DSM

Question 1

Schizophrenia DSM 5

Answer 1

A: 2 (or more); each present for a significant portion of time during a 1mo (or less if successfully treated). At least 1 of (1-3)

• 1. Delusions
  2. Hallucinations
  3. Disorganized speech* (e.g. frequent derailment or incoherence)
• *4. Grossly disorganized** or catatonic behavior
• *5. Negative symptoms** (i.e. diminished emotional expression or avolition)

B: Decrease level of function for a significant portion of time since onset, one or more major areas affected (e.g. work, interpersonal relations, self-care) is markedly decreased (or if childhood/adolescent onset, failure to achieve expected level)

C: at least 6mo of continuous signs of disturbance.

• may include periods of prodromal or residual symptoms (during which, disturbance may manifest by only negative symptoms or by two or more criterion A symptoms present in an attenuated form (e.g. odd beliefs, unusual perceptual experiences)

D: rule out schizoaffective disorder and depressive or bipolar disorder with psychotic features because either:

E: rule out other causes: GMC, substances (e.g. drug of abuse, medication)

F: if history of autism spectrum disorder or communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are present for at least 1 month (or less if successfully treated)

Question 2

Schizophrenia epidemiology

Answer 2

• Prevalence: 0,3-0,7 %, (0.5%) M:F = 1:1
• Mean age of onset: females late 20s, males early-to mid 20s
• Suicide risk: 10% die by suicide, 30% attempt suicide

Question 3

Schizophrenia subtypes

Answer 3

Paranoid type

Disorganized type (Hebephrenic)

Catatonic type

Undifferentiated type

Residual type

Question 4

Schizophrenia prgnosis

Answer 4

Over time: 1/3 improve, 1/3 remain the same, 1/3 worsen

Question 5

Schizophreniform disorder DSM5

Answer 5

Criterion A, D, and E of schizophrenia are met. Lasts 1mo-6mo

Question 6

Brief psychotic disorder DSM V

Answer 6

Criterion A1-A4, D, and E of schizophrenia. Lasts 1d-1mo. Eventual return to premorbid level of functioning

w/w.o marked stressor, with postpartum onset, with catatonia, current severity

Question 7

Schizoaffective disorder DSM V

Answer 7

A: concurrent psychosis (criterion A schizophrenia) and a major mood episode – uninterrupted period of illness

B: delusions or hallucinations for 2 or more weeks in the absence of a major mood episode during

C: major mood episode symptoms are present for the majority of the total duration of the active and residual periods of the illness

D: not caused by substance or another medical condition

Question 8

Schizoaffective disorder epidemiology

Answer 8

• 1/3 as prevalent as schizophrenia
• Schizoaffective disorder bipolar type more common in young adults, schizoaffective disorder depressive type ore common in older adults
• Depressive symptoms correlated with higher suicide risk

Question 9

Schizoaffective disorder Treatment

Answer 9

Antipsychotics

Mood stabilizers

Antidepressants

Question 10

Delusional disorder DSM V

Answer 10

A: 1 (or more) delusions with a duration of 1mo or longer

B: Criterion A for schizophrenia has never been met

C: apart from impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd

D: If manic or major depressive episode have occurred, these have been brief relative to the duration of the delusional periods

E: not attributable to physiological effects of a substance or another medical condition and is not better explained by another mental disorder

• Subtypes:

o Erotomanic, grandiose, jealous, persecutory, somatic, mixed, unspecified

• Further specifiy:
  o Bizarre content, type of episode (e.g. first episode, multiple episode), severity

Question 11

Panic disorder DSM V

Answer 11

STUDENTS FEAR the 3 C’s

A) Recurrent unexpected panic attacks – abrupt surge of intense fear/discomfort that reaches a peak within minutes, and during which 4 or more of the following symptoms occur

• Sweating
• Trembling, shaking
• Unsteadiness, dizziness, light-headed, or faint
• Depersonalization, Derealization
• Execessive heart rate, palpitations
• Nausea or abdominal distress
• Tingling, paresthesias (numbness, tingling sensation)
• SOB
• Fear of dying, losing control, going crazy
• Chest pain/discomfort
• Chills or heat sensation
• Choking (feelings of)

