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Year 3 Revision > Psych Diagnostic Criteria/Presentations > Flashcards

Psych Diagnostic Criteria/Presentations Flashcards

1
Q

Depression general criteria and core symptoms

A

Depressive episode should last at least 2 weeks
No hypomanic or manic symptoms

2 out of 3 must be present:

  1. Depressed mood
  2. Loss of interest or pleasure
  3. Decreased energy/increased fatiguability
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2
Q

Depression additional symptoms

A
  1. Loss of confidence/self-esteem
  2. Unreasonable feelings of self-reproach/guilt
  3. Suicidal thoughts/behaviour
  4. Impaired concentration
  5. Psychomotor agitation or retardation
  6. Sleep disturbance
  7. Change in appetite
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3
Q

ICD moderate depressive episode criteria (using core and additional symptoms of depression)

A

2 core symptoms and four additional symptoms

Need total of 6 so could include 3 core and 3 additional.

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4
Q

ICD severe depressive episode criteria (using core and additional symptoms of depression)

A

All 3 core symptoms and 5 additional symptoms

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5
Q

Somatic syndrome (depression subtype) criteria

A

4 of:

  1. Anhedonia
  2. Lack of emotional response to events which normally would produce emotional response
  3. Waking 2 hours of more before usual time
  4. Depression worse in morning
  5. Psychomotor retardation or agitation
  6. Marked loss of appetite
  7. Weight loss (5% in one month)
  8. Loss of libido
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6
Q

Atypical depression criteria

A

Mood reactivity (brightens with potential or actual positive events)

2 or more of:

  1. significant weight gain or appetite increase
  2. hypersomnia
  3. leaden paralysis
  4. Long standing interpersonal rejection resulting in sig social/occupational impairment
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7
Q

Bipolar I diagnostic criteria

A

Has to have met criteria for mania at some point, although previous episodes may have been hypomanic and/or depressive

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8
Q

Bipolar II diagnostic criteria

A

Current or past hypomanic episode and current or past depressive episode
Never met criteria for manic episode

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9
Q

Hypomanic episode diagnostic criteria

A

Mood elevated or irritable to abnormal degree for the person and is sustained for at least 4 days
At least 3 of these with impairment of personal functioning:
1. Increased activity/restlessness
2. Increased talkativeness
3. Difficulty in concentration/distractability
4. Decreased need for sleep
5. Increased sexual energy
6. Mild spending sprees/impulsive reckless behaviour

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10
Q

Manic episode diagnostic criteria

A

Elevated, expansive or irritable for at least 1 week
3 of these with impairment of personal functioning:
1. Increased activity/restlessness
2. Increased talkativeness
3. Flight of ideas or thoughts racing
4. Loss of social inhibitions resulting in inappropriate behaviour
5. Decreased need for sleep
6. Inflated self-esteem/grandiosity
7. Distractability or constant changes in activity/plans
8. Reckless behaviour
9. Marked sexual energy or sexual indiscretions

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11
Q

Anorexia nervosa ICD-10 criteria

A 
BMI of 17.5 or less
Self-induced weight loss (strict dieting, vomiting, excessive exercise, medication)
Body image disturbance
Fear of fatness
Amenorrhoea
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12
Q

High risk anorexia criteria

A 
BMI <13, weight loss >1kg per week
Prolonged QT, HR<40, BP <80 systolic
Core temp <34degreesC
Unable to rise from squat without using arms for leverage
Cognitive impairment
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13
Q

Bulimia nervosa ICD-10 criteria

A 
Persistent preoccupation with eating
Irresistable craving for food
Binges
Attempts to counter the effects of binges (starvation, vomiting, laxatives, drug misuse)
Morbid dread of fatness
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14
Q

PTSD DSM V criteria

A

Traumatic event
1 or more intrusive symptom
1 or more avoidance symptom
1 or more negative alteration in cognition and mood
2 or more increased arousal and reactivity

