psychiatric disorders Flashcards
Ego defenses: definition and examples
- Displacement vs Projection
- Reaction formation vs Sublimation
- Repression vs Suppression
- Altruism
- Intellectualization vs Rationalization
- Displacement
- unacceptable feelings directed to neutral object or person
- yell at the dog because you got yelled at
- Projection
- unacceptable feelings attributed to other person
- accuse partner of cheating when you (want to) cheat
- Reaction formation
- Unacceptable feelings replaced (unconsciously) by emphasis on opposite
- Gay social conservatives cruising bathrooms
- Sublimation
- Unacceptable feelings replaced by similar but acceptable course of action
- Play football b/c of aggression towards father
- Repression
- Unacceptable feelings unconsciously avoided
- Repressed memory
- Suppression
- Unacceptable feelings consciously avoided
- choosing not to think about exam
- Altruism
- Guilty feelings alleviated by unsolicited generosity
- Intellectualization
- Excessive thinking in order to avoid painful emotions or fears. Immature mechanism.
- Rationalization
- Cover up unacceptable acts or ideas using convincing reasoning. Justify feelings that would otherwise appear illogical or irrational.
Conduct disorder vs oppositional defiant disorder
Conduct disorder: repeated violation of rights of others
Oppositional defiant disorder: enduring pattern of hostile, defiant behavior toward authority figures.
Tourettes criteria
Sudden, rapid, recurrent motor and vocal tics persist for > 1 year.
Onset < 18y.
Autism vs Aspergers
Autism: greater focus on objects vs people, repetitive behavior
Asperger’s: milder, normal intelligence
Delirium vs Dementia
Delirium: rapid onset, fluctuating changes in consciousness. Often reversible. EEG changes.
Dementia: slow decline, memory loss. Often irreversible. Normal EEG.
Schizophrenia: criteria for diagnosis
What if you don’t meet the time criterion?
- Symptoms: require 2 of
- Positive symptoms - treated by antipsychotics: Delusions, Hallucinations, Disorganized speech, Disorganized behavior or catatonia
- Negative symptoms - flat affect, lack of speech or thought, etc
- Requires > 6 months duration
- < 1 month: brief psychotic disorder
- 1-6 months: schizophreniform disorder
- Schizoaffective disorder: 2 weeks plus depressive or bipolar
Bipolar vs cyclothymic disorders
Bipolar needs manic (DIG FAST x3) or hypomanic sx. Duration at least 1 week.
Cyclothymic has dysthymia and hypomania for 2 years.
Major depressive disorder vs dysthymia. How many sx, time course.
What is atypical depression
Need 5 SIG E CAPS for 2 or more weeks. Self-limited lasting 6-12 months.
Dysthymia: milder, lasts >= 2 years.
Atypical depression
- Mood reactivity (can experience happy reactions to events)
- Hypersomnia and weight gain
- leaden paralysis
- interpersonal rejection sensitivity
- TX MAOI, SSRI
Malingering vs Factitious disorder vs Muchhausens
Malingering: fake sick for secondary gain (eg time off work)
Factitious disorder: fake sick for primary gain (sick role)
Munchhausens: chronic factitious disorder
Somatoform disorders
Somatization vs Conversion vs Hyopochondriasis vs Pain
- Somatization: Complaints in multiple organ system, age < 30 yrs
- Conversion: Sudden loss of sensory or motor function; sometimes indifferent attitude toward sx (la belle indifference)
- Hypochondriasis preoccupation with illness
- Pain: prolonged pain with no physical findings
Cluster A personality disorders
Paranoid, Schizoid, Schizotypal
- “Weird”
- Paranoid: pervasive distrust and suspiciousness; uses projection
- Schizoid = distant, content with isolation (vs avoidant)
- Schizotypal = magical thinking, odd beliefs, awkwardness
Cluster B
Antisocial, Borderline, Histrionic, Narcissistic
- “Wild”
- Antisocial: disregard for rights of others (conduct disorder if < 18 yrs)
- Borderline: unstable mood and relationships; uses splitting
- Histrionic: excessive excitability, concerned with appearance, sexually provocative
- Narcissistic: grandiosity, sense of entitlement, reacts to criticism with rage
Cluster C
Avoidant, Obsessive-Compulsive, Dependent
- “Worried”
- Avoidant - hypersensitivity to rejection, feelings of inadequacy, desires relationships with others
- Obsessive-compulsive - preoccupation with order, perfectionism, control
- Dependent - submissive and clinging (Amelia)
Acute stress disorder vs PTSD
Acute stress disorder has duration < 4 weeks
Generalized anxiety disorder vs Adjustment disorder
GAD requires > 6 mo duration. Unrelated to specific thing. Tx SSRI, SNRI.
Adjustment disorder < 6 months.
