DSM Flashcards
(41 cards)
ODD
Diagnosis
4/8 symptoms
6 months
At least one individual not a sibling
1. Temper
2. Touchy
3. Angry
4. Argues w/ authority
5. Defies authority
6. Annoys
7. Blames others
8. Spiteful x 2 in 6 mo
Conduct d/o
3/15 symptoms in past 12 mo
1 in past 6 mo
TRAP - theft, rules, aggression, property
- Aggression
1. Bullies
2. Fights
3. Weapons
4. Cruel to ppl
5. Cruel to animals
6. Theft w/ weapon
7. Sexual assault - Property
8. Fire setting
9. Destruction - Theft
10. B & E
11. Lying
12. Theft - Rules
13. Curfew < 13
14. Fugues > 2
15. Truancy < 13
DMDD
Diagnosis
- Temper outbursts 3 x a week
- Mood in between is persistently irritable / angry
- Duration of 12 mo; no more than 3 mo without symptoms
- 2 settings
- Onset < 10 y.o.; don’t diagnose < 6 or > 18
Exclusion: PTSD, separation anxiety, ODD, IED, BAD, ASD
Can coexist with: MDD, ADHD, CD, SUD
ARFID
A. Eating/feeding disturbances: lack of interest in food, avoidance based on sensory characteristics, concern about aversive consequences of eating
Manifested by persistent failure to meet appropriate nutritional needs with at least 1:
a. significant weight loss
b. significant nutritional deficiency
c. dependence on enteral feeding
d. marked psychosocial dysfunction
B. Not explained by lack of food or cultural practice
C. No body image disturbance, not AN, not BN.
Delirium
DSM-5 Criteria
A. ∆ attention and awareness + 1 other ∆ cognitive domains
B. Acute onset and fluctuation
C. direct consequence of another medical condition, substance intoxication or withdrawal, or Rx
Specify hyper- or hypo-active
Specify : etiology ;
acute or persistent ;
hyper or hypoactive ;
Histrionic PD
Histrionic 5/8 PRAISE ME
Behaving towards others :
P : Provocative, sexually seductive, inapprops others
R : Relationships considered more intimate than they actually are
Inside , they want attention but lack subs :
A : Attention, center of, otherwise uncomfortable
I : Influenced easily by others or circumstances , suggestible
Speak and feel superficially :
S : Speech too impressionistic and lack detail
E : Emotions shallow , display rapidly shifting
M : Make up , uses physical appearance to draw attention to self
E : Emotions exaggerated , theatricality , self-dramatize
Schizoid
Schizoid 4/7 DISTANT (R/O psychosis and ASD)
Look :
D : Detachment, flat affect, emotional coldness
I : Indifferent to praise or criticism of others
Do little :
S : Sexually disinterested with others
T : Takes pleasure in few if any activities
Be with little :
A : Alone , absence of close friends or confidants, other than first-degree relatives
N : Neither desires nor enjoys close relationships, incl. family
T : Tasks activities almost always chooses solitary
Schizophrenia
A :
1 Delu
2 Hallu
3 Disorg speech
4 Disorg or catatonic behavior
5 Neg symptoms
B : Functioning
C : 6 months , 1 month of A
, and rest can be prodromal , residual symptoms like negative or attenuated positive
Delusional disorder
A : 1 or more delusion(s) , 1 month
B : not meeting A of schizophrenia
C : functioning not impaired apart from impact of delusion(s)
D : if man or dep , brief relative to duration of delu periods
E : not subs , not medical , not another mental like body dysmorphic disorder or OCD
Types : erotomanic , grandiose , jealous (Othello) , persecutory most common , somatic , mixed , unspec
With bizarre content ;
MNCD
A. Significant decline from baseline in ≥1 cognitive domains based on :
- Subjective c/o (pt, collat) or clinician concern
AND
- Documented by standardized neuropsychological or other testing
B. Interfere with independence in everyday activities
Alzheimer’s dementia
Progressive learning/memory decline + ≥1 cognitive domains
Vascular dementia
Vascular etiology suggested by onset after CVA or
Prominent decline in complex attention & executive fcts (frequent: abulia, step-wise decline)
mild or major NCD due to TBI
A- evidence of mild or major TBI
B- TBI and ≥1: LOC, PTA (post-traumatic amnesia), disorientation/confusion, neuro sign
C- presents immediately after the TBI or immediately after recovery of consciousness and persists past the acute post-injury period.