B) 1mo (or more) of “anxiety about panic attacks” – at least one of the attacks has been followed by one or both of the following:

• Persistent concern or worry about additional panic attacks or their consequences
• A significant maladaptive change in behavior related to attacks

C) not attributable to the physiological effects of a substance or another medical condition

D) the disturbance is not better explained by another mental disorder

Question 12

Panic disorder Epidemiology

Answer 12

• Prevalence: 2-5%
• M:F = 1:2-3
• Onset: average early-mid 20s
• Familial pattern

Question 13

Agoraphobia DSM V

Answer 13

A) marked fear or anxiety about 2 or more of the following situations

• Using public transportation
• Being in open spaces
• Being in enclosed spaces
• Standing in line or being in a crowd
• Being outside of the home alone

B) the individual fears or avoids these situations because of thoughts that escape might be difficult or help might not be available in the event of developing panic-like symptoms or other incapacitating or embarrassing symptoms

C) the agoraphobic situations almost always provoke fear or anxiety

D) the agoraphobic situations are actively avoided, require the presence of a companion, or are endured with intense fear or anxiety

E) the fear or anxiety is out of proportion to the actual danger posed by the agoraphobic situations and to the sociocultural context

F) the fear, anxiety, or avoidance is persistent, typically lasting > 6 mo

G) the fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning

H) if another medical condition is present, the fear, anxiety, or avoidance is clearly excessive

I) the fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder and are not related exclusively to obsessions, perceived defects or flaws in physical appearance, reminders of traumatic events, or fear of separation

Question 14

GAD DSM V

Answer 14

• C- FIRST

A) excessive anxiety and worry (apprehensive expectation), occurring more thays than not for at least 6mo, about a nr of events or activities (such as work or school performance)

B) the individual finds it difficult to control the worry

C) the anxiety and worry are associated with 3 or more of the following symptoms (with at least some symptoms having been present for more days than not for the past 6 months)

• Concentration issues or mind going blank
• Fatigue
• Irritability
• Restlessness or feeling keyed up or on edge
• Sleep disturbance – difficulty falling or staying asleep, or restless, unsatisfying sleep
• Tension (muscle)

D) the anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

E) The disturbance is not attributable to the physiological effects of a substance or another medical condition

F) the disturbance is not better explained by another mental disorder

Question 15

GAD Epidemiology

Answer 15

• 1 yr prevalence: 3-8%
• M:F = 1:2 inpatient ratio 1:1
• Most commonly present in early adulthood

Question 16

Phobic disorders

Answer 16

Specific phobia:

• Marked and persistent (>6m) fear that is excessive or unreasonable, cued by presence or anticipation of a specific object or situation
• Lifetime prevalence: 12-16%, variable M:F ratio
• Types:
  
  • Animal/insects
  • Environment(heights,storms)
  • Blood/injection/injury
  • Situational(airplane,closedspaces) § Other(loudnoise,clowns)

Social phobia (social anxiety disorder)

• Marked and persistent (>6m) fear of social or performance situations in which one is exposed to unfamiliar people or to possible scrutiny by others; fearing he/she will act in a way that may be humiliating or embarrassing (e.g. public speaking, initiating or maintaining conversation, dating, eating in public)
• 12-month prevalence: 7%
• Generalized social phobia occur in young (around 11y) and appears in majority of social situations.
• Simple social phobia occur after 20y and affects 1-2 social activities (e.g. public speech or eating)

Question 17

OCD DSM V

Answer 17

A) presence of obsessions, compulsions, or both

• Obsessions are defined by 1) and 2)

1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and cause marked anxiety or distress in most individuals
2. the individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e. by performing a compulsion)

• Compulsions are defined by 1) and 2)

1. repetitive behaviours (e.g.hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly
2. behaviours mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; (however, not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive)

B) the obsession or compulsion are time consuming (e.g. take >1h/d) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

C) the obsessive-compulsive symptoms are not attributable to the physiological effects of a substance or another medical condition

D) the disturbance is not better explained by the symptoms of another mental disorder

Question 18

OCD Epidemiology

Answer 18

• 12 month prevalence: 1,1-1,8%, F _slightly > M
• Rate of OCD in first-degree relatives is higher than in the general population

