Psychiatric definitions Flashcards
What is salient syndrome?
A core symptoms of psychosis
A feeling that things have a special meaning
Name the disorders that usually involve psychosis
Schizophrenia Schizoaffective disorder Delirium Delusional disorder Organic episode Psychotic depression Bipolar affective disorder
What are the positive symptoms of schizophrenia?
Hallucinations, delusions
What are the negative symptoms of schizophrenia?
Loss of drive, volition and energy
Flattened affect
Poor self care
What are the cognitive symptoms of schizophrenia?
Change in personality
Dementia praecox
Poor attention and memory
What are the different types of auditory hallucination?
1st person: thought echo
2nd person: depression, personality disorder. Someone speaking to you
3rd person: running commentary, schizophrenia
Name 7 types of delusional belief
Thought control (insertion, withdrawl, broadcasting) Passivity (someone is controlling me) Persecution Reference (radio/tv about me) Grandeur Love/jealousy Nihilistic
Name 10 symptoms of depression
Lowering of mood, reduction of energy, and decrease in activity Anhedonia Fatiguability Early morning waking Appetite loss/weight loss Guilt/self blame/worthlessness Agitation Loss of libido Thought of death/suicide, bleak/no future Psychosis with guilt & persecution
Name 10 symptoms of mania
Elevated mood out of keeping with circumstance Increased energy Overactivity Pressure of speech Distractibility Loss of normal social inhibitions-> reckless, inappropriate Increased libido Racing thoughts Psychosis w/grandiose delusions
What is bipolar?
Bipolar affective disorder is a disorder characterised by two or more episodes in which the patient’s mood and activity levels are significantly disturbed
Some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression).
What should be considered with visual hallucinations
Rare, consider organic cause
Sight problems, Lewy Body dementia, drugs
Name the 5 types of hallucination
Auditory (1st, 2nd, 3rd person) Visual Olfactory Gustatory Somatic
Give an example of a somatic hallucination
Bugs under skin during cocaine withdrawal
What is a delusion?
A false belief held with extraordinary conviction, that is not accepted by other members of the pt’s culture
What are the most important psychopathological phenomenon in the diagnosis of schizophrenia?
Thought echo Thought insertion/withdrawal Thought broadcasting Delusional perception Delusion of control Influence/passivity Hallucinatory voices commenting or discussing the pt in 3rd person Negative symptoms (loss of drive, energy, flattened affect, poverty of speech) Must be present for at least 1 month
Name 4 types of schizophrenia
Hebephrenic
Catatonic
Paranoid
Schizoaffective disorder
Describe what is defined as hebephrenic schizophrenia
Affective changes are prominent, delusions and hallucinations are fleeting and fragmentary.
Behaviour is irresponsible and unpredictable
Mood shallow and inappropriate, thought disorganised, speech incoherent
Social isolation
Describe what is defined as catatonic schizophrenia
- Dominated by prominent psychomotor disturbances that may alternate between extremes such as hyperkinesis and stupor, or automatic obedience and negativism
- Constrained attitudes and postures may be maintained for long periods
- Episodes of violent excitement
- The catatonic phenomena may be combined with a dream-like (oneiroid) state with vivid scenic hallucinations
Describe what is defined as paranoid schizophrenia
Dominated by relatively stable, often paranoid delusions, usually accompanied by hallucinations, particularly of the auditory variety, and perceptual disturbances. Minimal disturbances of affect, volition and speech
Describe what is defined as schizoaffective disorder
Episodic disorders in which both affective and schizophrenic symptoms are prominent but which do not justify a diagnosis of either schizophrenia or depressive or manic episodes
What is panic disorder?
• Essential feature is recurrent attacks of severe anxiety (panic), which are not restricted to any particular situation or set of circumstances and are therefore unpredictable
• Dominant symptoms include sudden onset of palpitations, chest pain, choking sensations, dizziness, and feelings of unreality (depersonalization or derealisation)
• Secondary fear of dying, losing control, or going mad
1.2-4% lifetime prevelence
How is GAD defined?
Anxiety that is generalised and persistent but not restricted to any particular environmental circumstances
Symptoms:
Psychic worry (worry, apprehension, difficulty concentrating
Motor tension (fidgeting, trembling, headaches)
Autonomic dysfunction (sweating, dizziness, dry mouth, abdominal churning)
Fears that the patient or a relative will shortly become ill or have an accident are often expressed.
For 6 months
What is a obsessional thought?