FTD
≥2 core Sx: probable
≥1 core + ≥1 suggestive : possible
core:
fluctuating cognition
parkinsonism after cognitive decline
well formed detailed VH
suggestive:
REM behav sleep d/o
neuroleptic sensitivity
Narcolepsy
Diagnosis requires:
* Recurrent periods of irrepressible need to sleep, lapsing into sleep, or napping (≥3x/week for ≥3 months)
AND one or more of the following:
1. Cataplexy (sudden loss of muscle tone, often with strong emotion) 2. Hypocretin deficiency (confirmed via CSF – not routine in OSCEs) 3. PSG/MSLT findings: * PSG: REM latency <15 minutes * MSLT: mean sleep latency <8 minutes, ≥2 sleep-onset REM periods
Also screen for:
* Sleep paralysis
*Hypnagogic/hypnopompic hallucinations
Narcissistic PD
5/9 SPEECH with 5 Es
S : ‘Special’ and unique, can only be understood by or associate with other special or high-status people or institutions
P : Preoccupies with fantasies of unlimited success, power, brilliance, beauty or love
Expects others , does to others :
E : Entitlement , unreasonable expectations of especially fav treat , or auto compliance with expectations
E : Excessive admiration required
E : Envious of others , believes others are envious of them
E : Exploitative interpersonally , takes advantage of others to achieve own ends
E : Empathy lacking , unwilling to recognize or identify with feelings needs of others
C : Conceited , grandiose cense of celf-importance , exaggerates achievements and talents , expects to be recognized as superior without commensurate achievements
H : Haughty arrogant attitudes behav
borderline PD
Borderline 5/9 IMPULSIVE
Impulsive, at least 2 areas, potentially self-damaging (spending, sex, subs use, driving, binge eating)
Moodiness: Affective instability, marked reactivity of mood
Paranoia: Transient, stress-related, paranoia or dissociative symptoms
Unstable self image or sense of self, identity disturbance
Labile intense relationships , alternating between idealization and devaluation
Suicidal behavior, gestures, threats, self-mutilation
Inappropriate anger, intense difficult to control
Vulnerability to abandonment. Frantic efforts to avoid abandonment, real or imagined
Emptiness chronic
Antisocial PD
Antisocial 3/7 CORRUPT (CD < 15)
What they commit and omit :
C : Crimes , conforms to social norms poorly with respect to lawful behavior (acts ground for arrest)
O : Obligations ignored, consistent irresponsibility (fails to sustain work or finances)
Inside , how they feel :
R : Reckless disregard for safety of self or others
R : Remorse lacking (indifferent about or rationalizes hurt, mistreat, steal from another)
So they treat others how?
U : Underhanded, deceitful (lies, aliases, cons for personal profit or pleasure)
Physically , in the moment :
P : Plans ahead poorly or impulsive
T : Temper irritable aggressive (fights or assaults)
Paranoid
4/7 SUSPECT (R/O psychosis)
S : Suspects without sufficient basis, that others exploit, harm, deceive
U : Unforgiving of insults, injuries, slights, bears udges
Who :
S : Spousal or partner infidelity suspected, without justification
P : Preoccupied, with unjustified doubts, about loyalty, trustworthiness of friends, associates
When interacting with others :
E : Easily reacts with anger or counterattacks , perceives attacks on their character or reputation, not apparent to others
C : Confides in others reluctantly, unwarranted fear information will be used maliciouslyT : Threatening or demeaning meanings hidden behind benign remarks or events
Schizotypal PD
5/9 (R/O psychosis and ASD)
Absence of close friend or confidants, other than first-degree relatives
Eccentric , peculiar , odd , appearance and behavior
Affect :
Constricted or inappropriate affect
Anxiety social excessive , does not diminish with familiarity , paranoid fears rather than negative judgement about self
Thought process, content, perception :
Unusual speech and thinking , vague , circumstant
Paranoid ideation or suspiciousness
Ideas of reference
Magical thinking or odd beliefs , influence behavior , inconsistent with subcultural norms , superstitious , clairvoyance, telepathy , 6 sense , in child and ado , bizarre fantasies or preoccupations
Experiences unusual perceptions , incl. bodily illusions
Not psychosis or ASD
Avoidant
Avoidant 4/7 CRINGES
C : Certain of being liked before involved with people
Because what’s on their mind?
R : Rejection or criticism are preoccupations in social situations
And they end up alone :
I : Intimate relationships shows restraint, because of fear of being shamed or ridiculed
N : New interpersonal relationships, inhibited because of feelings of inadequacy
And at work, and other things?G : Gets around occupational activities that involve interpersonal contact, fearing criticism, disapproval, rejection
E : Embarrassing, so reluctant to take personal risks or do new things
All of the above because the :
S : Self as socially inept, personally unappealing, or inferior to others
Dependant
Dependent 5/8 RELIANCE
R : Reassurance and advice from others to make everyday decisions
So they shut up?E : Express disagreement with difficulty, fear of loss of support or approval
The central problem is :
L : Life’s most major areas are others’ responsibilities
And they don’t do things :
I : Initiating projects or doing things on their own difficult, not tired or doesn’t want to, but lack confidence in judgement or abilities
What they feel and do :
A : Alone, feels uncomfortable or helpless, exaggeratedly fears unable to care for self
N : Nurturance or support are sought excessively, to the point of volunteering to do things that are unpleasant
In order to be with someone , to not be left :
C : Close relationship ends, companionship sought urgently as source of care and support
E : Execrates, unrealistically preoccupied with being left to take care of themselves
OCPD
Obsessive-compulsive 4/8 LAW FIRMS
L : Lost the point of details, rules, lists, order, org, or schedules
Consequence being :
A : Ability to complete task hindered by perfectionism
No space in their life for people , which is filled with things , work , ideas , instructions , money :
W : Worn-out or worthless objects, even if no sentimental values, cannot be discarded
F : Friendships and leisure excluded in favor of work, not because of economic necessity
I : Inflexible, scrupulous, over conscientious about morality, ethic, values, not because of culture or religion
R : Reluctant to delegate, unless others do exactly as they want
M : Miserly spending, self and others, money hoarded for future catastrophes
In short :
S : Stubborn and rigid
ID or IDD
Global developmental delay
ID or IDD
A : deficits in intellect, e. g. reason, problem solve, plan, abstract think, judge, academic learn, learn from exp, clinical assessment and standardized testing
B : deficits in adaptive functioning, fails to meet dev and sociocult standards for personal indep and social resp, without ongoing support, functioning limit
C : onset during dev period
Mild, IQ 55-70, 9-11 y. o.
moderate, IQ 40-55, 6-8 y. o.
severe, IQ 25-40, 3-5 y. o.
profound, IQ 25 and less, 3 y. o.
By 15 iq , 3 years
Global developmental delay
Reserved for under age 5