Duration over a month, can be delayed onset
Distress and functional impairment

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15
Q

Complex PTSD ICD-11 criteria

A

PTSD symptoms plus:
Negative self-concept
Emotional dysregulation
Chronic interpersonal difficulties

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16
Q

Generalised anxiety disorder criteria

A

Most days for at least 6 months
Not controllable
Causing significant distress/impairment of function
Generalised and persistent but not predominating in any environmental circumstance

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17
Q

Panic disorder criteria/symptoms

A 
Recurrent attacks of severe anxiety
Not restricted to particular situation or set of circumstances
Unpredictable
Other anxiety symptoms
May co-occur with agoraphobia
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18
Q

3 types of phobia

A

Agoraphobia
Social phobia
Specific phobia

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19
Q

Phobias criteria

A

Typically early onset
Fear recognised as irrational
Typified by avoidance and anticipatory anxiety

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20
Q

Does agoraphobia usually occur on its own or secondary to another mental illness?

A

Usually secondary

Can be primary

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21
Q

Social phobia description/symptoms

A

The individual fears that they will act in a way/show symptoms that will be embarrassing and humiliating
Exposure to situation will cause anxiety/panic attack
Common symptoms:
Blushing or shaking
Fear of vomiting
Urgency or fear of micturition or defaecation

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22
Q

Describe the obessional thoughts in OCD

A

Ideas, images or impulses entering the mind in a stereotyped way
Recognised as the patient’s own thoughts
Unpleasant, resisted and ego-dystonic (causes sense of distress)

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23
Q

Describe the compulsive acts in OCD

A 
Repeated rituals or stereotyped behaviours
Not enjoyable
Not functional
Often viewed as "neutralising"
Recognised as pointless
Resistance may diminish over time
24
Q

OCD diagnostic criteria

A 
Obsessional symptoms or compulsive acts must be present for at least 2 weeks AND be a source of distress and interfere with activities
Must be individuals own thoughts
Resistance must be present
Rituals are not pleasant
Must be repetitive
25
Q

Characteristics of people most at risk after deliberate self harm (DSH).

A 
Older
Male
Unemployed/retired
Single, separated or divorced
Isolated
Poor health
Psych diagnosis
Violent DSH
Suicide note
History of DSH
26
Q

Schizophrenia first rank symptoms

A

Delusions
Hallucinations
Thought interference
Passivity

27
Q

ICD-10 schizophrenia criteria

A 
One of:
Thought interference
Passivity
Auditory hallucinations
Delusions
OR Two of:
Hallucinations in any modality
Neologisms or breaks in train of though
Catatonic behaviour
Negative symptoms
28
Q

Features of paranoid subtype of schizophrenia

A

Most common

1st rank symptoms predominate

29
Q

Features of hebephrenic subtype of schizophrenia

A

Younger onset
Immaturity and silliness
Play pranks
Animated and giggly

30
Q

Features of catatonic subtype of schizophrenia

A

Movement disorder predominates

Responds very well to treatment

31
Q

Features of persistent delusional disorder

A

Delusions are only feature

32
Q

Features of schizotypal disorder

A 
Eccentricity and aloofness
Social withdrawal
Paranoid quasi-delusional ideas
Magical thinking
Transient auditory hallucinations
33
Q

Features of acute and transient psychotic disorder

A

Schizophrenia symptoms lasting less than one months

34
Q

Features of schizoaffective disorder

A

First rank symptoms with depression or mania

35
Q

Schizophrenia negative symptoms

A 
Reduced amount of speech
Reduced motivation/drive
Reduced interest/pleasure
Reduced social interaction
Blunting of affect
36
Q

Intellectual disability criteria

A 
Deficits in intellectual functioning (IQ<70)
Deficits in adaptive functioning (moving from one thing to another)
Developmental aetiology (occurs <18 years)
37
Q

Intellectual disability categories based on IQ

A 
Borderline - IQ 70 or over
Mild - IQ 50-69
Moderate - IQ 35-49
Severe - IQ 20-34
Profound - IQ <20
38
Q