Obsessional thoughts are ideas, images, or impulses that enter the patient’s mind again and again in a stereotyped form. They are almost invariably distressing and the patient often tries, unsuccessfully, to resist them. They are, however, recognized as his or her own thoughts, even though they are involuntary and often repugnant.
What is a compulsive act?
Compulsive acts or rituals are stereotyped behaviours that are repeated again and again. They are not inherently enjoyable, nor do they result in the completion of inherently useful tasks. Their function is to prevent some objectively unlikely event, often involving harm to or caused by the patient, which he or she fears might otherwise occur.
Name 9 features of PTSD
- Episodes of repeated reliving of the trauma in intrusive memories (“flashbacks”)
- Dreams or nightmares, occurring against the persisting background of a sense of “numbness” and emotional blunting
- Detachment from other people
- Unresponsiveness to surroundings
- Anhedonia
- Avoidance of activities and situations reminiscent of the trauma
- State of autonomic hyperarousal with hypervigilance
- Enhanced startle reaction
- Insomnia
What is somatisation disorder?
Multiple, recurrent and frequently changing physical symptoms of at least two years duration. Most patients have a long and complicated history of contact with both primary and specialist medical care services, during which many negative investigations or fruitless exploratory operations may have been carried out. Symptoms may be referred to any part or system of the body. The course of the disorder is chronic and fluctuating, and is often associated with disruption of social, interpersonal, and family behaviour
What makes an eating disorder classified as anorexia nervosa?
Body image distortion
Morbid fear of fatness
Restricted diet, excessive exercising, induced vomiting, induced purging, use of diuretics/appetite suppressants
Deliberate weight loss, induced and/or sustained by the patient, to 15% below what is expected (BMI<17.5)
Periods stop, men lose sexual interest
What makes an eating disorder classified as bulimia nervosa?
Body image distortion
Repeated bouts of overeating and an excessive preoccupation with the control of body weight, leading to a pattern of overeating followed by vomiting or use of purgatives
At least once a week for 3 months
Associated with EU/BPD
What is a personality disorder?
A variety of conditions and behaviour patterns of clinical significance which tend to be persistent and appear to be the expression of the individual’s characteristic lifestyle and mode of relating to himself or herself and others.
• Deeply ingrained and enduring behaviour patterns, manifesting as inflexible responses to a broad range of personal and social situations.
• Not directly resulting from disease, damage, or other insult to the brain, or from another psychiatric disorder
• Usually manifest since childhood or adolescence and continuing throughout adulthood.
• Personal distress and social disruption
Name 3 groups and 11 types of personality disorder
A) Mad (Paranoid, Schizoid, Schizotypal)
B) Bad (Borderline, Impulsive, Emotionally unstable, Antisocial psychopathic, Narcissistic)
C) Sad (Dependent, Avoidant, Anankastic slow and obsessional)
What is paranoid personality disorder?
- Excessive sensitivity to setbacks
- Unforgiving of insults
- Suspiciousness and a tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous
- Recurrent suspicions, without justification, regarding the sexual fidelity of the spouse or sexual partner
- Combative and tenacious sense of personal rights
- Excessive self-importance, and often excessive self-reference
What is schizoid personality disorder?
- Withdrawal from affectional, social and other contacts with preference for fantasy, solitary activities, and introspection
- Limited capacity to express feelings and to experience pleasure
- Exclude: Asperger’s, schizophrenia
What is dissocial PD?
- Disregard for social obligations, and callous unconcern for the feelings of others
- Gross disparity between behaviour and the prevailing social norms
- Behaviour is not readily modifiable by adverse experience, including punishment
- Low tolerance to frustration and a low threshold for discharge of aggression, including violence
- Tendency to blame others, or to offer plausible rationalisations for the behaviour bringing the patient into conflict with society
- Includes: amoral, antisocial, psychopathic, sociopathic
What is EUPD?
- Definite tendency to act impulsively and without consideration of the consequences
- Mood is unpredictable and capricious
- Liability to outbursts of emotion and an incapacity to control the behavioural explosions
- Tendency to quarrelsome behaviour and to conflicts with others, especially when impulsive acts are thwarted or censored.
What is borderline PD?
Disturbances in self-image, aims, and internal preferences
• Chronic feelings of emptiness
• Intense and unstable interpersonal relationships
• Tendency to self-destructive behaviour, including suicide gestures and attempts
What is histrionic PD?
- Shallow and labile affectivity
- Self-dramatization, theatricality, exaggerated expression of emotions
- Suggestibility, egocentricity, self-indulgence, lack of consideration for others
- Easily hurt feelings
- Continuous seeking for appreciation, excitement and attention.
- Including: Hysterical/psychoinfantile
