Final

Question 1

Delusional Disorder (5 criteria)

Answer 1

A. The presence of one delusions with a duration of 1 month or longer
B. Criterion A for schizophrenia has never been met (Hallucinations, if present, are not prominent and are related to the delusional theme (e.g. the sensation of being infected with insects associated with delusions of infestation).
C. Apart from the impact of the delusions(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd
D. If manic or major depressive episodes have occurred, these have been brief relative to the duration of the delusional periods
E. The disturbance is not attributable to the psychological effects of a substance or another medical condition and is not better explained by another mental disorder, such as body dysmorphic disorder or obsessive-compulsive disorder.

Question 2

In schizoaffective disorder, a mood episode and the active phase symptoms of blank occur together and were preceded or are followed by a least blank weeks of delusions or hallucinations without prominent mood symptoms.

Answer 2

Blank: schizophrenia
Blank: 2

Question 3

Schizophrenia lasts for at least blank months and includes at least blank month of active-phase symptoms

Answer 3

Blank: 6
Blank: 1

Question 4

is characterized by a symptomatic presentation equivalent to that of schizophrenia except for its duration (less than 6 months) and the absence of a requirement for a decline in functioning.

Answer 4

Schizophreniform disorder

Question 5

Brief psychotic disorder lasts more than blank day and remits by blank month

Answer 5

Blank: 1
Blank: 1

Question 6

Delusional disorder is characterized by at least blank month of delusions but no other psychotic symptoms

Answer 6

Blank: 1

Question 7

The diagnosis blank captures a pervasive pattern of social and interpersonal deficits, including reduced capacity for close relationships, cognitive or perceptual distortions; and eccentricities of behavior, usually beginning by early adulthood but in some cases first becoming apparent in childhood and adolescence.

Answer 7

schizotypal personality disorder

Question 8

refers to the apparent lack of interest in social interactions and may be associated with avolition, but it can also be a manifestation of limited opportunities for social interactions

Answer 8

Asociality

Question 9

is a decreased ability to experience pleasure from positive stimuli or a degradation in the recollection of pleasure previously experienced

Answer 9

Anhedonia

Question 10

is manifested by diminished speech output

Answer 10

Alogia

Question 11

is a decrease in motivated self-initiated purposeful activities. The individual may sit for long periods of time and show little interest in participating in work or social activities.

Answer 11

Avolition

Question 12

includes reductions in the expression of emotions in the face, eye contact, intonation of speech (prosody), and movements of the hand, head, and face that normally given an emotional emphasis to speech

Answer 12

Diminished emotional expression

Question 13

Negative symptoms (5)

Answer 13

1. Diminished emotional expression (Flat affect)
2. Avolition (loss of motivation)
3. Anhedonia (lack of pleasure)
4. Asociality (lack of interest in social interactions)
5. Alogia (poverty of speech)
   ? Attention deficits

Question 14

is a marked decrease in reactivity to the environment. This ranges from resistance to instructions (negativism); to maintaining a rigid, inappropriate or bizarre posture; to a complete lack of verbal and motor responses (mutism and stupor). It can also include purposeless and excessive motor activity without obvious cause (catatonic excitement). Other features are repeated stereotyped movements, staring, grimacing, mutism, and the echoing of speech.

Answer 14

Catatonic behavior

Question 15

may manifest itself in a variety of ways, ranging from childlike “silliness” to unpredictable agitation. Problems may be noted in any form of goal-directed behavior, leading to difficulties in performing activities of daily living.

Answer 15

Grossly disorganized or abnormal motor behavior

Question 16

is typically inferred from the individual’s speech. The individual may switch from one topic to another (derailment or loose associations). Answers to questions may be obliquely related or completely unrelated (tangentiality). Rarely, speech may be so severely disorganized that it is nearly incomprehensible and reassembles receptive aphasia in its linguistic disorganization (incoherence or word salad).

Answer 16

Disorganized thinking (formal thought disorder)

Question 17

the central theme of the delusion is that another person is in love with the individual. The person about whom this conviction is held is usually of higher status but can be a complete stranger

Answer 17

erotomanic type

Question 18

the central theme of the delusion is the conviction of having some great talent or insight or of having made some important discovery.

Answer 18

grandiose type

Question 19

the central theme of the delusion is that of an unfaithful partner. This belief is arrived at without due cause and is based on incorrect inferences supported by small bits of evidence.

Answer 19

jealous type

Question 20

the central theme of the delusion involves the individual’s belief of being conspired against, cheated, spied on, followed, poisoned, maliciously maligned, harassed, or obstructed in the pursuit of long term goals.

Answer 20

persecutory type

Question 21

the central theme of the delusion involves bodily functions or sensations. Most common is the belief that the individual emits a foul odor; that there is an infestation of insects on or in the skin; that there is an internal parasite; or that parts of the body are not functioning

Answer 21

somatic type

Question 22

Social, marital, or work problems can result from the blank beliefs of blank disorder. Individuals with blank disorder may be able factually describe that others view their beliefs as irrational but are unable to accept this themselves.

