Psych Diagnostic Criteria/Presentations Flashcards by William MacDonald

Depression general criteria and core symptoms

Depressive episode should last at least 2 weeks
No hypomanic or manic symptoms

2 out of 3 must be present:

Depressed mood
Loss of interest or pleasure
Decreased energy/increased fatiguability

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Depression additional symptoms

Loss of confidence/self-esteem
Unreasonable feelings of self-reproach/guilt
Suicidal thoughts/behaviour
Impaired concentration
Psychomotor agitation or retardation
Sleep disturbance
Change in appetite

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ICD moderate depressive episode criteria (using core and additional symptoms of depression)

2 core symptoms and four additional symptoms

Need total of 6 so could include 3 core and 3 additional.

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ICD severe depressive episode criteria (using core and additional symptoms of depression)

All 3 core symptoms and 5 additional symptoms

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Somatic syndrome (depression subtype) criteria

4 of:

Anhedonia
Lack of emotional response to events which normally would produce emotional response
Waking 2 hours of more before usual time
Depression worse in morning
Psychomotor retardation or agitation
Marked loss of appetite
Weight loss (5% in one month)
Loss of libido

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Atypical depression criteria

Mood reactivity (brightens with potential or actual positive events)

2 or more of:

significant weight gain or appetite increase
hypersomnia
leaden paralysis
Long standing interpersonal rejection resulting in sig social/occupational impairment

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Bipolar I diagnostic criteria

Has to have met criteria for mania at some point, although previous episodes may have been hypomanic and/or depressive

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Bipolar II diagnostic criteria

Current or past hypomanic episode and current or past depressive episode
Never met criteria for manic episode

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Hypomanic episode diagnostic criteria

Mood elevated or irritable to abnormal degree for the person and is sustained for at least 4 days
At least 3 of these with impairment of personal functioning:
1. Increased activity/restlessness
2. Increased talkativeness
3. Difficulty in concentration/distractability
4. Decreased need for sleep
5. Increased sexual energy
6. Mild spending sprees/impulsive reckless behaviour

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Manic episode diagnostic criteria

Elevated, expansive or irritable for at least 1 week
3 of these with impairment of personal functioning:
1. Increased activity/restlessness
2. Increased talkativeness
3. Flight of ideas or thoughts racing
4. Loss of social inhibitions resulting in inappropriate behaviour
5. Decreased need for sleep
6. Inflated self-esteem/grandiosity
7. Distractability or constant changes in activity/plans
8. Reckless behaviour
9. Marked sexual energy or sexual indiscretions

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Anorexia nervosa ICD-10 criteria

BMI of 17.5 or less
Self-induced weight loss (strict dieting, vomiting, excessive exercise, medication)
Body image disturbance
Fear of fatness
Amenorrhoea

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High risk anorexia criteria

BMI <13, weight loss >1kg per week
Prolonged QT, HR<40, BP <80 systolic
Core temp <34degreesC
Unable to rise from squat without using arms for leverage
Cognitive impairment

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Bulimia nervosa ICD-10 criteria

Persistent preoccupation with eating
Irresistable craving for food
Binges
Attempts to counter the effects of binges (starvation, vomiting, laxatives, drug misuse)
Morbid dread of fatness

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PTSD DSM V criteria

Traumatic event
1 or more intrusive symptom
1 or more avoidance symptom
1 or more negative alteration in cognition and mood
2 or more increased arousal and reactivity

Duration over a month, can be delayed onset
Distress and functional impairment

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Complex PTSD ICD-11 criteria

PTSD symptoms plus:
Negative self-concept
Emotional dysregulation
Chronic interpersonal difficulties

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Generalised anxiety disorder criteria

Most days for at least 6 months
Not controllable
Causing significant distress/impairment of function
Generalised and persistent but not predominating in any environmental circumstance

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Panic disorder criteria/symptoms

Recurrent attacks of severe anxiety
Not restricted to particular situation or set of circumstances
Unpredictable
Other anxiety symptoms
May co-occur with agoraphobia

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3 types of phobia

Agoraphobia
Social phobia
Specific phobia

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Phobias criteria

Typically early onset
Fear recognised as irrational
Typified by avoidance and anticipatory anxiety

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Does agoraphobia usually occur on its own or secondary to another mental illness?

Usually secondary

Can be primary

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Social phobia description/symptoms

The individual fears that they will act in a way/show symptoms that will be embarrassing and humiliating
Exposure to situation will cause anxiety/panic attack
Common symptoms:
Blushing or shaking
Fear of vomiting
Urgency or fear of micturition or defaecation

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Describe the obessional thoughts in OCD

Ideas, images or impulses entering the mind in a stereotyped way
Recognised as the patient’s own thoughts
Unpleasant, resisted and ego-dystonic (causes sense of distress)

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Describe the compulsive acts in OCD

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Repeated rituals or stereotyped behaviours
Not enjoyable
Not functional
Often viewed as "neutralising"
Recognised as pointless
Resistance may diminish over time

OCD diagnostic criteria

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Obsessional symptoms or compulsive acts must be present for at least 2 weeks AND be a source of distress and interfere with activities
Must be individuals own thoughts
Resistance must be present
Rituals are not pleasant
Must be repetitive