Question 19

PTSD DSM V

Answer 19

TRAUMA

• Traumatic event
• Re-experience the event
• Avoidance of stimuli associated with the event
• Unable to function
• More than a month
• Arousal increased
• + negative alterations in cognition and mood to little), disinhibited social

H) the history is not attributable to the physiological effects of a substance or another medical condition

Question 20

PTSD Epidemiology

Answer 20

• Prevalence of 7% in general population
• Mens - combat experience/physical assault
• womenns - physical or sexual assault

Question 21

Acute stress disorder

Answer 21

• May be a precursor to PTSD
• Similar symptoms to PTSD
• Symptoms persist 3d after a trauma until 1 mo after the exposure

Question 22

Adjustment disorder DSM V

Answer 22

A) the development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3mo of the onset of the stressor(s)

B) the symptoms or behaviors are clinically significant as evidenced by either of the following: Marked distress that is in excess of what would be expected from exposure to the stressor OR Significant impairment in social or occupational (academic) functioning

C) the stress-related disturbance doesn’t meet criteria for another mental disorder and is not merely an exacerbation of a pre-existing mental disorder

D) the symptoms do not represent normal bereavement

E) once the stressor (or its consequences) has terminated, the symptms do not persist for more than an additional 6 months

Question 23

Substance use disorder Criteria

Answer 23

Severity based on nr of criteria met within 12mo:

• mild = 2-3, moderate= 4-5, severe 6 or more

Maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 2 or more of the following occurring within a 12 month period

“PEC WITH MCAT”

• Use despite Physical or Psychological problem
• Failure in important External roles at work/school/home
• Craving or a strong desire to use substance
• Withdrawal
• Continued use despite Interpersonal problems
• Tolerance
• Use in physically Hazardous situations
• More substance used or for longer period than intended
• Unsuccessful attempts to Cut down
• Activities given up due to substance (social, occupational, recreational)
• Excessvie Time spent on using or finding substance

Question 24

Alcohol intoxication

Pathophysiology

Effect of alcohol

Answer 24

• Delayed impulse transmission in CNS
• Arterial hypotension
• Hypoglycemia due to inhibited gluconeogenesis
• Increased diuresis

Question 25

Alcohol intoxication Management

Answer 25

* **Surveillance** and **supportive** tx until danger passes * **Gastric lavage** * Considered in case of children if arrive within 1h * Rarely done in adult due to quick alcohol absoption * Correct **fluid** balance * Vitamin **B1** (thiamine) is given **IV** **before** **glucose** in alcoholics * **Correct** **hypoglycemia** * Alcohol intoxication, unease: **Haloperidol** can be indictated in addition to **benzo** if mared unease/aggression * Hemodialysis

Question 26

Alcohol withdrawal/abstinence stages

Answer 26

Stage 1 (onset **12-18h** after last drink): ***“the shakes”*** **tremor**, sweating, **agitation**, anorexia, cramps, **diarrhea**, sleep disturbance Stage 2 (onset **7-48h**): Alcohol withdrawal **seizures**, usually **tonic-clonic**, non-focal and brief Stage 3 (onset **48h**): Visual, auditory, olfactory, or tactile **hallucinations** Stage 4 (3-5d): **Delirium tremens**, confusion, delusions, hallcuinations, agitation, tremors, autonomic hyperactivity (fever, tachycardia, HTN)

Question 27

Alcohol withdrawal/abstinence Management

Answer 27

Benzo Thiamine If hallucination: Halloperidol Betablockers If seizures: Valproate / Carbamazepine

Question 28

Suicide Epidemiology

Answer 28

* Attempted: completed = 20:1 * M:F - 1:**4** for **attempts**, **3**:1 for **completed**

Question 29

Suicide etiology

Answer 29

**Epidemiologic factors:** * Age: increase after age 14, second most common cause of death for ages 15-24, **highest rate of completion** **\> 65y** * Sex: **male** * Race/ethic background: **white** or native canadians * Marital status: **widowed/divorced** * Living situation: **alone, no children** \<18y old in household * Other: **stressful** life **events**, **access** to **firearms** **Psychiatric disorders:** * **Mood** disorders (15% of lifetime risk in depression, higher in **bipolar**) * **Anxiety** disorders (esp panic disorder) * **Schizophrenia** (10-15% risk) * **Substance** **abuse** (esp alcohol – 15% lifetime risk) * **Eating** disorder (5% lifetime risk) * **Adjustment** disorder * **Conduct** disorder * Personality disorders (**borderline**, **antisocial**) **Past history** * Prior suicide **attempt** * **Family history** of suicide attempt/completion