Answer 22

Blank: delusional
Blank: delusional
Blank: delusional

Question 23

Brief psychotic disorder (3 criteria)

A. Presence of one or more of the following symptoms. At least one of these must be (1), (2), or (3): There are 4

Answer 23

A. Presence of one or more of the following symptoms. At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
B. Duration of an episode of the disturbance is at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning.
C. The disturbance is not better explained by major depressive or bipolar disorder with psychotic features or another psychotic disorder such as schizophrenia or catatonia, and is not attributable to the physiological effects of a substance.

Question 24

Brief psychotic disorder
B. Duration of an episode of the disturbance is at least blank day but less than blank month, with eventual full return to premorbid level of functioning.

Answer 24

Blank: 1
Blank: 1

Question 25

Individuals with blank typically experience emotional turmoil or overwhelming confusion. They may have rapid shifts from one intense affect to another. Although the disturbance is brief, the level of impairment may be severe, and supervision may be required to ensure that nutritional and hygienic needs are met and that the individual is protected from the consequences of poor judgment, cognitive impairment, or acting on the basis of delusions.

Answer 25

Blank: brief psychotic disorder

Question 26

The essential feature of blank is a disturbance that involves the sudden onset of at least one of the following positive psychotic symptoms: delusions, hallucinations, disorganized speech, or grossly abnormal psychomotor behavior, including catatonia

Answer 26

blank: brief psychotic disorder

Question 27

Schizophreniform Disorder 4 Criteria (Master Card)
A. Two or more of the following, each present for a significant portion of time during a blank month period or less if successfully treated. At least one of these must be (1), (2), or (3).
1.
2.
3.
4.
5.

Answer 27

A. Two or more of the following, each present for a significant portion of time during a 1 month period or less if successfully treated. At least one of these must be (1), (2), or (3).
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms
B. An episode of the disorder lasts at least 1 month but less than 6 months. When the diagnosis must be made without waiting for recover, it should be qualified as “provisional”
C. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either (1) no major depressive or manic episodes have occurred concurrently with the active phase symptoms, or (2) if mood episodes have occurred during active phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness
D. The disturbance is not attributable to the physiological effects of a substance or another medication condition.

Question 28

Schizophreniform Disorder 4 Criteria
B. An episode of the disorder lasts at least blank month but less than blank months. When the diagnosis must be made without waiting for recover, it should be qualified as “blank”

Answer 28

Blank: 1
Blank: 6
Blank: Provisional

Question 29

The characteristic symptoms of blank are identical to those of schizophrenia

Answer 29

schizophreniform disorder

Question 30

For the majority of individuals with blank who eventually receive a diagnosis of schizophrenia or schizoaffective disorder, the functional consequences are similar to the consequences of those disorders. Most individuals experience dysfunction in several areas of daily functioning, such as school or work, interpersonal relationships, and self care. Individuals who recover from blank have better functional outcomes

Answer 30

blank: schizophreniform disorder
blank: schizophreniform disorder

Question 31

Schizophrenia Diagnostic Criteria (6) Master Card
A. Two or more of the following, each present for a significant portion of time during a blank month period or less if successfully treated. At least one of these must be (1), (2), or (3):
1.
2.
4.
5.

Answer 31

A. Two or more of the following, each present for a significant portion of time during a 1 month period or less if successfully treated. At least one of these must be (1), (2), or (3):
1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms
B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset ( or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).
C. Continuous signs of the disturbance persist for at least 6 months. This 6 month period must include at least 1 month of symptoms that meet criterion A and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated from (e.g., odd beliefs, unusual perceptual experiences).
D. Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either (1) no major depressive or manic episodes have occurred concurrently with the active phase symptoms, or (2) if mood episodes have occurred during active phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
E. The disturbance is not attributable to the physiological effects of a substance or another medical condition
F. If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia are also present for at least 1 month.

Question 32

Major Criteria for what?
B. For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset ( or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).

Answer 32

Schizophrenia

Question 33

Diagnosis Criteria for what?
C. Continuous signs of the disturbance persist for at least blank months. This blank month period must include at least blank month of symptoms that meet criterion A and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated from (e.g., odd beliefs, unusual perceptual experiences).

Answer 33

Blank: 6

blank: 6
blank: 1

Question 34

Positive Symptoms of schizophrenia (4)

Answer 34

1. Hallucinations
2. Delusions
3. Disorganized speech (frequent derailment or incoherence)
4. Grossly disorganized speech or catatonic behavior

Question 35

The characteristic symptoms of blank involve a range of cognitive, behavioral, and emotional dysfunctions, but no single symptom is pathognomonic of the disorder. The diagnosis involves the recognition of a constellation of signs and symptoms associated with impaired occupational or social functioning. Individuals with the disorder will vary substantially on most features, as blank is a heterogeneous clinical syndrome.

