Psych Disorders Flashcards
Prion Dz
Time: rapidly progresses over several months, death w/in 1 yr
Microlissencephaly
Cause: Zika virus, targeting progenitor cells
Delirium
*aka Acute Confusional State, Acute Brain Syndrome, Encephalopathy
ROS: disturbance in awareness and attention; physiological cause, plus cognitive disturbance
Onset: sudden w/ sx that fluctuate
Time: usually resolves w/in 3-7 days
Schizophreniform Disorder
1 or more core psychotic domain symptom
Time: active phase > 1 mo, but total disturbance LESS THAN 6 mo
Alzheimer’s Dementia
ROS: significant memory impairment + 1 other cognitive domain, most common type of dementia
Onset: gradual w/ steadily progressive decline
Early: memory, anomia
Middle: agnosias, mood changes
Late: global aphasia, motor dysfunction, death
*cortical atrophy
Schizoaffective Disorder
ROS: actives phase of schizophrenia occur concurrently w/ MDE or manic episode
Time: active phase >2 wks w/o mood sx
Subtypes: BP type (if mania), or depressive type (if depression but no mania)
Antisocial Personality Disorder (ASPD)
*Cluster B
ROS: pervasive disregard for others rights - unlawful acts, deceitfulness, aggressiveness, lack of remorse
Time: must be 18+ for dx w/ evidence of Conduct Disorder before age 15
Histrionic Personality Disorder
*Cluster B
ROS: excessive emotionality - must be center of attention, exaggerated emotions, provocative behavior, rapidly shifting emotions
PTSD
Symptoms: intrusions, avoidance, negative cognition/mood, altered arousal/reactivity
Features: traumatic stressor exposure may include direct experience of event, witnessing or learning about event to close fam member/friend
Onset: usually w/ in 3mo of trauma
Time: lasts > 1mo
Focal Cortical Dysplasia
Abnml lamination and failure to mature or apoptosis fails, etc., elevated risk of intellectual disability and FDC-associated focal epilepsy
*cognitive deficits are present in FCD at group level but may vary individually
Pseudodementia
*aka Dementia Syndrome of Depression
ROS: MDD pt often show memory and other cognitive disturbances resembling dementia
Disruptive Mood Dysregulation Disorder
Severe temper outbursts; sad/angry mood daily, rxn is disproportionate to sitch
Onset: pt must be @ least 6yo and sx must begin before age 10
Time: 3X per wk
Factitious Disorder
ROS: fakes/induces sx in absence of “external” reward, inconsistent PMH, histrionic presentation of HPI
Subtypes: on self, on others (by proxy)
Avoidant Personality Disorder
*Cluster C
ROS: inferiority complex - avoids activities for fear of criticism, unwilling to start relationships unless certain of being liked, negative self image, DOES want relationships
Conversion Disorder
*aka Functional Neurological Syndrome
ROS: altered voluntary motor or sensory function, evidence of incompatibility btwn sx and neuro conditions
Time: sudden onset after traumatic stressor, short duration w/o recurrence
Narcissistic Personality Disorder
*Cluster B
ROS: grandios - sense of self-importance, preoccupied w/ success, require admiration, sense of entitlement, lacks empathy with haughty attitude
Illness Anxiety Disorder
ROS: preoccupation w/ having/acquiring a serious illness, no physical c/o but nonetheless worries about their health
Time: >6 months
Obsessive-Compulsive Personality Disorder
*Cluster C
ROS: inflexible perfectionism and control - preoccupation w/ details, perfectionism interferes w/ task completion, rigid/stubborn, over conscientious, “type A” personality, hoarding
Panic Disorder
Unexpected/recurrent panic attacks (intense fear w/ somatic or cognitive symptoms)
Time: > 6 months w/ at least 1 month of panic attacks
Major Depressive Disorder (MDD)
Experiences 1 or > MDE and no h/o mania/hypomania, must have 2 wks of 5 or > SIGECAPS sx’s (1 req to be depressed mood OR anhedonia)
Time: persists for 6-12 months
Subtypes: melancholic, atypical, psychotic, anxious, peripartum, seasonal
OCD
Recurrent obsessions (intrusive thoughts/urges/images that increase distress), and compulsions (repetitive behaviors/mental acts that are performed to decrease distress) Subtype: "absent insight" Tx: SSRI, psychotherapy, deep brain stimulation
Generalized Anxiety Disorder
Persistent uncontrolled anxiety about multiple events
