Flashcards in dx criteria Deck (18):
Restricting Type AN
3 months of no binging or purging (no self-induced vomiting or use of laxatives)
Excessive exercising, fasting, dieting
Major Depressive Episode (and in elderly)
At least five (4 for elderly)of the following for a 2-week period with at least one either (1) depressed mood or (2) loss of interest or pleasure:
Depressed mood most of the day, nearly every day
Markedly diminished interest or pleasure in all, or almost all, activities most of the day nearly every day (anhedonia)
Significant weight loss or weight gain when not dieting (usu loss)
Insomnia or hypersomnia nearly every day (antisuppressnats make worse)
Psychomotor agitation or retardation nearly every day
Fatigue or loss of energy nearly every day
Feelings of worthlessness or excessive guilt
Diminished ability to think or concentrate
Bipolar I Disorder (has mania)
• Single manic episode is necessary to diagnose. (Patient only need one “pole” of the bipolar for this diagnosis.)
• At least one manic or mixed episode.
• Major depressive episode not required for diagnosis
o But is usually is the episode that presents first
o Delusions (not always “nonbizzare”, ie. involving situations that could occur in real life such as being followed, poisoned, or infected, having a disease, being loved at a distance) of at least 1 month’s duration.
o Has never met criterion A for schizophrenia (for more than a few hours).
o Apart from the impact of the delusion, functioning is not impaired and behavior is not odd or bizarre.
Bipolar II Disorder (mania)
• Patients have had at least one major depressive episode and one hypomanic episode in the absence of any manic or mixed episodes
o Meets criteria A, D and E for schizophrenia.
o An episode of the disorder lasts at least 1 month but less than 6 months. (schizo must be more than 6 mos)
A. Two (or more) of the Following for Most of 1 Month; at least one of the first 3 symptoms
Grossly Disorganized or Catatonic Behavior
B. Marked social or occupational dysfunction.
C. Duration of at least 6 months of persistent symptoms such as attenuated forms of group A symptoms (above) or negative symptoms. At least 1 month of this must include a group A symptom.
D. Symptoms of schizoaffective and mood disorder ruled out.
E. Substance abuse and medical conditions ruled out as etiologic
o Uninterrupted period of illness with either a major depressive episode or manic episode concurrent with symptoms that meet criterion A for schizophrenia.
o Same period of illness, have been delusions or hallucinations for at least 2 weeks in the absence of prominent mood symptoms.
Catatonic Type of Schizophrenia
The clinical picture is dominated by at least two of the following:
• Motoric immobility as evidenced by catalepsy or stupor.
• Excessive motor activity (apparently purposeless and not influenced by external stimuli).
• Extreme negativism or mutism.
• Peculiarities of voluntary movement such as posturing, stereotyped movements, prominent mannerisms or prominent grimacing.
• Echolalia or echopraxia.
Similar to manic episode but is less severe. Episodes only need to last 4 days and must not include psychotic features
o No social/occupational impairment
Both (1) and (2):
(1) Recurrent unexpected panic attacks. (See next slide for criteria of panic attacks.)
(2) At least one attack followed by 1 month or more of one or more:
o Persistent concern about additional attacks.
o Worry about the implications of the attack or its consequences (ie losing control, heart attack, etc).
o Significant change in behavior related to the attacks.
Generalized Anxiety Disorder
Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, for most of day, about a number of events or activities.
It is difficult to control the worry.
The anxiety and worry are associated with at least three persisting for more days than not of the past 6 months:
• Restlessness or Feeling On Edge
• Easily Fatigued
• Difficulty Concentrating
• Muscle Tension
• Sleep Disturbance
• Characterized as dysthymic disorder with intermittent hypomanic periods
• Patient who, over the last 2 years (1 year for children), experiences repeated episodes of hypomania and depression (not severe enough to meet criteria for major depressive disorder)
• During the first 2 years the patient may not have major depressive, manic, or mixed episode.
Binge-eating/purging type AN
3 months of the binging and purging behaviors
Misuse of laxatives, diuretics, enemas
Abnormally and persistently elevated, expansive, or irritable mood lasting at least 1 week with at least three of the following:
o During the mood disturbance and increased energy, three of the following:
Inflated Self-Esteem or Grandiosity
Decreased Need for Sleep (not tired)
More Talkative (pressured/push of speech)
Flight of Ideas / Racing Thoughts
Increased Goal-Oriented Behavior
Excessive Involvement in Pleasurable Activities
A discrete period of intense fear or discomfort, in which four or more of the following developed abruptly and reached peak within 10 minutes and usually last <25 mins: Now specified as “unexpected and expected” panic attack
o Trembling / Shaking
o Sensations of Shortness of Breath
o Chest Pain or Discomfort
o Feeling Dizzy / Unsteady / Lightheaded
o Fear of Losing Control or Going Crazy or Dying
o Chills or Hot Flashes
Brief Psychotic Disorder
Presence of at least of the the following:
Grossly Disorganized or Catatonic Behavior
Duration of an episode of the disturbance is at least 1 day and no more than 1 month, with eventual return to premorbid level of functioning.