Answer 35

blank: schizophrenia
blank: schizophrenia

Question 36

Individuals with blank may display inappropriate affect (e.g., laughing in the absence of an appropriate stimulus); a dysphoric mood that can take the form of depression, anxiety, or anger; a disturbed sleep pattern (e.g., daytime sleeping and nighttime activity); and a lack of interest in eating or food refusal. Depersonalization, derealization, and somatic concerns may occur and sometimes reach delusional proportions.

Answer 36

Schizophrenia

Question 37

Schizoaffective Disorder Diagnostic Criteria (4) Master Card:
A. An uninterrupted period of illness during which there is a blank concurrent with criterion A of blank

Answer 37

A. An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with criterion A of schizophrenia
B. Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness
C. Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness
D. The disturbance is not attributable to the effects of a substance or another medical condition

Question 38

Disorder Criteria for what?
B. Delusions or hallucinations for blank or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness

Answer 38

Schizoaffective Disorder

blank 2

Question 39

The diagnosis of blank is based on the assessment of an uninterrupted period of illness during which the individual continues to display active or residual symptoms of psychotic illness. The diagnosis is usually, but not necessarily, made during the period of psychotic illness.

Answer 39

blank: schizoaffective disorder

Question 40

Occupational functioning is frequently impaired, but this is not a defining criterion. Restricted social contact and difficulties with self-care are associated with blank, but negative symptoms may be less severe and less persistent than those seen in schizophrenia. Anosognosia (poor insight) is also common in schizoaffective disorder, but the deficits in insight may be less severe and pervasive than those in schizophrenia. Individuals with blank may be at increased risk for later developing episodes of major depressive disorder or bipolar disorder if mood symptoms continue following the remission of symptoms meeting criterion A for schizophrenia. There may be associated alcohol and other substance related disorder.

Answer 40

blank: schizoaffective disorder
blank: schizoaffective disorder
blank: schizoaffective disorder

Question 41

Substance/Medication-Induced psychotic disorder (6 criteria)

Answer 41

A. Presence of one or both of the following symptoms:
1. Delusions
2. Hallucinations
B. There is evidence from the history, physical examination, or laboratory findings of both (1) and (2):
1. The symptoms in Criterion A developed during or soon after substance intoxication or withdrawal or after exposure to a medication
2. The involved substance/medication is capable of producing the symptoms in Criterion A
C. The disturbance is not better explained by a psychotic disorder that is not substance/medication-induced. Such evidence of an independent psychotic disorder could include the following: The symptoms preceded the onset of the substance/medication use; the symptoms persist for a substantial period of time (e.g., about 1 month) after the cessation of acute withdrawal or severe intoxication; or there is other evidence of an independent non-substance/medication-induced psychotic disorder.
D. The disturbance does not occur exclusively during the course of a delirium
E. The disturbance causes clinically significant distress or impairment in social, occupation, or other important areas of functioning.
F. This diagnosis should be made instead of a diagnosis of substance intoxication or substance withdrawal only when the symptoms in Criterion A predominate in the clinical picture and when they are sufficiently severe to warrant clinical attention.

Question 42

Psychotic disorder due to another medical condition (5 diagnostic criteria)

Answer 42

A. Prominent hallucinations or delusions
B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition
C. The disturbance is not better explained by another mental disorder
D. The disturbance does not occur exclusively during the course of a delirium
E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Question 43

What diagnostic criteria?
A. the clinical picture is dominated by three (or more) of the following symptoms:
1. stupor (no psychomotor activity; not actively relating to environment)
2. Catalepsy (passive induction of a posture held against gravity).
3. Waxy flexibility (slight, even resistance to positioning by examiner).
4. Mutism (no, or very little, verbal response)
5. Negativism (opposition or no response to instructions or external stimuli)
6. Posturing (spontaneous and active maintenance of a posture against gravity)
7. Mannerism (odd, circumstantial caricature of normal actions
8. Stereotype (repetitive, abnormally frequent, non-goal-directed movements)
9. Agitation, not influenced by external stimuli
10. Grimacing
11. Echolalia (mimicking another speech)
12. Echopraxia (mimicking another’s movements)

Answer 43

Catatonia associated with another mental disorder

Question 44

For a diagnosis of blank, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes

Answer 44

Bipolar I Disorder

Question 45

Manic Episode (4 diagnostic criteria) Master Card

Answer 45

A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day ( or any duration if hospitalization is necessary).
B. During the period of mood disturbance and increased energy or activity, three or more of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep
3. More talkative than usual or pressure to keep talking
4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility, as reported or observed
6. Increase in goal directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e. purposeless non-goal directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences
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 medication condition. A full manic episode that emerges during antidepressant treatment but persists at a fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode and, therefore, a bipolar I diagnosis.

Question 46

What diagnostic criteria?
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least blank week and present most of the day, nearly every day ( or any duration if hospitalization is necessary).