Time: > 6 months
Neuroleptic Malignant Syndrome (NMS)
ROS: tachycardia, HTN, tachypnea, fever, extreme rigidity, delirium, death
Onset: w/in first 2 wks of starting med or increasing dose (of anti-psychotic dec DA levels)
Specific Learning Disability: w/ Reading Impairment
Thickening of left fusiform gyrus, right superior temporal gyrus, rightward plenum temporale lateralization found to contribute to loss of integrity in reading networks
Hoarding
distress about discarding items, hoarding causes significant functional impairment
Subtype: “absent insight”
Somatic Symptom Disorder
ROS: 1 or more distressing/disruptive somatic symptom + abnml or excessive behaviors/thoughts/feelings in response to the distressing somatic sx
Time: > 6mo
Acute Stress Disorder
Exposure to traumatic stressor, PTSD-like symptoms that start an resolve w/in the first 30 days after trauma
Time: lasts 3 days to 1mo post-trauma (< 1 month)
Heterotopia
Misplaced gray matter lining lateral ventricles, 6 layers of cortex preserved in the heterotopic nodule so molecular signaling still there to form the 6 layers
Agoraphobia
Fear of enclosed or open spaces, must have to do with fear of humiliation or inability to escape the embarrassment
Time: > 6 months
Brief Psychotic Disorder
1 core psychotic symptom (delusion/hallucination/disorganized speech), pt returns to full function
Time: LESS THAN 1 mo
Subtypes: w/ or w/o marked stressor
Group I MCD
Malformations secondary to abnml neuronal and glial proliferation or apoptosis
E.g. - microcephaly, macrocephaly
Premenstrual Dysphoric Disorder
ROS: mood lability, irritability, dysphoria, anxiety, anhedonia, lethargy, appetite/sleep change
Time: present wk before and improve few days after menstruation
*Symptoms must cause significant distress
Schizophrenia
2 or more psychotic domain symptoms and 1 must be core symptom (1, 2, or 3)
*prodromal phase, active phase, residual phase
Onset: typical is late teens, late is >40yo
Time: active phase > 1 mo, signs of disturbance (prodromal, active, residual) > 6 mo
Body Dysmorphic Disorder (BDD)
Preoccupation w/ a perceived flaw in physical appearance (flaw is minimal/non-observable)
ROS: repetitive behaviors or mental acts performed in response to appearance concerns, must cause functional impairment
Subtypes: “absent insight”, “muscle dysphoria”
Huntington’s Dz
ROS: dementia dev AFTER choreathetosis and psych sx’s
Time: motor/psych precede dementia
Depersonalization/Derealization Disorder
- Either or both:
- Depersonalization: experiences of unreality, detachment or being an outside observer w/ respect to ones thoughts, feelings, sensations, body or actions
- Derealization: experiences of unreality or detachment w/ respect to surroundings (e.g. objects seem unreal/dreamlike)
- Reality testing remains intact
Delusional Disorder
ROS: presence of delusion “believed w/ certainty”; no other psychotic domain sx and no impairment in functioning aside from direct impact of delusion
Time: > 1 month
Subtypes: persecutory, grandiose, erotomanic, jealous, somatic (bizarre vs. non-bizarre content)
Adjustment Disorder
Emotional/behavioral symptoms due to any life stressor w/ acute onset (w/in 3 months), brief duration (lasts < 6 months)
Subtypes: w/ anxiety, w/ depressed mood, w/ misconduct
*stressor req for dx
Bipolar I (manic-depression)
Manic episode: abnormally elevated mood w/ increased energy and at least 3 sx of DIG FAST (Distractibility, Irresponsibility, Grandiosity, Flight of ideas, 👆🏽Activity, 👇🏽Sleep need, Talkativeness)
Time: @ least 1 week of mania (usually lasts ~3mo)
*mania causes MARKED impairment in functioning
Malingering
ROS: fakes/induces physical or psychological sx for “external” reward
Subtype: on self, on others (by proxy)
Mild Neurocognitive Disorder
Modest decline in @ least 1 cognitive domain; doesn’t interfere w/ independence
Vascular Dementia
ROS: caused by multiple infarcts caused by CVD, HA/sz, focal neuro sx
Onset: sudden w/ STEPWISE progression
SIGECAPS
Sleep change Interest loss Guilt Energy probs Concentration probs Appetite change Psychomotor change Suicidal ideation
Lewy Body Dementia
ROS: fluctuating cognition and alertness, visual hallucinations, mild parkinsonism; REM-sleep disorder often prodromal sx
