Personality/Behavioural Disorders

Question 1

What are Personality Disorders?

Answer 1

Maladaptive patterns of behaviour, cognition and inner experiences seen across many contexts and deviating from cultural/societal norms

Question 2

How does a patient with Paranoid personality disorder present?

Answer 2

Suspicious 
Mistrustful
Interprets events as persecutory
Bears grudges
Strong sense of rights

Question 3

How does a patient with Schizoid personality disorder present?

Answer 3

Detached
Solitary
Aloof
Little interest in people and sex
Lack close friends

Question 4

How does a patient with Schizotypal personality disorder present?

Answer 4

Eccentric
Odd behaviour/thinking
Unconventional beliefs

Question 5

How does a patient with Borderline personality disorder present?

Answer 5

Emotionally unstable
Impulsivity
Parasuicidal acts
Chronic feelings of emptiness
Unstable + Intense relationships
Fear of abandonment

Question 6

How does a patient with Narcissistic personality disorder present?

Answer 6

Grandiose
Self-important
Degrading others

Question 7

How does a patient with Antisocial personality disorder present?

Answer 7

Unconcerned with feelings of others
Disregard for rules
Impulsive
Low tolerance for frustration

Question 8

How does a patient with Histrionic personality disorder present?

Answer 8

Theatrical
Dramatic
Superficial Emotionality
Seductiveness
Suggestibility

Question 9

How does a patient with Obsessive-Compulsive personality disorder present?

Answer 9

Rigid
Stubborn
Perfectionistic
Pre-occupied with rules, order and routine

Question 10

How does a patient with Dependant personality disorder present?

Answer 10

Need others to make decisions for them
Fear abandonment
Need reassurance

Question 11

How does a patient with Anxious-Avoidant personality disorder present?

Answer 11

Persistent anxiety
Sensitive to rejection
Avoid relationships unless acceptance guaranteed

Question 12

What is panic disorder?

Answer 12

A sudden onset of intense anxiety with cognitive and somatic symptoms

Question 13

What are some symptoms of a panic disorder?

Answer 13

Sweating
Tremor
Palpitations
Paraesthesia
Hyperventilation

Question 14

What is Agoraphobia?

Answer 14

Anxiety in specific situations - far from home,using public transport. Restriction in activities

Question 15

How can a panic disorder be managed?

Answer 15

SSRIs

CBT

Question 16

How can agoraphobia be managed?

Answer 16

SSRIs

CBT

Question 17

What is Social Anxiety?

Answer 17

Fear of judgement in social situations leads to anxiety and avoidance

Question 18

How can Social Anxiety be managed?

Answer 18

SSRIs

CBT

Question 19

What is OCD?

Answer 19

Unwanted recurring distressing thoughts/images out of character and abhorrent to the patient

Question 20

How do patients compensate for OCD?

Answer 20

Compulsions:
Overt - Actions
Covert - Praying, counting, repeating words

Question 21

What is Health Anxiety?

Answer 21

Obsessional pre-occupation with idea they are ill. Often severe, with HIV, AIDS or Cancer

Question 22

What is Body Dysmorphic Disorder?

Answer 22

Preoccupation with imagined physical defect which can lead to time-consuming behaviours

Question 23

What is PTSD?

Answer 23

Reaction to an excessively threatening situation/experience

Question 24

What are some symptoms of PTSD?

Answer 24

Avoidance
Hyperarousal
Re-experience of the situation as a nightmare/flashback

Question 25

What are some comorbid features often found with PTSD?

Answer 25

Other anxiety disorders Depression Substance Misuse

Question 26

What is Autism Spectrum Disorder (ASD)?

Answer 26

Neurodevelopmental disorder characterised by abnormal social interaction, communication and restricted repetitive behaviours

Question 27

What are some risk factors for ASD?

Answer 27

Male FHx Genetic Variants Chromosomal abnormalities

Question 28

What are some pre-disposing factors for ASD?

Answer 28

Infantile spasms Congenital Rubella Tuberous Sclerosis Fragile X Syndrome

Question 29

How may social interaction be altered for patients with ASD?

Answer 29

Lack of response to others' emotions Unable to interpret social clues Unable to form social attachment

Question 30

How may communication be altered for patients with ASD?

Answer 30

Delayed/minimal expressive speech Impairment of make-believe Lack of social gestures One-way conversational skills

Question 31

What are some restrictive repetitive behaviours patients with ASD may demonstrate?

Answer 31

Resist change with a rigid daily routine Unable to adapt Preoccupation with specific interests

Question 32

How is ASD diagnosed?

Answer 32

Clincial assessment Diagnostic Interview for Social and Communication Disorders (DISCO) Autism Diagnosis Observation Schedule (ADOS)

Question 33

What are pharmacological management options for ASD?

Answer 33

SSRIs | Melatonin if sleep cycle is disturbed

Question 34

What are some non-pharmacological interventions for ASD?

Answer 34

``` Specialist education OT Clinical Psychology Sleep hygeine Care agency ```

Question 35

What are some complications of ASD that patients may face?

Answer 35

Social Isolation Bullying and Victimisation Unable to live independently

Question 36

What is ADHD?

Answer 36

A condition incorporating features of inattention +/- hyperactivity that are persistent

Question 37

What are some features of inattention found with ADHD?

Answer 37

``` Does not follow through instructions Reluctant to engage in intense tasks Easily distracted Difficult to sustain tasks Difficult to organise tasks Forgetful with daily activities Loses things needed for activities Does not appear to listen ```

Question 38

What are some features of hyperactivity found with ADHD?

Answer 38

``` Unable to play quietly Talks excessively Does not wait their turn Often - "On the go" Will spontaneously leave their seat Often interruptive Will answer prematurely Will run and climb in inappropriate situations ```

Question 39

How should suspected ADHD initially be managed?

Answer 39

10w of watch and wait, followed by CAMHS referral if appropriate

Question 40

Which drugs are used to manage ADHD?

Answer 40

Methylphenidate | Lisdexamfetamine

Question 41

What is the caution with ADHD management drugs?

Answer 41

Cardiotoxic - Need baseline ECG