Answer 46

Manic Episode

blank: 1 week

Question 47

What diagnostic criteria (2 possibilities)?
B. During the period of mood disturbance and increased energy or activity, three or more of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep
3. More talkative than usual or pressure to keep talking
4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility, as reported or observed
6. Increase in goal directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e. purposeless non-goal directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences

Answer 47

Manic episode vs hypomanic episode

Question 48

Hypomanic Episode (5 diagnostic criteria)

Answer 48

A. a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day
B. During the period of mood disturbance and increased energy and activity, three or more of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
1. Inflated self-esteem or grandiosity
2. Decreased need for sleep
3. More talkative than usual or pressure to keep talking
4. Flight of ideas or subjective experience that thoughts are racing
5. Distractibility, as reported or observed
6. Increase in goal directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e. purposeless non-goal directed activity).
7. Excessive involvement in activities that have a high potential for painful consequences
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.

Question 49

What diagnostic criteria?
A. a distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least blank consecutive days and present most of the day, nearly every day

Answer 49

Hypomanic Episode

blank: 4

Question 50

What diagnostic criteria?
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.

Answer 50

Hypomanic episode

Question 51

Major Depressive Episode 3 diagnostic criteria

Answer 51

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, early every day
3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day
4. Insomnia or hypersomnia nearly every day
5. Psychomotor agitation or retardation nearly every day
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
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 physiological effects of a substance or another medical condition.

Question 52

Mania vs hypomanic time line and intensity

Answer 52

mania lasting at least 1 week and causes marked impairment in social and occupational functioning vs hypomanic lasting at least 4 consecutive days and not severe enough to cause impairment in social or occupational settings.

Question 53

Is hypomanic episode or major depressive episode require for diagnosis of bipolar I disorder?

Answer 53

NO, only necessary to meet the criteria of manic episode.

Question 54

The essential feature of blank is a distinct period during which there is an abnormally, persistently elevated, expansive, or irritable mood and persistently increased activity or energy that is present for most of the day, nearly every day, for a period of at least 1 week, accompanied by at least three additional symptoms from Criterion B. If the mood is irritable rather than elevated or expansive, at least four criterion B symptoms must be present.

Answer 54

manic episode

Question 55

For a diagnosis of blank, it is necessary to meet the following criteria for a current or past hypomanic episode and the following criteria for a current or past major depressive episode. There has never been a manic episode.

Answer 55

Bipolar II disorder

Question 56

Blank is characterized by a clinical course of recurring mood episodes consisting of one or more major depressive episodes and at least one hypomanic episode. The major depressive episode must last at least blank weeks, and the hypomanic episode must last at least blank days, to meet the diagnostic criteria.

Answer 56

Blank: bipolar II disorder

blank: 2
blank: 4

Question 57

Individuals with blank disorder typically present to a clinician during a major depressive episode and are unlikely to complain initially of hypomania.

Answer 57

blank: bipolar II disorder

Question 58

Diagnostic criteria of what?
A. Severe recurrent temper outbursts manifested verbally and/or behaviorally that are grossly out of proportion in intensity or duration to the situation or provocation
B. The temper outbursts are inconsistent with developmental level
C. The temper outbursts occur, on average, three or more times per week
D. The mood between temper outbursts is persistently irritable or angry most of the day nearly every day, and is observable by others
E. Criteria A-D have been present for blank or more months. Throughout that time, the individual has not had a period lasting 3 or more consecutive months without all of the symptoms in Criteria A-D
F. Criteria A and D are present in at least two of three settings (i.e., at home, at school, with peers) and are severe in at least one of these.
G. The diagnosis should not be made for the first time before age blank years or after age blank years.
H. By history or observation, the age at onset of Criteria A-E is before blank years
I. there has never been a distinct period lasting more than 1 day during which the full symptom criteria, except duration, for a manic or hypomanic episode have been met.
J. The behaviors do not occur exclusively during an episode of major depressive disorder and are not better explained by another mental disorder.
K. The symptoms are not attributable to the physiological effects of a substance or another medical or neurological condition

Answer 58

Disruptive mood dysregulation disorder
E. 12
G. 6, 18
H. 10

Question 59

The onset of blank must be before age 10 years, and the diagnosis should not be applied to children with a developmental age of less than 6 years.

