AIDS Dementia Complex (ADC): features
AIDS:
Atrophy of cortex
Infection/ Inflammation
Demyelination
Six months death
Autistic disorder: features
AUTISTICS:
Again and again (repetitive behavior)
Unusual Abilities
Talking (language) delay
IQ subnormal
Social development poor
Three years onset
Inherited component [35% concordance]
Cognitive impairment
Self injury
Biological symptoms in psychiatry
SCALED:
Sleep disturbance
Concentration
Appetite
Libido
Energy
Diurnal mood variation
Cluster personality disorders
Cluster A Disorder = Atypical. Unusual and eccentric.
Cluster B Disorder = Beast. Uncontrolled wildness.
Cluster C Disorder = Coward [avoidant type], Compulsive [obsessive-compulsive type], or Clingy [dependent type].
Conduct disorder vs. Antisocial personality disorder
Conduct disorder is seen in Children.
Antisocial personality disorder is seen in Adults.
Dementia: main causes
VITAMIN D VEST:
Vitamin deficiency (B12, folate, thiamine)
Intracranial tumour
Trauma (head injury)
Anoxia
Metabolic (diabetes)
Infection (postencephalitis, HIV)
Normal pressure hydrocephalus
Degenerative (Alzheimer's, Huntington's, CJD, etc)
Vascular (multi infarct dementia)
Endocrine (hypothyroid)
Space occupying lesion (chronic subdural haematoma)
Toxic (alcohol)
Depression: causes
UNHAPPINESS:
Understandable (such as bereavement, major stresses)
Neurotic (high anxiety personalities, negative parental upbringing
Hypochondriasis
Agitation (usually organic causes such as dementia
Pseudodementia
Pain
Importuniing (whingeing, complaining)
Nihilistic
Endogenous
Secondary (ie cancer at the head of the pancreas, bronchogenic cancer)
Syndromal
Depression: criteria/symptoms
A SAD FACES:
Appetite, weight changes
Sleep changes
Anhedonia
Dysphoria (low mood)
Fatigue
Agitation (psychomotor)
Concentration
Esteem
Suicide
Depression: major depression criteria
DEAD SWAMP:
Depressed mood most of the day
Energy loss or fatigue
Anhedonia
Death thoughts (recurrent), suicidal ideation or attempts
Sleep disturbances (insomnia, hypersomnia)
Worthlessness or excessive guilt
Appetite or weight change
Mentation decreased (ability to think or concentrate, indecisiveness)
Psychomotor agitation or retardation
Depression: major episode characteristics
SPACE DIGS:
Sleep disruption
Psychomotor retardation
Appetite change
Concentration loss
Energy loss
Depressed mood
Interest wanes
Guilt
Suicidal tendencies
Depression: melancholic features (DSM IV)
MELANcholic:
Morning worsening of symptoms/ psychoMotor agitation, retardation/ early Morning wakening
Excessive guilt
Loss of emotional reactivity
ANorexia/ ANhedonia
Depression: symptoms
BAD CRISES:
Behavioural change (slowing down or agitation)
Appetite change (weight loss or weight gain in the young)
Depressed look (looking down)
Concentration decrease (does not do serial 7s well)
Ruminations (constant negative thoughts, hopelessness good indicator of suicidality)
Interest (reduced interest in what is normally pleasurable)
Sleep change (insomnia or hypersomnia, sleeping early, waking up at night, waking up feeling tired)
Energy change (fatigue)
Suicide
Depression: symptoms and signs (DSM-IV criteria)
AWESOME:
Affect flat
Weight change (loss or gain)
Energy, loss of
Sad feelings/ Suicide thoughts or plans or attempts/ Sexual inhibition/ Sleep change (loss or excess)/ Social withdrawal
Others (guilt, loss of pleasure, hopeless)
Memory loss
Emotional blunting
Erikson's developmental stages
"The sad tale of Erikson Motors":
*The stages in order by age group:
Mr. Trust and MsTrust had an auto they were ashamed of. She took the initiative to find the guilty party.
