Flashcards in PERSONALITY DISORDERS/SOMATIC/PSYCHOTIC Deck (44):
What is a personality trait?
Repetitive pattern or perceiving, relating to, and thinking about the environment and oneself
If a person has one or two components of a disorder that is effecting their life
What is a personality disorder?
Inflexible, maladaptive manner by which the world is viewed, which originates in adolescence
Must have 5 out of the 9 components of the disorder
Are personality disorders easy to diagnose?
NO – patient is unaware of their condition and often feel persecuted by society as a result (aka ego-syntonic).
BUT ALWAYS RULE OUT A MEDICAL CONDITION (even r/o drug use like bath salts)
Is there really any way to treat personality disorders?
No; meds can be used for symptoms (not the actual disorder); also behavioral therapy for borderline personality disorder
At what age can you diagnose a borderline disorder?
If a person seems to lack trust, believing the motives of others are malicious. This person makes a mountain out of a mole hole and will cause character assassination (resulting in extreme suspicion) – what type of personality disorder do they have?
If a person lives alone and is constantly starting lawsuits & persecutions of the other tenants - what type of personality disorder do they have?
Scan their brain! Personality disorders are present by age 20 (and get less as they age)
If a person has complete absence of emotional dependence on other people (AKA a blunted affect), with no desire to make friends; and no outside interest, and may come across as very hard to read – what type of personality disorder do they have?
A patient works as a night watchman, doesn’t interact with others, and ignores all invites from coworkers. They go to work, come home and repeat every day. Along with eat the same thing everyday - what type of personality disorder do they have?
If a person has to rely on what they “feel” is right or that they are “seers” and may be highly intuitive – what type of personality disorder do they have?
What can schizotypal personality disorder lead to?
If a person feels the need to be the center of attention, very dramatic, and are easily swayed by fads, overly trusting, and my interact in inappropriate sexual manners (AKA act very seducing) – what type of personality disorder do they have?
A 30 year old woman is detained by police after becoming highly disruptive while getting in an argument with her husband. She is provocatively dressed and is known by friends as being difficult to work with - what type of personality disorder do they have?
If a person believe in their superiority, views themselves as a glory seeker, or that they better than you. They often get incredibly jealous. – what type of personality disorder do they have?
Is it easy to treat a narcissist?
What type of personality disorder involves being very unstable in self-image and interpersonal relationships. They believe relationships are polarized (black & white) and can fill their feelings of emptiness with sex or drugs. They often fluctuate wildly (happy and sad) and appear to be bipolar?
If a patient is a cutter for therapeutic relief of the pain in their head’s - what type of personality disorder do they have?
How do you treat borderline disorder?
Dialectical behavioral therapy (a form of cognitive therapy)
If a patient has no respect for position with very little regard for the feelings of others, responsibility (always someone else’s fault), and participate in unlawful activities and lack remorse for those – what type of personality disorder do they have?
If a patient burns animal, or scams the elderly out of their money and they feel no remorse - what type of personality disorder do they have?
If a patient appears to be easily hurt if they feel you are criticizing or disapprove of them. They want friends, or would like to go to the party but are terrified to deal with something that will occur (thus they interact with others as little as possible) – what type of personality disorder do they have?
If a patient has difficulty making decisions, overly reliant on others. They feel the need to be cared for and when their significant other leaves they have separation anxiety – what type of personality disorder do they have?
If a patient is very focused on details, strive for perfection, preoccupation with details, rules, lists, and organization. They are often inflexible – what type of personality disorder do they have?
How do you treat personality disorders?
Cognitive behavioral therapy (can you medication therapy as an adjunct)
What personality disorders fall is Cluster C – Anxious?
Avoidant, dependent, OCD
What personality disorders fall is Cluster B – Moody?
Historionic, borderline, antisocial, and narcissistic
What personality disorders fall is Cluster A – Odd?
Paranoid, schizoid, and schizotypal
If a person is extremely anxious and they have diarrhea – what is it?
What’s it called when the doctor is reminded of his ex-wife with the patient and therefore treats them poorly?
If a patient has one or more organ systems that they complain of constantly (months to years), and therefore see multiple doctors for (lots of meds and possibly multiple surgeries)?
Somatic symptom disorder
If a patient ALWAYS seems to have a variety of different disorders, they doctor shop, and “have a checkerboard abdomen” and want serious medical evaluation despite medical evidence for the need, what diagnosis?
illness anxiety disorder (hypochondriasis)
If a patient got a call that their son died and now have paralysis or blindness – what diagnosis?
What is different about somatic disorders & some diagnostic clues?
Complaints are dramatic and CHANGING; history is vague; peculiar indifference to significant medical complains; PE & labs are inconsistent
The patient is NOT faking this (appear as an unconscious stressor)
If a patient IS faking complaints, with intent for secondary gain (money, time off work, etc). They are often non-compliant with treatment – what diagnosis?
If a patient likes to assume the sick role to get medical attention; for PRIMARY gain (often falls into the Boy Who Cried Wolf)– what diagnosis?
Factitious disorder (Munchausen or Munchausen syndrome by proxy [done to a child or elderly])
If a patient has gross impairments in the ability to assess reality, and behave coherently – what diagnosis?
Who needs to be referred to a psychiatrist in order to control them acutely and is then often maintained in the PCP setting?
What’s the major diagnosis of psychosis? How do you diagnosis it?
For 6+ months; must have 2 or more sxs (delusions, hallucinations, disorganized speech, catatonic behavior, or negative symptoms – diminished emotional expression, avolition – no social interests) PLUS postmorbid decline (occupational, social, or self-care AKA it HAS to affect your daily life)
Do you have to have hallucinations to diagnose schizophrenia?
What should you DDX include with visual hallucinations?
Picks, lewy body dementia, frontal tumor, schizophrenia, or autism
What should we remember about how schizophrenia presents?
They are fine throughout their early life in their late teens to 20’s then they develop – Disintegration
How do you compare the diagnosis timeline of schizophrenia; schizophreniform; and brief psychotic disorder?
>6 months = schizophrenia
Schizophreniform disorder: 1 month to 6 months
Brief psychotic disorder: 1 day to 1 month
If a patient has mania, hypomania, depression, or mixed states that is separated by 2 week period with the absence of mood symptoms and just psychotic symptoms?