Answer 59

disruptive mood dysregulation disorder

Question 60

Diagnostic Criteria of what?
A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. (in children and adolescents, mood can be irritable and duration must be at least 1 year
B. Presence, while depressed, of two or more of the following:
1. poor appetite or overeating
2. Insomnia or hypersomnia
3. Low energy or fatigue
4. Low self-esteem
5. Poor concentration or difficulty making decisions
6. Feelings of hopelessness
C. During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time.
D. Criteria for a major depressive disorder may be continuously present for 2 years.
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 specified or unspecified schizophrenia spectrum and other psychotic disorder
G. The symptoms are not attributable to the physiological effects of a substance or another medical condition
H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Answer 60

Persistent Depressive Disorder (Dysthymia)

Question 61

The essential feature of blank is a depressed mood that occurs for most of the day, for more days than not, for at least 2 years, or at least 1 year for children and adolescents

Answer 61

Persistent depressive Disorder (dysthymia)

Question 62

Diagnostic criteria of what?
A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
B. One (or more) of the following symptoms must be present:
1. Marked affective lability (e.g. mood swings; feeling suddenly sad or tearful, or increased sensitivity to rejection).
2. Marked irritability or anger or increased interpersonal conflicts
3. marked depressed mood, feelings of hopelessness, or self-deprecating thoughts
4. marked anxiety, tension, and/or feelings of being keyed up or on edge.
C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
1. Decreased interest in usual activities
2. Subjective difficulty in concentration
3. Lethargy, easy fatigability, or marked lack of energy
4. Marked change in appetite; overeating; or specific food cravings.
5. Hypersomnia or insomnia
6. A sense of being overwhelmed or out of control
7. Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain.
Note: The symptoms in criteria A-c must have been met for most menstrual cycles that occurred in the preceding year
D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others
E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder, or a personality disorder.
F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles
G. The symptoms are not attributable to the physiological effects of a substance

Answer 62

Premenstrual dysphoric disorder

Question 63

the essential features of blank are the expression of mood lability, irritability, dysphoria, and anxiety symptoms that occur repeatedly during the premenstrual phase of the cycle and remit around the onset of menses or shortly thereafter.

Answer 63

premenstrual dysphoric disorder

Question 64

Diagnostic Criteria to what?
The following criteria apply to adults, adolescents, and children older than 6 years. For children 6 years and younger, see corresponding criteria.
A. Exposure to actual or threatened death, serious injury, or sexual violence in one of the following ways:
1. Directly experiencing the traumatic event
2. Witnessing, in person, the events as it occurred to others
3. Learning that the traumatic event occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the events must have been violent or accidental.
4. Experiencing repeated or extreme exposure to averse details of the traumatic events (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse).

Answer 64

Posttraumatic stress disorder

Question 65

Diagnostic criteria of what?
B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred:
1. Recurrent, involuntary, and intrusive distressing memories of the traumatic event(s). Note in children older than 6 years, repetitive play may occur in which themes or aspects of the traumatic events(s) are expressed.
2. Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s).
3. Dissociative reactions (e.g. flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. (such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings.) Note: In children, trauma-specific reenactment may occur in play.
4. Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).
5. Marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event(s).

Answer 65

Posttraumatic stress disorder

Question 66

Diagnostic criteria of what?
C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:
1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).
2. Avoidance of or efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Answer 66

Posttraumatic Stress Disorder

Question 67

Diagnostic Criteria of what?
D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:
1. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs).
2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the word (e.g., “I am bad,” “no one can be rusted,” “the world is completely dangerous,” “My whole nervous system is permanently ruined”).
3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.
4. Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
5. Markedly diminished interest or participation in significant activities.
6. Feelings of detachment or estrangement from others.
7. Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings).

Answer 67

Posttraumatic stress disorder

Question 68

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by tow (or more) of the following:
1. Irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects.
2. Reckless or self-destructive behavior
3. hypervigilance
4. Exaggerated startle response
5. Problems with concentration
6. Sleep disturbance
F. Duration of the disturbance (Criteria B,C, D, and E) is more than 1 month.
G. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
H. The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

Answer 68

Posttraumatic stress disorder

Question 69

Common for this disorder:
Presence of sad, empty, or irritable mood
Accompanied by somatic and cognitive changes that significantly affect the person’s ability to function

Answer 69

mood disorders

Question 70

Common for this disorder:
Core feature: chronic, severe persistent irritability
Do not diagnose before the age of 6 or after age 18 and the onset must occur before age 10 years
Prevalence:
Common in children being seen in pediatric mental health clinics (2-5%)
More common in males and school age children
Etiology:
Complicated psych histories. Possible history of DD, ADHD, Anxiety disorder, and some MDD.
Diagnosis:
Occur frequently 3x week over the past year, in at least 2 settings and be developmentally inappropriate
irritable mood that is present between severe temper outburst

Answer 70

Disruptive mood dysregulation disorder

Question 71

Treatment for disruptive mood dysregulation disorder

Answer 71

Individualized
includes individual therapy, family therapy, parent training, school interventions
Antidepressants: fluoxetine
Anti psychotics: risperidone or aripiprazole
Consider stimulants if appropriate and if it is the cause of the symptoms

Question 72

Common symptoms for this diagnosis:
Five or more symptoms present during the same 2 week period
Change from previous functioning
Must have either depressed mood or loss of interest pleasure
Prevalence
7% in the US
18-29 year old 3 x higher prevalence than those 60 plus
1.5-3 x higher rates in females