Time: dementia develops w/in 12mo of parkinsonian signs
Dissociative Identity Disorder
Disruption of identity w/ 2 or more distinct personality states (host and alter)
ROS: frequent memory gaps in host while and alter takes control, amnesia along w/ mistaken identity
Excoriation Disorder
Recurrent skin picking, attempts to stop, not other disorder
ROS: significant distress/impairment, social avoidance, med complications
Time: >1 hour/day
Predictors of good outcome in Schizophrenia pt
Older age of onset, rapid onset, positive sx, mood sx present, female pt
Schizotypal Personality Disorder
*Cluster A
ROS: eccentric - social and interpersonal deficits, acute discomfort for close relationships, odd speech/thinking, paranormal beliefs, odd appearance, unusual perceptions
Group III MCD
Malformations secondary to abnml postmigratinoal development
E.g. - polymicrogyria, focal cortical dysphasia
Psychotic domain symptoms
1 - delusions 2 - hallucinations 3 - disorganized speech 4 - disorganized behavior 5 - negative symptoms (abolition, alogia, anhedonia, asociality)
Trichotillomania
Recurrent hair pulling that usually occurs during sedentary activities
Tx: urge distraction (“finger toys”)
Autism Spectrum Disorder (ASD)
Even visually subtle MCDs may play an important etiological role
Persistent Depressive Disorder
Chronic depressed mood w/ 2 or more sx
ROS: poor appetite/overeating, insomnia/hypersomina, low energy, low self-esteem, trouble concentrating, hopelessness
Time: 2 or more yrs
Specific Phobia
Excessive, persistent, disproportional fear of an object or situation
Time: > 6 months
Bipolar II
At least 1 MDE w/ hypomanic episode (doesnt cause impaired functioning like mania does, mood change must be uncharacteristic)
ROS: depressive phase is most disruptive
Time: hypomania for >4 days
Anterograde Amnesia
*anterograde can only be physiologic
ROS: problems encoding STM into LTM, in prominent anterograde amnesia - pt may “confabulation” when their memory fails, STM intact
Dependent Personality Disorder
*Cluster C
ROS: excessive need to be cared for - indecisive, feels helpless alone, difficulty disagreeing,
Gray and white matter blurring (GWB)
Strong relationship btwn GWB on MRI and decreased general cognitive abilities in FCD pt’s
Dissociative Amnesia
Memory loss for autobiographical info which doesn’t occur due to another disorder
ROS: if physiological there is anterograde amnesia, dissociative only has retrograde
Amnesia types: localized, selective, generalized
Subtypes: dissociative “fugue”
*psych amnesia pt’s CAN learn new info well
Major Neurocognitive Disorder
Significant decline in @ least 1 cognitive domain; interferes w/ independence
Social Anxiety Disorder
Excessive, persistent and unrealistic fear of social situations involving possible scrutiny by others due to fear of negative evaluation
Time: > 6 months
Parkinson’s Dz Dementia
Time: > 1 year after well-established parkinsonism
*subcortical
Retrograde Amnesia
*psychogenic is always retrograde
ROS: problems retrieving LTM, intact STM, in short duration subtype - temporal gradient often characterizes the amnesia w/ recent LTMs more impaired than remote LTMs
Schizoid Personality Disorder
*Cluster A
ROS: interpersonal detachment - lack of desire for close relationships, prefer solitary activities, emotionless, coldness
*movie theater dude from SG
Frontotemporal Dementia (Pick’s Dz)
ROS: similar to AD w/ “frontal” sx’s; hypersexual behavior, disinhibition, personality change
Mechanism: frontal lobe atrophy and hypermetabolism
Cyclothymic Disorder
Similar to BP1 but mood shifts are not as extreme (basically moderate BP1), pt experiences periods of hypomania that fluctuate w/ periods of depression
Time: > 2 years
Paranoid Personality Disorder
*Cluster A
ROS: distrust/suspiciousness, suspicion that others are being exploitative or deceptive
(paranoid thought is merely “suspected”)
Borderline Personality Disorder
*Cluster B
ROS: instability - unstable relationships, uncontrolled anger, reactivity of mood, chronic emptiness feelings, unstable self-image, self-mutilation/SI, transient stress-related dissociative/paranoid sx
Group II MCD
Malformations due to abnml neuronal migration
E.g. - heterotopias