She found the industry was inferior. They were making cars with dents [identity] and rolling fuses [role confusion].
Mr. N.T. Macy [intimacy] isolated the problem, General TVT absorbed the cost. In the end, they found the tires were just gritty and the should have used de- spare!
Gain: primary vs. secondary vs. tertiary
Primary: Patient's Psyche improved.
Secondary: Symptom Sympathy for patient.
Tertiary: Therapist's gain.
HM: this classic patient's lesion
HM had Hippocampus Missing.
Hippocampus and surrounding areas were removed surgically: prevented formation of new memories.
Impotence causes
PLANE:
Psychogenic: performance anxiety
Libido: decreased with androgen deficiency, drugs
Autonomic neuropathy: impede blood flow redirection
Nitric oxide deficiency: impaired synthesis, decreased blood pressure
Erectile reserve: can't maintain an erection
Keober-Ross dying process: stages
"Death Always Brings Great Acceptance":
Denial
Anger
Bargaining
Grieving
Acceptance
Male erectile dysfunction (MED): biological causes
MED:
Medicines(propranalol, methyldopa, SSRI, etc.)
Ethanol
Diabetes mellitus
Male Erectile Dysfunction (MED): drugs causing it
"STOP erection":
SSRI (fluoxtine)
Thioridazone
methyldOpa
Propranalol
Mania: cardinal symptoms
DIG FAST:
Distractibility
Indiscretion (DSM-IV's "excessive involvement in pleasurable activities")
Grandiosity
Flight of ideas
Activity increase
Sleep deficit (decreased need for sleep)
Talkativeness (pressured speech)
Mania: diagnostic criteria
Must have 3 of MANIAC:
Mouth (pressure of speech)/ Moodl
Activity increased
Naughty (disinhibition)
Insomnia
Attention (distractability)
Confidence (grandiose ideas)
Middle adolescence (14-17 years): characteristics
HERO:
Heterosexual crushes/ Homosexual Experience
Education regarding short term benefits
Risk taking
Omnipotence
*And there is interest in being a Hero (popular).
Narcolepsy: symptoms, epidemiology
CHAP:
Cataplexy
Hallucinations
Attacks of sleep
Paralysis on waking
*Usual presentation is a young male, hence "chap".
Parasomnias: time of onset
SLeep terrors and SLeepwalking occur during SLow-wave sleep (stages 3 & 4).
NightmaRE occurs during REM sleep (and is REMembered).
Premature ejaculation: treatment
2 S's:
SSRIs [eg: fluoxitime]
Squeezing technique [glans pressure before climax]
*More detail with 2 more S's:
Sensate-focus excercises [relieves anxiety]
Stop and start method [5-6 rehearsals of stopping stimulation before climax]
Psychiatric review of symptoms
"Depressed Patients Seem Anxious, So Claim Psychiatrists":
Depression and other mood disorders (major depression, bipolar disorder, dysthymia)
Personality disorders (primarily borderline personality disorder)
Substance abuse disorders
Anxiety disorders (panic disorder with agoraphobia, obssessive-compulsive disorder)
Somatization disorder, eating disorders (these two disorders are combined because both involve disorders of bodily perception)
Cognitive disorders (dementia, delirium)
Psychotic disorders (schizophrenia, delusional disorder and psychosis accompanying depression, substance abuse or dementia)
Reinforcement schedules: variable ratio
SLOT machines show SLOwesT extinction.
REM: features
REM:
Rapid pulse/ Respiratory rate
Erection
Mental activity increase/ Muscle paralysis
Schizophrenia: negative features
4 A's:
Ambivalence
Affective incongruence
Associative loosening
Autism
Sleep stages: features
DElta waves during DEepest sleep (stages 3 & 4, slow-wave).
dREaM during REM sleep.
Substance dependence: features (DSM IV)
"WITHDraw IT":
*3 of 7 within 12 month period:
Withdrawal
Interest or Important activities given up or reduced
Tolerance
Harm to physical and psychosocial known but continue to use
Desire to cut down, control
Intended time, amount exceeded
Time spent too much