Affective Disorders and Personality Disorders in Psychiatry

Classified in Psychology and Sociology

Written at on English with a size of 8.09 KB.

Psychiatry: Affective Disorders

Systemic of Affective Disorder (Mood Disorders)

DefinitionDiagnostic Criteria

Depression Types:

  • Psychotic
  • Severe
  • Bipolar

Depression Diagnostic Criteria:

  • > 2 weeks
  • Depressed mood or apathy
  • Combination of 4: Weight loss, sleep disorder, agitation, retardation, fatigue, guilt

Dysthymia: Mild Depression

Dysthymia Diagnostic Criteria:

  • Definition: Chronic depressed mood but does not meet Major Depressive Disorder criteria
  • Depressed mood for most of the day for 2 years
  • Combination of 2+: Eating disorder/sleep disorder, fatigue/low self-esteem
  • In 2 years, the patient is never without a symptom

Cyclothymia: Mood disorder causes emotional rollercoaster (Highs and Lows)

Diagnostic Criteria:

  • Various hypomanic episodes that are interposed with episodes of depression that do not meet criteria for Major Depressive Disorder
  • Low-grade cycling of mood

Bipolar Disorder Diagnostic Criteria:

Bipolar Diagnostic Criteria:

  • Period of elevation or irritability
  • 3 Characteristics: Increased talking, racing thoughts, inflated self-esteem, decreased sleep
  • Negative impact on occupation

Affective Disorder Treatment Principle:

Depression without Psychosis

  1. Give Antidepressant: SSRIs (citalopram/fluoxetine) / SNRIs (Venlafaxine) / TCAs (amitriptyline)
  2. Psychotherapy
  3. Mixed

1st line therapy is Antidepressant
If only partial response ---> add Lithium
Maintain: Continue therapy until the end, if recurrence give prophylaxis

Depression with Psychosis:

  • Psychotherapy
  • Combine Antidepressant + Antipsychotic
  • Olanzapine - Fluoxetine

Combination Antidepressant + Antipsychotic is better

Dysthymia:

  • Treatment: SSRI, TCA, MAOI
  • Psychological: Mania
  • Other Treatment: (Olanzapine/Quetiapine/Risperidone/Lithium/Carbamazepine)

Stages of Grief:

I. Grief Crisis:

Shock ReactionDisorganization
  • First physiological & psychological response to loss!
  • Heart rate increase
  • Faintness
  • Emotional outburst
  • Understanding the loss
  • Hardest stage of grief
  • Pain, grief, inner void
  • Loneliness
  • Behavior changes

II. Coping With Grief

ReorganizationReconstruction
  • Admitting loss & inner and outer reconciliation
  • Emotions less intense
  • Live in the moment, stronger realization of self
  • Start to take care of himself
  • Person adapts to new condition of life
  • Find inner strength to carry on
  • Memories remain, do not invoke negative feelings
  • 1-2 years!
  • Shock: Paralysis by bad news
  • Denial: Avoid the inevitable
  • Anger: Frustration
  • Bargaining: Seek in vain
  • Depression
  • Testing: Realistic solution!
  • Acceptance: Way forward

Hallucinations:

False perception with no external stimuli, can be any number of sensations (auditory, visual, smell, taste, tactile)

Types:
  1. Elementary
  2. Simple
  3. Complex (couple of senses)
  4. Induced (same hallucination to a group of people)
  5. Stereotype (same voice and image)
  6. Hypnagogic (while falling asleep)
  7. Hypnopompic (occur while awake)

Conversation Stages:

Medical Conversation

(Stages + Function)

O - C - D - C

Orientation Stage:
  • Reasons to visit the doctor
  • Ask open questions (What happened? How can I help you?)
  • Observe non-verbals
  • Goal: Find ailment
Clarification Stage:
  • Differentiation in progress
  • Doctor takes initiative
  • Semi-open/closed questions
  • Diagnosis clears up
Definition Stage:
  • Collaboration
  • Explain the etiology of disease, treatment & diagnosis
Conclusion Stage:
  • Prescription, filling documents

Diagnostic Criteria of Specific Personality Disorders:

  1. Changes in one's personality
  2. Stereotypic behavior that affects social & occupational function
  3. Stereotypic features begin
  4. May cause distress!

Antisocial & Emotionally Unstable Personality Disorder: Symptoms & Differential Diagnosis:

PD: Personality Disorder

Psychopathic PD:

Ignoring and violating the rights of others

Symptoms:
  • Apathy to others
  • Ignore social norms
  • Can't maintain long-term relationships
  • Low threshold of frustration
  • Inability to feel guilt
  • Blame surroundings
Differential Diagnosis:
  • Narcissistic PD
  • Histrionic PD - Seeking attention & psychopathic power-seeking
  • Psychotic or manic episodes - specific trigger

Paranoid Personality Disorder: Symptoms & Differential Diagnosis

Paranoid - Constant distrust & suspicion of others!

Symptoms:
  • Interpretation of other's actions as deliberate
  • Oversensitivity, suspicion
  • Jealousy
  • Blaming others
  • Overvalue one's ability
  • Hold grudges
  • Problems with colleagues & authority
Differential Diagnosis:
  • Schizophrenia: PPD do not lose it & have no hallucinations
  • Schizoid PD: PPD speech is normal
  • Use of treatment!

Schizoid Personality Disorder: Symptoms & Differential Diagnosis:

Schizoid PD:

  • High dissociation from social relations
  • Poor emotional reaction
Symptoms:
  • Emotional coldness
  • Limited ability to love, anger
  • Ignore criticism
  • Low interest in sex
  • No close friends
  • Ignore social norms
  • Odd speech
Differential Diagnosis:
  • Schizophrenia: SPD have negative symptoms but not positive symptoms
  • Anxiety disorder: SPD no criticism fear
  • Medical disorder

Anankastic Personality Disorder: Symptoms & Differential Diagnosis:

Definition:

Anankastic (Obsessive-Compulsive) PD - pursuit of perfection

Symptoms:
  • Preoccupation
  • Devotion to work activities & productivity
  • Inflexible about other opinions & thoughts
  • Unable to discard objects or money
  • Can't work in a group
Differential Diagnosis:
  • OCD: Anxiety disorder, sudden onset, no need for protection

Avoidant Personality Disorder: Symptoms & Differential Diagnosis:

Definition (Anxious PD):

  • Social discomfort
  • Self-conscious
  • Fear of rejection
  • Negative evaluation
  • Hesitant
Symptoms:
  • Restricted lifestyle
  • Avoiding activities due to fear
  • Failing to develop relationships
Differential Diagnosis:
  • Dependent PD: APD no need to have them taken care of
  • Neurotic disorder: No sudden onset, trigger
  • Schizoid PD: Social isolation but no low self-esteem

Histrionic Personality Disorder: Symptoms, Differential Diagnosis:

Histrionic PD:

  • Excessive emotional
  • Attention-seeking
  • Drama queen
Symptoms:
  • Center of attention
  • Acting like a victim
  • Interpersonal relationships with dormant partners
  • Excessive concern about physical activity
Differential Diagnosis:
  • Narcissistic PD - desperately looking for attention
Karma: 8%
Visits: 0

Entradas relacionadas:

Tags:
Affective Disorder Depression Psychiatry Dysthymia Mood Disorder