Characteristics of people most at risk after deliberate self harm (DSH).

``` Older Male Unemployed/retired Single, separated or divorced Isolated Poor health Psych diagnosis Violent DSH Suicide note History of DSH ```

Schizophrenia first rank symptoms

Delusions Hallucinations Thought interference Passivity

ICD-10 schizophrenia criteria

``` One of: Thought interference Passivity Auditory hallucinations Delusions OR Two of: Hallucinations in any modality Neologisms or breaks in train of though Catatonic behaviour Negative symptoms ```

Features of paranoid subtype of schizophrenia

Most common | 1st rank symptoms predominate

Features of hebephrenic subtype of schizophrenia

Younger onset Immaturity and silliness Play pranks Animated and giggly

Features of catatonic subtype of schizophrenia

Movement disorder predominates | Responds very well to treatment

Features of persistent delusional disorder

Delusions are only feature

Features of schizotypal disorder

``` Eccentricity and aloofness Social withdrawal Paranoid quasi-delusional ideas Magical thinking Transient auditory hallucinations ```

Features of acute and transient psychotic disorder

Schizophrenia symptoms lasting less than one months

Features of schizoaffective disorder

First rank symptoms with depression or mania

Schizophrenia negative symptoms

``` Reduced amount of speech Reduced motivation/drive Reduced interest/pleasure Reduced social interaction Blunting of affect ```

Intellectual disability criteria

``` Deficits in intellectual functioning (IQ<70) Deficits in adaptive functioning (moving from one thing to another) Developmental aetiology (occurs <18 years) ```

Intellectual disability categories based on IQ

``` Borderline - IQ 70 or over Mild - IQ 50-69 Moderate - IQ 35-49 Severe - IQ 20-34 Profound - IQ <20 ```

Mild intellectual disability presentation

Mental age 9-12 years Delayed speech (able to use everyday speech) Full independence (self care, practical and domestic skills) Difficulties in reading and writing Capable of unskilled or semi-skilled work Problems if social or emotional immaturity Rarely organic aetiology

Moderate intellectual disability presentation

``` Mental age 6-9 years Slow with comprehension and language Limited achievements Delayed self care and motor skills Can do simple practical tasks often with supervision Usually fully mobile Majority organic aetiology Epilepsy and physical disability common Will likely need to be looked after ```

Severe intellectual disability presentation

Mental age 3-6 years More marked impairment and more restricted achievements Epilepsy

Profound intellectual disability presentation

``` Mental age <3 years Severe limitation in ability to understand or comply with requests or instructions Little or no self-care Often severe mobility restriction Basic or simple tasks may be acquired ```

What are the chromosomal syndromes that can result in intellectual disability? (lots of them)

``` Cri du chat (causes microcephaly) Angelman (maternally derived, ataxia, paroxysms of laughter) Prader-Willi (paternally derived) Velo-cardiofacial syndrome (increased risk of schizophrenia) Williams syndrome Down's syndrome Patau syndrome Edward's syndrome ```

What sex chromosome syndromes cause intellectual disability

``` Turners (XO) Trisomy X Klinefelter (XXY) XXY male may have slight lower IQ Fragile X ```

Schizophrenia presentation in a person with an intellectual disability

(3 times more common) Earlier age of onset Negative symptoms more common Main presenting symptoms may be behaviour change

Depression presentation in a person with an intellectual disability

More likely to have somatisation Reduced verbal expression of their feelings Biological symptoms (sleep, appetite, energy, concentration, anhedonia)

Cluster A "odd and eccentric" personality disorders (DSM V)

Paranoid Schizoid Schizotypal

Cluster B "dramatic and emotional" personality disorders (DSM V)

Antisocial Borderline Histrionic Narcissitic

Cluster C "anxious and avoidant" personality disorders (DSM V)

``` Avoidant (anxious) Dependent Obsessive compulsive (anankastic) ```

ICD-10 hazardous drinking description/criteria

A pattern of alcohol consumption that increases the risk of harmful consequences for the user 15-34 units a week for women 15-49 units a week

ICD-10 harmful drinking description/criteria

A pattern of alcohol drinking that is causing mental or physical damage 35 or more units a week for women 50 or more units a week for men

ICD-10 alcohol dependence description

A cluster of behavioural, cognitive and physiological factors that typically include a strong desire to drink alcohol and find difficulties in controlling its use

DSM-V combined name for alcohol abuse and alcohol dependence

Alcohol use disorder (mild, moderate and severe)

ADHD criteria

Triad of inattention, hyperactivity and impulsivity Frequently co-occuring with impairing symptoms relating to self regulation e.g. executive function, emotional regulation Need to be: Developmentally inappropriate Impairing functioning Pervasive across settings Longstanding from age of 5

ADHD children diagnostic criteria

6 or more symptoms of inattentiveness and/or 6 or more symptoms of hyperactivity and impulsiveness

Triad of impairments and one extra feature in ASD

Social communication Social interaction Social imagination Repetitive behaviours (not essential but very common)

Mild cognitive impairment features and test scores

Noticeable cognitive impairment with little deterioration of function ACE - 75-90, MOCA - 24-26 (not absolute)

Vascular dementia common presenting symptoms

``` Dysphasia Dyscalculia Frontal lobe and affective symptoms May have: focal neurological signs vascular risk factors step wise decline ```

Psych Diagnostic Criteria/Presentations Flashcards

(57 cards)