Mild intellectual disability presentation

A

Mental age 9-12 years
Delayed speech (able to use everyday speech)
Full independence (self care, practical and domestic skills)
Difficulties in reading and writing
Capable of unskilled or semi-skilled work
Problems if social or emotional immaturity
Rarely organic aetiology

39
Q

Moderate intellectual disability presentation

A 
Mental age 6-9 years
Slow with comprehension and language
Limited achievements
Delayed self care and motor skills
Can do simple practical tasks often with supervision
Usually fully mobile
Majority organic aetiology
Epilepsy and physical disability common
Will likely need to be looked after
40
Q

Severe intellectual disability presentation

A

Mental age 3-6 years
More marked impairment and more restricted achievements
Epilepsy

41
Q

Profound intellectual disability presentation

A 
Mental age <3 years
Severe limitation in ability to understand or comply with requests or instructions
Little or no self-care
Often severe mobility restriction
Basic or simple tasks may be acquired
42
Q

What are the chromosomal syndromes that can result in intellectual disability? (lots of them)

A 
Cri du chat (causes microcephaly)
Angelman (maternally derived, ataxia, paroxysms of laughter)
Prader-Willi (paternally derived)
Velo-cardiofacial syndrome (increased risk of schizophrenia)
Williams syndrome
Down's syndrome
Patau syndrome
Edward's syndrome
43
Q

What sex chromosome syndromes cause intellectual disability

A 
Turners (XO)
Trisomy X
Klinefelter (XXY)
XXY male may have slight lower IQ
Fragile X
44
Q

Schizophrenia presentation in a person with an intellectual disability

A

(3 times more common)
Earlier age of onset
Negative symptoms more common
Main presenting symptoms may be behaviour change

45
Q

Depression presentation in a person with an intellectual disability

A

More likely to have somatisation
Reduced verbal expression of their feelings
Biological symptoms (sleep, appetite, energy, concentration, anhedonia)

46
Q

Cluster A “odd and eccentric” personality disorders (DSM V)

A

Paranoid
Schizoid
Schizotypal

47
Q

Cluster B “dramatic and emotional” personality disorders (DSM V)

A

Antisocial
Borderline
Histrionic
Narcissitic

48
Q

Cluster C “anxious and avoidant” personality disorders (DSM V)

A 
Avoidant (anxious)
Dependent
Obsessive compulsive (anankastic)
49
Q

ICD-10 hazardous drinking description/criteria

A

A pattern of alcohol consumption that increases the risk of harmful consequences for the user
15-34 units a week for women
15-49 units a week

50
Q

ICD-10 harmful drinking description/criteria

A

A pattern of alcohol drinking that is causing mental or physical damage
35 or more units a week for women
50 or more units a week for men

51
Q

ICD-10 alcohol dependence description

A

A cluster of behavioural, cognitive and physiological factors that typically include a strong desire to drink alcohol and find difficulties in controlling its use

52
Q

DSM-V combined name for alcohol abuse and alcohol dependence

A

Alcohol use disorder (mild, moderate and severe)

53
Q

ADHD criteria

A

Triad of inattention, hyperactivity and impulsivity
Frequently co-occuring with impairing symptoms relating to self regulation e.g. executive function, emotional regulation
Need to be:
Developmentally inappropriate
Impairing functioning
Pervasive across settings
Longstanding from age of 5

54
Q

ADHD children diagnostic criteria

A

6 or more symptoms of inattentiveness and/or 6 or more symptoms of hyperactivity and impulsiveness

55
Q

Triad of impairments and one extra feature in ASD

A

Social communication
Social interaction
Social imagination

Repetitive behaviours (not essential but very common)

56
Q

Mild cognitive impairment features and test scores

A

Noticeable cognitive impairment with little deterioration of function
ACE - 75-90, MOCA - 24-26 (not absolute)

57
Q

Vascular dementia common presenting symptoms

A 
Dysphasia
Dyscalculia
Frontal lobe and affective symptoms
May have:
focal neurological signs
vascular risk factors
step wise decline

Year 3 Revision (70 decks)

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