Question 30

Eating disorders Epidemiology

Answer 30

**Anorexia nervosa**: **1**% adolescents and young adult females, onset 13-20y **Bulimia nervosa**: **2-4**% adolescents and young adult females, onset 16-18y **F**:M = **10:1** Mortality 5-10%

Question 31

Anorexia nervosa DSM V

Answer 31

A) **Restriction of intake** relative to requirements, leading to a **significantly low body weight** in the context of age, sex, developmental trajectory, and physical health. B) Intense **fear of gaining weight** or of becoming fat, or **persistent behavior that interferes with weight gain**, even though at a significantly low weight C) **Disturbance** in the way in which ones **body weight** **or shape is experienced**, undue influence of body weight and shape on self-evaluation, or **persistent lack of recognition of seriousness** of the current low body weight Severity based on BMI * § Mild\>17kg/m2 * § Moderate16-16,99 * § Severe15-15,99

§Extreme<15

Question 32

Anorexia Nervosa Criteria for Hospitalization

Answer 32

* **\< 65%** of **standard** body weight ( \<85% of standard BW for adolescents) * **Hypovolemia** requiring IV fluids * **Heart rate \< 40** * Abnormal **serum chemistry** * Actively **suicidal**

Question 33

Bulimia nervosa DSM V

Answer 33

A) **recurrent** episodes of **binge-eating**; characterized by both the following: * Eating, in a discrete period of time, an amount of food that is definitely larger than what most individuals would eat during a similar period of time and under similar circumstances * A sense of lack of control over eating during the episode B) recurrent **inappropriate compensatory** behavior in order to prevent weight gain, such as self-induced vomiting, misuse of laxatives, diuretics, enemas, or other medications, fasting, or excessive exercise C) the binge-eating and inappropriate compensatory behaviors both occur, on average, at least **1/wk for 3mo** D) **self-evaluation** is unduly influenced **by body shape** and **weight** E) the disturbance **doesn’t** occur exclusively during episodes of **AN** Severity measured in nr inappropriate compensatory behaviors/w § Mild1-3 § Moderate4-7 § Severe8-13 § Extreme14+

Question 34

Binge-eating disorder

Answer 34

Recurrent episodes of binge-eating that are associated with eating much more rapidly than normal, eating until feeling uncomfortably full, eating large amounts when not physically hungry, eating alonen because embarrassed by how much one is eating, feeling disgusted with self/depressed, very guilty afterwards At least **1/wk for 3mo** Epidemiology * F:M = 2:1 * Begins in adolescence or young adulthood

Question 35

Delirium DSM5

Answer 35

A) Disturbance in **Attention** and **awareness** B) **Acute and fluctuating:** fluctuate in severity during the course of a day C) **cognitive changes** D) **not better explained**: Criteria A and C are not better explained by another **neurocognitive disorder** (pre-existing, established, or evolving) and do not occur in the context of a severely reduced level of arousal (e.g. coma) E) **direct physiological cause**: Evidence that disturbance is a direct physiological consequence of another medical condition, substance intoxication or withdrawal (i.e. due to a drug of abuse or medication), toxin, or its due to multiple etiologies

Question 36

Insomnia DSM-5

Answer 36

Dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms: Difficulty **initiating** sleep,Difficulty **maintaining** sleep, Early-morning awakening Other criteria include the following: * The sleep disturbance causes **clinically significant** **distress** or **impairments** in social, occupational, educational, academic, behavioral, or other important areas of functioning * The sleep difficulty occurs at least **3 nights per week** * The sleep difficulty is present for at least **3 mo** * The sleep difficulty occurs despite **adequate opportunity for sleep** * The insomnia **cannot be explained** by and does not occur exclusively during the course of another sleep-wake disorder * The insomnia is not attributable to the physiological effects of a **drug** of abuse or **medication**. * **Coexisting** mental **disorders** and medical conditions **do not** adequately **explain** the predominant complaint of insomnia