Answer 72

Major depressive disorder

remember if functioning normally then just sadness possibly

Question 73

Symptoms of this disorder: SIGECCAPS
Sleep changes
Interest (loss)
Guilt (worthlessness)
Energy (lack)
Cognition/Concentration (reduced)
Appetite (wt. loss)
Psychomotor (agitation)
Suicide

Answer 73

Major Depressive Disorder

Question 74

Colombia Suicide Severity Rating Scale

Answer 74

Best to assess for suicide

Question 75

Treatment for Major Depressive Disorder

Answer 75

Psychotherapy, vagal nerve stimulation, transcranial magnetic simulation, phototherapy (1,500-10,000 lux-1-2 hours dwan or dusk), sleep deprivation
SSRIs (e.g.) fluoxetine, sertraline, paroxetine, citalopram, escitalopram, fluvoxamine
SNRIs venlafaxine, duloxetine, desvenlfaxine, fetzima
MAOIs not likely
TCAs: imipramine, amitriptyline, clomipramine, trazodone
atypical antidepressants: buproprion, mirtazapine, nefazodone
hybrids: vilaxodone, vortioxetine

Question 76

Diagnosis criteria for what
Depressed mood for most of the day, more days than not, for 2 plus years
individuals whose symptoms meed MDD criteria for 2 years should be given a diagnosis of persistent depressive disorder as well as major depressive disorder

Answer 76

Persistent depressive disorder

Question 77

Diagnosis criteria for what
Occurrence in the majority of menstrual cycles
5 symptoms present and must be in the final week before the onset of menses
improvement of symptoms within a few days after onset of menses and becomes minimal or absent in the week post menses

Answer 77

Premenstrual dysphoric disorder

Question 78

Diagnosis criteria for what
Must meet the criteria for a manic episode, the manic episode may have been preceded by and may be followed by a hypomanic or major depressive episode

Answer 78

Bipolar I Disorder

Question 79

DIG FAST
Distractibility
Indiscretion
Grandiosity
Flight of ideas
Activity Increase
Sleep Deficit
Talkativeness

Answer 79

Bipolar I disorder

Question 80

Bipolar I Disorder treatment

Answer 80

Lithium levels of 0.6-1.2
Valproate levels of 50-120
Carbamazepine level 4-12
Atypical antipyschotics

Question 81

Does not treat the manic episodes but can help prevent the manic episodes

Answer 81

Lamictal

Question 82

Diagnosis criteria of what?
Must have hypomanic episode and major depressive episode
There has never been a manic episode

Answer 82

Bipolar II Disorder

Question 83

Diagnosis criteria of what?
Symptoms for at least 2 years (or 1 year in those under age 18)
Numerous periods with hypomanic symptoms that do not meet criteria for hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode
Symptoms half the time and not without symptoms for more than 2 months

Answer 83

Cyclothymic Disorder

Question 84

Cyclothymic Disorder Treatment

Answer 84

Mood stabilizers and antimanic drugs consider carbamazepine and valproic acid first

Question 85

Emotional response to real or perceived imminent threat

Answer 85

fear

Question 86

anticipation of future threat

Answer 86

anxiety

Question 87

physical symptoms in relation to fear and anxiety

Answer 87

panic attack

Question 88

Diagnostic criteria of what?
Developmentally inappropriate and excessive fear/anxiety
lasting at least 4 weeks in children/teens and 6 plus months in adults

Answer 88

Separation anxiety disorder

Question 89

Treatment for Separation Anxiety Disorder

Answer 89

psycho education, CBT, play therapy, SSRIs: fluoxetine, fluvoxamine, sertraline, paroxetine

Question 90

Failure to speak in specific social situation for which there is an expectation despite speaking in other situations and having no difficulty with speaking or language (at least 1 month)
Typically occurs before the age of 5, but may not notice until in school

Answer 90

Selective mutism

Question 91

Treatment for selective mutism

Answer 91

psycho education, CBT (1st line), play therapy, SSRIs: fluoxetine, fluvoxamine, sertraline, paroxetine

Question 92

Specific phobia

1. Arachnophobia
2. Social phobia
3. Aerophobia
4. Aoraphobia
5. Claustrophobia
6. Emetophobia
7. Acrophobia
8. Cancerphobia
9. Brontophobia
10. Necrophobia

Answer 92

1. spiders
2. social or public situations
3. flying
4. open or public spaces
5. enclosed spaces
6. vomiting
7. heights
8. developing cancer
9. thunder storms
10. death

Question 93

Diagnositic criteria for what?
Marked anxiety or fear about a specific object or situation
lasting 6 months or more
one of the most common mental disorder in the US
Always assess for suicide as 60% more likely to make a suicide attempt.

Answer 93

Specific phobia

Question 94

Code based on the phobic stimulus

1. Animal
2. Natural environment
3. Blood injection injury
4. Situational
5. Other

Answer 94

1. spiders, insects, dogs
2. heights, storms, water
3. needles, invasive medical procedures
4. airplanes, elevators, enclosed places
5. situations that may lead to choking or vomiting; in children loud sounds or costumed characters.

