psychiatry Flashcards
What are the characteristics features of a pervasive developmental disorder?
the presence from early life of differences & delay in social-communicative
development associated with restricted patterns of interest or behaviour. This
definition applies to disorders such as Childhood Autism, Atypical Autism, Rett’s
syndrome, Childhood Disintegrative Disorder & Asperger’s Syndrome. Pervasive
developmental disorder is analogous with autistic spectrum disorders.
Criteria for Childhood Autism (ICD-10, WHO 1992)
the presence of and/or
impaired development that is manifest before the age of three years, and by the
characteristic type of abnormal functioning in all three areas of social interaction,
communication, and restricted, repetitive behaviour.
criterial for adjustment disorder
state of subjective distress and emotional disturbance,
usually interfering with social functioning and performance, and arising in the period of
adaptation to a significant life change or to the consequences of a stressful event
What factors influence the symptoms in cases of somatisation.
Prev med experience and beliefs
Personality
Social circumstances
Prevailing mental state
Ddx medically unexplained symptoms.
Somatic dist if mood or psychotic illness
Hypochondriasis
Somatoform disorder - somatization, conversion, psychogenic pain disorder
Body dysmorphic d
Feigned illness
Factitious
Malingering
Do pts with factitious disorder have an awareness
Yes
What med works for body dysmorphic
Ssri
Diff between briquets and somatization
Briquets are shifters between systems
Somatizers are narrow simple lots detail
About how many pts with major depression only report somatic symptoms to gp
69%
Hypochondriacs are concerned with _____ where as somatisers are concerned with _______
Hypochondriacs are concerned with disease_ where as somatisers are concerned with symptoms
Conversion disorder presents with
Small no symptoms
Often just 1
1 organ system - typically CNS
Dissociative disorder presents with
Psychological symps?… Like amnesia..?..
What medical illnesses might mimic somatization disorder?
Sle ms sarcoidosis etc!
What proportion of pts wuth somatization disorder will experiemce an additional psychiatric disorder at some point
2/3
Depression and anx most common
Also substance abuse
What percent of hypochondriacs meet criteria for anxiety or depressive disorder?
50%
Prevalence and prognosis of somatization disorder?
Prev: 0.5%
75% improve over time
choosing anti depressants: 3 things to think about when assessing likely tolerability:
- anticipated adverse events (ses and discontinuation symps)
- potential interactions with concom meds and illnesses
- persons perception of the efficacy they have already taken
big problem with ssris?
bleeding.. thus prescribe ppi if on nsaids or aspirin
which ssri is ass with discontinuation symps very early if stopped
paroxetine has very short half life
which 2 antidepressants are ass with greater risk from od?
tcas and venlafaxine