Question 37

Hypersomnolence DSM-5 criteria

Answer 37

A) self reported **excessive sleepiness despite** a main sleep period lasting at least **7 hours**, with aleast one of the following symptoms B) the hypersomnolence lasts **3 times/week for at least 3 m** C) the hypersomnolence is accompanied by significant **distress** or **impairment** in cognitive, social, occupational, or other important areas of functioning D) the hypersomnolence is **not better explained** by and doenst occur exclusively during the coruse of another sleep disorder (e.g. narcolepsy, breathing related sleep disorder etc) E) the hypersomnolence is **not attributable to** the physiological effects of a **substance** (e.g. a drug of abuse, a medication) o F) Coexisting mental and medical disorders do not adequately explain the predominant complain of hypersomnolence

Question 38

Narcolepsy DSM V

Answer 38

A) recurrent periods of an irrepressible need to sleep, lapsing in to sleep, or napping occurring within the same day. These must have been occurring at least **3x per week over the past 3 mo** B) presence of at least one of the following: * Episode of **cataplexy**, defined as either occurring at least a few times per month o In individuals with long-standing disease, brief (seconds to minutes) episodes of sudden bilateral loss of muscle tone with maintained consciousness that are precipitated by laughing or jokin * **Hypocretin deficiency** (measured in CSF) * Nocturnal sleep polysomniography showing **REM sleep latency less thann or equal to 15 minutes**, or a multiple sleep latency test showing mean sleep latency less than or equal to 8 minutes and two or more sleep onset REM peridos

Question 39

DSM-5 Diagnostic criteria for **major depressive episode**

Answer 39

A) **5 or more** of the following present during the same **2 week** period and represent a change from previous functioning, at least one of the symptoms is either 1) 3) 1. Mood: Depressed 2. Sleep: increased/decreased 3. Interest: Decreased 4. Guilt 5. Energy: Decreased 6. Concentration: Decreased 7. Appetite: increased/decreased 8. Psychomotor: agitation/retardation B) The symptoms cause clinically significant **distress** or **impairment** in social, occupational, or other important areas of functioning C) the episode is **not attributable** to the direct physiological effects of a **substance** or a **GMC**

Question 40

DSM-5 Criteria for **manic episode**

Answer 40

* A) A distinct period of **abnormally and persistently elevated**, expansive, or **irritable mood** and abnormally and persistently increased goal-directed activity or energy, lasting **\> 1 week** and present most off the day, nearly every day (or any duration if **hospitalization** is necessary). * B) During the period of mood disturbance and increased energy or activity, **3 or more** of the following symptoms have persisted (4 if the mood is only irritable) and have been present for a significant degree and represent a noticeable change from usual behavior: ***GSTPAID*** * **G**randiosity * **S**leep (decreased need) * **T**alkative * **P**leasurable activity, painful consequences * **A**ctivity (goal directed) * **I**deas (flight off) * **D**istractible * C) The mood disturbance is sufficiently severe to cause marked **impairment** in social or occupational **functioning** or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features * D) The episode is **not attributable** to the physiological effects of a **substance** or another **medical** condition

Question 41

MDD DSM V + Epidemiology

Answer 41

DSM-5 diagnostic criteria A-C) Presence of a MDE D) the MDE is **not better accounted for by schizoaffective disorder** and is not superimposed on **schizophrenia**, **schizophreniform** disorder, delusional disorder, or psychotic disorder NOS E) there has never been a manic episode or a hypomanic episode **Epidemiology** * Lifetime prevalence: 12% * Peak prevalence: 15-25 y (M:F = 1:2)

Question 42

Persistent depressive disorder DSM-5 criteria

Answer 42

* A) **depressed** mood for **most of the day, for more days than not**, as indicated either by subjective account or observation by others, for **\>2 years** * B) presence, while depressed, of 2 or more of the following: * Appetite: increased/decreased * Insomnia/hypersomnia * Lowenergy/fatigue * Lowself-esteem * Poor concentration or difficulty making decisions * Feelings of hopelessness * C) during the 2y period (1y for children/adolescents) of the disturbance, the person has **never been without the symptoms** in criteria A and B for **more than 2 months** at a time * D) criteria for a MDD may be continuously present for **2 y** * E) there has **never been a manic** episode or a hypomanic episode, and criteria have never been met for cyclothymic disorder * F) the disturbance is **not better explained** by a persistent **schizoaffective** disorder, **schizophrenia**, delusional disorder, or other specificied or unspecified schizophrenia spectrum and other psychotic disorder

