Childhood & Early Onset Disorders plus more....

Question 1

Onset before age 12. At least 6 months of limited attention span and or poor impulse control. Characterized by hyperactivity, impulsivity, and or in attention in multiple settings. Often persists into adulthood.

Answer 1

Attention-deficit hyperactivity disorder

Question 2

Characterized by poor social interactions, social communication deficits, repetitive/ritualized behaviors, restricted interests. Must present in early childhood. May be accompanied by intellectual disability; rarely accompanied by unusual abilities (savants). More common in boys. Associated with increased head/brain size.

Answer 2

Autism Spectrum Disorder

Question 3

Repetitive and pervasive behavior violating the basic rights of others or social norms (eg, aggression to people and animals, destruction of property, theft). After age 18, classified as something else. Treatment for both include psychotherapy like CBT.

Answer 3

Conduct Disorder

Question 4

Onset before age 10. Severe and recurrent temper outbursts out of proportion to situation. Child is constantly angry and irritable between outbursts. Treatment: Stimulants, antipsychotics, CBT.

Answer 4

Disruptive mood dysregulation disorder

Question 5

Enduring pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social norms. Treatment: psychotherapy such as CBT

Answer 5

Oppositional Defiant Disorder

Question 6

Overwhelming fear of separation from home or attachment figure lasting >_ 4 weeks. Can be normal behavior up to age 3-4. May lead to factitious physical complaints to avoid school. Tx: CBT, play therapy, family therapy

Answer 6

Separation Anxiety Disorder

Question 7

Onset before age 18. Characterized by sudden, rapid, recurrent, non rhythmic, stereotyped motor and vocal ties that persist for >1 year. Coprolalia found in only 40% of patients. Assoc. with OCD and ADHD. TX: Psychoeducation, CBT. For intractable and distressing tics, high-potency anti-psychotics (eg, haloperidol, fluphenazine), tetrabenaine, alpha-2 agonists, or atypical antipsychotics.

Answer 7

Tourette syndrome

Question 8

What are the “stages of change in overcoming substance addiction” (6)?

Answer 8

1. Precontemplation - not yet acknowledging that there’s a prob.
2. Contemplation - ackn that there’s a prob. but not ready or willing to make a change.
3. Preparation/determination - getting ready to change behaviors.
4. Action/willpower - changing behaviors
5. Maintenance - maintaining the behavioral changes
6. Relapse - returning to old behaviors and abandoning new changes. (Does not always happen).

Question 9

Group of disorders there the symptoms are intentional, motivation is unconscious. Patient consciously creates physical and or psychological symptoms in order to assume a sick role and get medical attention and sympathy (primary internal gain).

Answer 9

Factitious disorders

Question 10

Chronic factitious disorder with predominantly physical signs and symptoms. Characterized by a history of multiple hospital admissions and willingness to undergo invasive procedures. MC in women and healthcare workers.

Answer 10

Factitious disorder imposed on self - AKA Munchausen SD.

Question 11

Illness in a child or elderly px is caused or fabricated by the caregiver. Motivation is to assume a sick role by proxy. Considered a type of child/elder abuse.

Answer 11

Factitious disorder imposed on another - AKA Munchausen Sd by proxy

Question 12

These group of disorders are characterized by symptoms that are unconscious, and the motivation is unconscious. Characterized by physical symptoms causing significant distress and impairment. Symptoms not intentionally produced or fringed. More common in women.

Answer 12

Somatic symptom and related disorders

Question 13

Variety of bodily complaints (eg pain and fatigue) lasting months to years. Associated with excessive, persistent thoughts and anxiety about symptoms. May co-occur with medical illness.

Answer 13

Somatic symptom disorder - TX: Regular office visits with same physician, and CBT.

Question 14

Also known as functional neurologic symptom disorder. Loss of sensory or motor function (eg, paralysis, blindness, mutism), often following an acute stressor; patient may be aware of but indifferent toward symptoms (la belle indifference); MC in females, adolescents, and young adults.

Answer 14

Conversion disorder

Question 15

AKA Hypochondriasis. Excessive preoccupation with acquiring or having a serious illness, often despite medical evaluation and reassurance; minimal somatic symptoms.

Answer 15

Illness anxiety disorder

Question 16

What three components are associated with Cluster A personality disorder?

Answer 16

Paranoid - Pervasive distrust of others and a cynical world view.
Schizoid - Voluntary social withdrawal, limited emotional expression, and social solution.
Schizotypal - Eccentric appearance, odd beliefs or magical thinking, interpersonal awkwardness.

Question 17

What four components are associated with Cluster B personality disorders?

Answer 17

Antisocial - disregard for and violation of rights of others with lack of remorse, criminality, impulsivity. If under 18, conduct disorder.
Borderline - Unstable mood and interpersonal relationships, impulsivity, self-mutilation, suicidality, sense of emptiness. Splitting is Def. Mech.
Histrionic - Excessive emotionality and excitability, attention seeking, sexually provocative, overly concerned with appearance.
Narcissistic - Grandiosity, sense of entitlement; lacks empathy and requires excessive admiration; demands the best and reacts to criticism with rage.

Question 18

What three components are involved with Cluster C personality disorder?

Answer 18

Avoidant - Hypersensitive to rejection, socially inhibited, timid, feeling of inadequacy, desires relationships with others.
Obsessive-Compulsive - Preoccupation with order, perfectionism, and control. Ego-syntonic: behavior consistent with one’s own beliefs.
Dependent - Excessive need for support, low self-confidence. Patients often get stuck in abusive relationships.

Question 19

What is the DX criteria of schizophrenia, and name the 4 positive symptoms, and the negative associated symptoms:

Answer 19

2 or more positive symptoms lasting 6 months or more (must include at least one from 1-3):
1) Delusions
2) Hallucinations
3) Disorganized speech
4) Disorganized, or catatonic behavior
NEG: 5) Affective flattening, social withdrawal, avolition, alogia, thought blocking, poor grooming

Question 20

Name the DX timeline for the subtypes of schizophrenia:

Breif psychotic disorder

Answer 20

Brief Psychotic Episode: at least one positive symptom, that lasts less than 1 month.

Question 21

Waxing and waning level of consciousness with acute onset; rapid decrease in attention span and level of arousal. Characterized by disorganized thinking, hallucinations, (often visual), illusions, misperceptions, disturbance in sleep-wake cycle, cognitive dysfunction, agitation. What pathology is at hand?

Answer 21

Delirium

Question 22

Name the DX timeline for the subtypes of schizophrenia:

Schizophrenia

Answer 22

Schizophrenia - symptoms lasting >6 months.

Question 23

Name the DX timeline for the subtypes of schizophrenia: Schizophreniform disorder

Answer 23

Schizophreniform disorder - symptoms lasting 1-6 months.

Question 24

Schizophrenia+ mood disorder = ?

Answer 24

Schizoaffective Disorder - Meets criteria for schizophrenia + MDD or bipolar. Need to differentiate from MDD with psychotic features.

Psychotic symptoms for 2+ wks in the absence of a mood disorder. Then a time period with BOTH psychosis and a major mood disorder episode at the same time.

Question 25

Name the diagnosis for CF: Fixed, persistent delusional belief system lasting >1 month Functioning is not impaired (Ex-girlfriend is stalking her and installed security cameras, and can even be shared... what is this also called???)

Answer 25

Delusional disorder 2 people involved: Folie a deux