Question 95

Treatment for specific phobia

Answer 95

Behavioral therapy is best
behavior therapy, insight oriented psychotherapy, virtual therapy, hypnosis, supportive therapy, family therapy
beta adrenergic receptor antagonists- Propranolol
benzodiazepines along with psychotherapy

Question 96

diagnosis criteria for what?
individual is exposed to possible scrutiny by others-causing fear/anxiety
lasting for 6 plus months

Answer 96

social anxiety disorder (social phobia)

Question 97

Treatment social anxiety disorder

Answer 97

behavioral and cognitive methods

pharmacologic: SSRI 1st line, SNRI-venlafaxine, beta adrenergic receptor antagonist: atenolol vs propranolol

Question 98

Diagnostic criteria for what?
Recurrent unexpected panic attack-but can occur from calm or anxious state
must have 4 plus symptoms
at least one attack has been followed by 1 month or more of persistent worry about other panic attacks or a maladaptive change in behavior
be sure to ask about substance abuse
be sure to ask about sleep

Answer 98

panic disorder

Question 99

Treatment Panic Disorder

Answer 99

Superior CBT then taking medication alone
SSRI: treat 8-12 months, 1st line treatment, paroxetine, sertraline, citalopram, escitalopram, fluvoxamine, fluoxetine
SNRI-venlafaxine
Buspirone
benzodiazepine after 4-12 weeks taper off slowly 4 to 10 weeks
TCAs take 8-12 weeks to taper up
mood stabilizer as adjunct
calcium channel blockers
High relapse rate regardless

Question 100

Diagnosis criteria of what?
This is different than panic disorder but must still have 4 plus symptoms
this added to the diagnosis (e.g. major depressive disorder with panic attack)

Answer 100

panic attack specifier

Question 101

diagnosis criteria of what?
marked fear of 2 plus of 5 situations
fear and panic related to inability to escape or no one is there to help
often times has another mental illness

Answer 101

agoraphobia

Question 102

Agoraphobia treatment

Answer 102

Supportive or insight oriented psychotherapy, cognitive or behavioral therapy, virtual therapy
SSRI is 1st line
benzos
tcas: clomipramine, imipramine

Question 103

diagnostic criteria for what?
excessive anxiety and worry more days than not for greater then 6 months
difficult to control worry

Answer 103

generalized anxiety disorder

Question 104

generalized anxiety disorder treatment

Answer 104

symptom relief is not always the most appropriate course of action: should consider if the anxiety is normal, adaptive, maladaptive, too intense or too mild
CBT therapy

Question 105

generalized anxiety disorder treatment

Answer 105

SSRI: sertraline, citalopram, paroxetine/could also consider fluoxetine, fluvoxamine, escitalopram
SNRI: venalfaxine
Buspirone
Beta adrenergic antagonists: propranolol

Question 106

Diagnostic criteria for what?

Symptoms causing functional impairment but not meeting full criteria of other anxiety disorders

Answer 106

Other specified and unspecified anxiety disorder

Question 107

are recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted

Answer 107

obsessions

Question 108

repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly

Answer 108

compulsions

Question 109

must be excessive or persisting beyond developmentally appropriate periods

Answer 109

obsessive compulsive and related disorders

Question 110

diagnostic criteria for what?
presence of obsessions, compulsions, or both
time consuming taking more than 1 hour
suicide attempts in 25% of individuals

Answer 110

obsessive compulsive and related disorders

Question 111

obsessive compulsive disorder treatment

Answer 111

behavioral therapy as effective as medication
SSRIs-fluxoetine, fluvoxamine, paroetine, sertraline, citalopram
TCA: clomipramine (was first line)
Mood stablizers: valproate, lithium, carbamazepine
SNRI: venlafaxine

Question 112

Diagnostic criteria for what?
Preoccupation with one plus perceived defects or flaws in physical appearance that are not observable to appear slight to others causing repetitive behaviors or mental acts in response
high rates of childhood neglect or abuse, increased rates in those with 1st degree relative with OCD

Answer 112

Body Dysmorphic Disorder

Question 113

Body dysmorphic disorder treatment

Answer 113

psychotherapy

Question 114

Diagnostic criteria for what?
Holding on to objects regardless of value and distress with discarding objects
Possessions clutter living spaces
Specifiers related to insight and excessive acquisition
often 75% of the time have another mood or anxiety disorder

Answer 114

Hoarding disorder

Question 115

Hoarding disorder treatment

Answer 115

Hard to treat, CBT, possible SSRI

Question 116

Diagnostic criteria for what?
Pulling out hair which results in hair loss, attempts to stop, and causing significant distress
etiology: genetic, those with OCD

Answer 116

Trichotillomania

Question 117

Treatment for trichotillomania

Answer 117

Behavioral therapy
hydroxyzine
SSRI: fluvoxamine, citalpram

Question 118

swallowing of hair

Answer 118

trichophagia

Question 119

Diagnostic criteria for what?
Recurrent skin picking resulting in LESIONS
attempts to decrease or stop
resulting in significant distress
more common in those with OCD disorders

Answer 119

Excoriation (skin-picking) disorder

Question 120

Treatment for excoriation disorder

Answer 120

CBT
SSRI: fluoxetine
Naltrexone, lamotrigine

Question 121

Among the most common mental health problems in children and teens (irritable and withdrawn)

Answer 121

Anxiety

Question 122

how many months to diagnose a learning disorder?