Question 43

Cyclothymia Diagnosis

Answer 43

* Presence of numerous episodes of hypomanic and depressive symptoms (not meeting criteria for full hypomanic or MDE) for **\>2y**, never without symptoms for **more than 2 months** * Never met criteria for MDE, manic, or hypomanic episodes * Symptoms are **not** **due** to direct physiological effects of a **substance** or **GMC** * Symptoms cause clinically **significant** **distress** or imp**airment** in social occupational, or other important areas of functioning

Question 44

Sexual dysfunctions

Answer 44

* Criterion B: symptoms of A have persisted for a **minimum of 6 months** * Criterion C: symptoms of A cause clinically significant distress in the individual * Criterion D: the sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition * 1. Male hypoactive sexual desire disorder * 2. Female sexual interest/arousal disorder * 3. Male erectile disorder * 4. Female orgasmic disorder * 5. Delayed ejaculation * 6. Premature (early ejaculation) * 7. Genito-pelvic pain/penetration disorder * 8. Sexual dysfunction due to a general medical condition * 9. Substance/medication induced sexual dysfunction * 10. Other specified sexual dysfunction * 11. Unspecified sexual dysfunction

Question 45

Paraphilia DSM5

Answer 45

Patient experienced **intense and recurrent arousal** from their deviant fantasy for **at least 6 mo** and to have **acted on the paraphilic** impulse

Question 46

Major neurocognitive disorder (Dementia) DSM V

Answer 46

- “4 A’s: amnesia, aphasia, apraxia, agnosia” A) evidence of significant **cognitive decline** from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on * 1. Concern of the **individual**, a knowledgeable **informant**, or the **clinician** that there has been a significant decline in cognitive function; and * 2. Substantial **impairment** in cognitive **performance**, preferably documented bby standardized neuropsychological testing, or, in its absence, another quantified clinical assessment B) Cognitive deficits interfere with independence in everyday activities (i.e. at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications) o Note: if do not interfere in B, and impairments are mild-moderate in A, considered “mild cognitive disorder” C) cognitive deficits do **not** occur exclusively in the context of a **delirium** D) cognitive deficits are **not better** **explained** by another **mental** disorder (e.g. MDD, schizophrenia)

Question 47

Somatic symptom disorder DSM5 criteria

Answer 47

A) **one or more somatic** symptoms that are distressing or result in significant disruption of daily life B) **excessive thoughts, feelings**, or behaviors related to the somatic symptoms or associated health concerns as manifested by at least one of the following: 1. **Disproportionate** and persistent thoughts about the seriousness of ones symptoms 2. **Persistently** high level of **anxiety** about health or symptoms 3. **Excessive** time and **energy** devoted to these symptoms or health concerns C) although any one somatic symptom may not be continuously present, the state of being symptomatic is persistent (typically **\> 6m**)

Question 48

Somatic symptom disorder

Answer 48

lifetime prevalence: **5-7%**

Question 49

Illness anxiety disorder (formerly hypochondriasis) DSM5 criteria

Answer 49

* The individual is **preoccupied** with having or acquiring a serious illness * **Somatic symptoms are not present** or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g. strong family history is present), the preoccupation is clearly excessive or disproportionate * The individual has **high level of anxiety about health**, and is easily alarmed about personal health satus * The individual preforms excessive health-related behaviors or exhibits maladaptive avoidance * The individual has been preoccupied with illness for **at least 6 months** * The individuals preoccupation is **not better explained** by another mental disorder

Question 50

Conversion disorder DSM criteria

Answer 50

* **One or more symptoms** of **altered voluntary or sensory function** * Physical findings provide evidence of incompatibility btw the symptom and recognized neurological or medical conditions * The symptom or deficit is **not better explained** by another medical or mental disorder * The symptom or deficit causes clinically **significant distress** or **impairment** in social, occupational, or other important areas of functioning or warrants medical evaluation