Psych Flashcards
What are common comorbidities to factitious disorder?
Borderline personality disorder
Antisocial personality disorder
History of trauma (sexual, verbal, and/or emotional)
What is factitious disorder?
Pt assumes a sick role in the absence of any true disease
Will intentionally produce symptoms in the absence of external incentives.
Value on emotional comfort from being cared for, may not have insight
What is malingering?
Pt assumes the sick role with goal of obtaining something
ie. medication, shelter
What is conversion disorder?
Motor or sensory dysfunction that causes distress to pt that can’t be explained by any neurological/medical disorder
Symptoms are subcontiousally produced
While stress is a common trigger, not needed for dx
Average age of presentation for somatic symptom/somatoform disorder:
Before 30 years old
What is somatic symptom/somatoform disorder?
Recurrent and multiple somatic complaints not due to any physical disorder
DSM V criteria for diagnosis of somatic symptom disorder:
- Four pain symptoms
- Two gastrointestinal symptoms
- One sexual symptom
- At least one symptom or deficit suggesting a neurologic condition not limited to pain (pseudo-neurologic)
What is a dissociative disorder?
Disruption of normally integrated functions of consciousness, environmental perception, memory, and identity
What is dissociative fugue?
Pts will present in a new geographic location with amnesia and possibly a new identity
Can be associated with traumatic circumstances
Symptoms of major depressive disorder:
- Sleep
- Loss of interest
- Guilt
- Loss of energy
- Loss of concentration
- Appetite/weight changes
- Psychomotor retardation,
- Suicidal ideations
SIGECAPS
How long must symptoms last to be classified as major depressive disorder?
Long than 2 weeks
MDD may be associated with low ___ levels in the brain.
Serotonin
Specific suicidal risk factors:
Severe depression
Widowed/divorced
Male gender
Age over 45
White ethnicity
Past suicide attempts
What neurologic diseases have higher risks of depression and suicide?
- Parkinson’s disease
- Stroke
- Epilepsy
- Huntington’s disease
- Multiple sclerosis
What therapy should be considered for for refractory MDD?
Electroconvulsive therapy (ECT)
Contraindications to electroconvulsive therapy?
Recent stroke
Myocardial infarction
Increased intracranial pressure
Having an intracranial space-occupying lesion
What is dysthymia?
Mild depression for 2 years or longer
What are the defining features of bipolar disorder?
Depression and recurrent episodes of hypomania/mania
Catatonia symptoms
Akinetic mutism
Waxy flexibility
Echopraxia/echolalia
Utilization behavior
Automatic obedient behavior
Treatment for cataonia:
Electroconvulsive therapy (ECT)
Benzodiazepines may also be beneficial
What medications can worsen catatonia?
Dopamine antagonists
Baclofen
Cluster A personality disorders:
Paranoid
Schizoid
Schizotypal
Cluster B personality disorders:
Borderline
Histrionic
Antisocial
Narcissistic
Cluster C personality disorders:
Avoidant
Obsessive compulsive
Dependent
Characteristics of paranoid personality disorder:
Excessive suspicion and distrust of others
Characteristics of schizoid personality disorder:
Blunted affect and emotion. Prefers to be alone.
Characteristics of schizotypal personality disorder:
Magical thinking, odd and eccentric behavior
Paranoid ideation
Characteristics of borderline personality disorder:
Splitting/dichotomous thinking
Impulsive outbursts of anger, suicidal gestures, self-mutilation, and dissociative states
Unstable mood/interpersonal relationships
Characteristics of histrionic personality disorder:
Excessive pattern of emotionality and attention-seeking behavior
Inappropriately sexually provocative
Overly concerned about their appearance.
Lively, dramatic, enthusiastic, and flirtatious
Characteristics of antisocial personality disorder:
Disregard for authority and violation of the rights of others
Men > women
Tend to have a history of substance abuse.
Characteristics of avoidant personality disorder:
Avoids social interactions with others
Characteristics of narcissistic personality disorder:
Grandiosity, a sense of entitlement, and a lack of empathy
Characteristics of obsessive-compulsive personality disorder:
Heightened focus on organization and intricacies
Does not have pervasive compulsions that impair functioning
Characteristics of dependent personality disorder:
Excessive reliance on others
Often described someone always in a relationship
Needy
What is the hallmark of a panic disorder?
Fear of having a panic attack which can impair function
Recurrent panic attacks
What are the symptoms of post traumatic stress disorder?
Involuntary distressing memories
Flashbacks
Avoidance of reminders
How long must symptoms persist to be considered PTSD?
More than a month
Mainstay treatment for PTSD?
SSRIs
SNRIs, trazodone, and mirtazapine can also be used
Treatment for PTSD nightmares?
Alpha-1 adrenergic receptor antagonist
Prazosin
What are the symptoms of schizophrenia?
Bizarre delusions
Hallucinations (auditory>visual)
Disorganized speech/behavior
“Negative symptoms” with flat affect or social withdrawal
cognitive deficits in executive function, processing speed, attention, and working memory
How long must symptoms be present for a diagnosis of schizophrenia?
> 6 months
Schizophrenic symptoms <1 month:
Brief psychotic disorder
Schizophrenic symptoms between 1-6 months:
Schizophreniform disorder
What is Childhood Disintegrative Disorder (CDD)?
Rare condition characterized by late onset (>2-3 years of age) of developmental delays in language, social function, and motor skills
No specific medical cause associated
Causes regression
How must the diagnosis of ADHD be made?
Symptoms must be present in two separate settings
What is William’s Syndrome?
Microdeletion syndrome of chromosome 7
Symptoms of William’s syndrome:
Developmental delay
Congenital heart defects (i.e. aortic stenosis)
Hypercalcemia
Characteristic facial features (microcephaly, large mouth, and epicanthal folds).
excellent social and language skills