Answer 122

6 months

Question 123

affects oral and written communication

Answer 123

dyslexia

Question 124

difficult with writing: poor spelling and grammar and poor handwriting even thought they don’t have issues with fine motor skills

Answer 124

dysgraphia

Question 125

difficult with numbers, magnitude or relationship to one another. trouble with number sense

Answer 125

dyscalculia

Question 126

2 plus motor tics plus 1 vocal tic that does not have to happen at the same time, must persists for at least 1 year and started before the age of 18 most common from 4-6. Most severe

Answer 126

Tourette’s syndrome

Question 127

1 motor or 1 vocal but not both, have to persist for 1 year, started before age 18

Answer 127

Persistent motor or vocal tic disorder

Question 128

quick, non rhythmic movements or vocalizations

Answer 128

tic

Question 129

1 motor and/or 1 vocal, persists less than 1 year, started before age 18

Answer 129

provisional tic disorder

Question 130

shor in duration, e.g. blinking or throat clearing

Answer 130

simple tic

Question 131

complex longer in duration, often combination of simple tics: shake head, shrug shoulders

Answer 131

complex tic

Question 132

repeat movement of others

Answer 132

echopraxia

Question 133

obscene gestures

Answer 133

copropraxia

Question 134

repeating last word or phrase from others

Answer 134

echolalia

Question 135

repeats own words or phrases

Answer 135

palilalia

Question 136

inappropriate words

Answer 136

coprolalia

Question 137

TIC treatment

Answer 137

CBT, habit reversal training
anti psychotics Haldol, risperidone
epilepsy medications 
ADHD medication
botox injections

Question 138

inattentive, hyperactive, impulsive, overly active

Answer 138

ADHD: attention deficit hyperactivity disorder

Question 139

3 sub types of ADHD

Answer 139

1. Inattentive: not paying attention 6/9 symptoms for at least 6 months
2. hyperactive/impulsive 6/9 symptoms for at least 6 months
3. both most common
4. Must have started between 6-12 years of age

Question 140

Dopamine’s reward, risk, impulsiveness and norepinephrine’s attention and arousal are inadequate in this condition

Answer 140

ADHD

Question 141

ADHD treatment

Answer 141

behavioral psychotherapy

medications: stimulants

Question 142

1. Social communication and interaction
   A. social reciprocity
   B. Joint attention (wanting to share an interest)
   C. Nonverbal communication (using or interpreting)
   D. Social relationships (developing and maintaining relationships)
2. Restricted or Repetitive behavior/interests/activities
   A. lining up toys, flapping hands, imitating
   B. Fixed on certain routines
   C. Restrictive thinking, specific knowledge

Answer 142

Autism Spectrum Disorder

Level 1-3 (3 being the worse)

Question 143

These disorders make up what?  
Oppositional defiant disorder
Conduct disorder
Antisocial personality disorder
Intermittent explosive disorder
Impulse control disorder

Answer 143

Disruptive, impulse control and conduct disorders

Question 144

desire to burn things

Answer 144

pyromania

Question 145

desire to steal things

Answer 145

kleptomania

Question 146

defiant behavior
persistent willful
emotional disregulation
arguments, angry
dislikes authority
resentful
irritable
vindictive
spiteful
must persist for greater than 6 months
must disrupt social interactions

Answer 146

oppositional defiant disorder

Question 147

defiant behavior
persistent willful
emotional disregulation
arguments, angry
dislikes authority
resentful
irritable
vindictive
spiteful
must persist for greater than 6 months
must disrupt social interactions 
aggressive towards people and animals
antisocial behaviors: destroy property, steal things, hurt pets

Answer 147

conduct disorder
childhood onset before 10
adolescent onset 10-18

Question 148

disregard moral values and societal norms
lack empathy and impulse control
will hurt others
aggressive
will break laws
often are in prison 
substance abusers
do not show remorse or accept responsibility
can be charming 
must be over 18 years old
must have history of conduct disorder

Answer 148

antisocial personality disorder

Question 149

recurrent explosive outbursts: brief, spontaneous, response to real or perceived provocation, out of proportion
Intense anger, violence
older than 6 years of age
twice a week for 3 months or 3 times a year with damage to people or property

Answer 149

intermittent explosive disorder