Peaks within 10 minutes, rarely lasts longer than 1 hour
Feel anxious for hours after
Must have 4 S/S (impending Doom is hallmark)
tachy, diaphoresis, tremors etc
Benzo is first line
Agoraphobia
Fear of situations where escape or help is difficult
Enclosed spaces, going outside, bridges, public trans
last at least 6 months, cause social impairment
CBT and SSRI’s
Social anxiety disorder
Public speaking (most common phobia)
Disabling, persistent fear of social performance
Scrutiny, embarrassment
Can cause panic attacks
CBT inital
SSRI
Can use BB for situational uses
Specific Phobias
Persistent (at least 6 months)
Heights, flying, snakes, spiders, blood, hospitals, etc
Situation triggers response
Fear out of proportion
Actively avoided
Must impair everyday activities
Exposure and desensitization therapy
Can use short term Benzo or BB
Subtypes:
Animal, Situational, Natural environment, Blood and injection injury
Specific Phobia Subtypes
Subtypes:
Animal: Spiders, dogs, mice, etc.
Situational: Airplanes, elevators, etc.
Natural environment: Heights, thunder, water, dark, etc.
Blood and injection injury: injury, needles, blood, etc.
Conversion Disorder
Now is Functional Neurological Symptom disorder
Convert stress into Neuro Symptoms
S/S Not intentionally Produced
Calm and unconcerned by S/S
Paralysis, Blindness, HA, Vision, Hearing, Gait, weakness, tics etc.
Causes impairment
Patient education about illness
CBT
Functional Neurological Symptom Disorder
Formerly Conversion disorder
Convert stress into Neuro Symptoms
S/S Not intentionally Produced
Calm and unconcerned by S/S
Paralysis, Blindness, HA, Vision, Hearing, Gait, weakness, tics etc.
Causes impairment
Patient education about illness
CBT
Somatic
Creates symptoms through excessive thoughts and behaviors
Vague symptoms
SOB, Dysmenorrhea, Dysphagia, Amnesia, Vomiting, Pain in extremities, etc.
Must disrupt daily life
Tx: regular visits to Provider
CBT
Adjustment disorder
within 3 months of stressor
Resolves within 6 months
Distress out of proportion to stressor
Job loss, breakup, illness etc.
Depressed mood, Anxiety, Etc.
CBT
PTSD
Traumatic event over 1 month ago
S/S last over 1 month
Intrusive thoughts, reliving, avoidance, cognition, mood, hypervigilance, anger etc.
SSRI first line
Trazodone for insomnia
CBT
Acute Stress
PTSD with event under 1 month ago
S/S last under 1 month
CBT
Narcissistic
Cluster B
Grandiose thoughts, self importance
Need admiration
lacks empathy
Fragile self esteem (aging, loss of power, depression)
Fantasies of wealth, brilliance, success
CBT
Histrionic
Cluster B
Hissy Fits
Attention seeking
Inappropriate sexual advances
Seeks reassurance
Hyperinflated relationships
CBT
Borderline
Cluster B
Unstable, unpredictable mood, affect and self image
Mood swings, Black and white, Blown up reactions, Unstable relationships, fear of abandonment
Reckless behavior, self harm, substance abuse, binge eating, poor self worth, etc.
CBT
Narcissistic
Grandiose thoughts, self importance
Need admiration
lacks empathy
Fragile self esteem (aging, loss of power, depression)
Fantasies of wealth, brilliance, success
CBT
Cluster B
Histrionic
Hissy Fits
Attention seeking
Inappropriate sexual advances
Seeks reassurance
Hyperinflated relationships
CBT
Cluster B
Borderline
Unstable, unpredictable mood, affect and self image
Mood swings, Black and white, Blown up reactions, Unstable relationships, fear of abandonment
Reckless behavior, self harm, substance abuse, binge eating, poor self worth, etc.
CBT
Cluster B
Anti-Social
Harmful or hostile to society
Criminal Acts
Over 18
Violation of others rights
Drunk driving, assault, lack of remorse, lying, deceit, aggression
CBT (establish limits) Avoid medication
Under 18 is conduct disorder
Cluster B
Avoidant
Social inhibition
Intense fear of rejection
Timid shy, no confidence
Inferiority complex
preoccupation with rejection
CBR
Cluster C
Dependent
Codependent
Submissive
fear of being alone or making decisions
Clingy, need taking care of
need approval from others
CBT
Cluster C
OCPD
Preoccupation with order, details, perfectionism
Without compulsions or obsessions
Don’t think their behaviors are bad or wrong
Stubborn, rigid,
CBT
BB, SSRI
Cluster C
Alcohol Withdrawal S/S
IV benzos
IV fluids, thiamine, magnesium, multivitamins
CAGE
CBT
Disulfiram
Naltrexone
Nicotine Withdrawal S/S
Restlessness, anxiety, irritability, HA, depression, Increased appetite, Weight gain, cravings
Chantix increases suicide risk
Stimulant Withdrawal S/S
Cocaine, meth
Elevated mood, euphoric, psychomotor agitation, pressured speech
NV, seizures
Opioid Withdrawal S/S
Not life threatening (unpleasant)
Lacrimation, Piloerection, Pupil Dilation (midiasis)
Flu like symptoms
Joint pain, myalgias
Narcan, Clonidine, benzos, Methadone, suboxone
Alcohol Withdrawal Time Frame
6-36 hours (onset from last drink)
Tremors, anxiety, irritability, palpitations, hypertension, insomnia, NVD,
no seizures, hallucinations or delirium tremens if uncomplicated
Complicated:
Seizures 6-48 hours
Hallucinations: 12-48 hours
Delirium tremens: 2-5 days
Nicotine Withdrawal Time Frame
Start therapy 1-2 weeks prior to quitting,
Keep therapy 4-6 months after quit date
Avoid abrupt withdrawal
Opioid use
Drowsiness, sedation, impairment, slurred speech, N/V coma, Euphoria
Pupil constriction (miosis)
Resp depression, AMS
Bradycardia, hypotension
Constipation
