SPMM Part A(1) > A(1) 5- Classification > Flashcards

A(1) 5- Classification Flashcards

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1
Q

DSM-5 (from the American Psychiatric Association) and ICD-11 (from the WHO) don’t provide information on…

A

assessmnet plans, case formulations or treatment plans

(I.E. ONLY reliable diagnoses)

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2
Q

Operationalised approach

A

Introduced in DSM-III. Uses precise definitions of disorders with predefined inclusion and exclusion criteria, as well as duration and intensity of symptoms. Enables algorithm-based diagnosis (e.g. checklists such as OPCRIT). Some criteria are essential; others optional.

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3
Q

Characteristic symptoms

A

Symptoms that are central to a diagnosis (e.g. low mood in depression). Help distinguish one disorder from another.

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4
Q

Discriminating symptoms

A

Symptoms necessary for diagnosis because they are not found in other disorders (e.g. thought insertion in schizophrenia).

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5
Q

Pathognomonic symptoms

A

Symptoms that strongly indicate one specific disorder (e.g. flashbacks in PTSD).

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6
Q

Inclusion and exclusion criteria

A

A hierarchy of symptoms arranged by importance (e.g. Criterion A, B). Used to define which symptoms must or must not be present for diagnosis. These form the structure of operationalised systems (e.g. OPCRIT).

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7
Q

Atheoretical approach

A

Classification is based purely on observed phenomena, not on theories of cause. No use of behavioural, psychoanalytic, or biological models—only descriptive observation.

(e.g. disorders defined by symptom clusters (e.g. low mood, anhedonia, sleep disturbance for depression) without reference to underlying cause or theory.)

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8
Q

Descriptive approach

A

Classifies illnesses based on what they look like (symptoms and course), not on what causes them. Rational approach given limited understanding of aetiology in psychiatry. Forms the basis of atheoretical classification.

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9
Q

Categorical approach

A

Current diagnostic systems classify disorders as present or absent (yes/no) — similar to diagnosing medical diseases (e.g. a person either has or doesn’t have schizophrenia).

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10
Q

Dimensional approach

A

Views symptoms on a continuum (e.g. mood, anxiety, personality traits) rather than as all-or-nothing. Recognises that symptoms vary in intensity and can be clinically significant even below diagnostic thresholds.

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11
Q

Hierarchial organisation

A

largely abandoned in DSM but still used in ICD

some disorders take precedence over others when making. a diagnosis

(follows Jasperian ideas)

ladder starts from organic and moves through to substance, pysochosis, affective and neurosis to personality.

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12
Q

Is hierarchial organisation reflexive or non-reflexive?

A

non-reflexive

each disorder manisfests the Sx of those lower down but not higher up

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13
Q

Changes of ICD10 from 11? (5)

A
  • 21 disorder groupings (comapred to 11 before)
  • sleep-wake disorders andn conditions related to sexual health separated into two
  • gender-identify disorders renamed as “gender incongruence” and moved to Sexual health. transgender no longer considered a mental health disorder
  • no separate disorder grouping for mental and behavioural disorders with onset in childhood
  • attemtps to harmoise ICD-11 to DSM-5 a bit..
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14
Q

How has catatonia changed in ICD-11? (1)

A

now in own category (not with schizophrnia) as recognised it is associated with lots of disorders

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15
Q

Term schizophrenia coined by.. (1)

A

Bleuler
(means split mind)

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16
Q

ICD-11, minimum duration for diagnosis of alcohol dependence

A

3 months

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17
Q

borderline personality disorder: which Sx declines after 2 years? (1)

A

self harm

impulsivity, self-injurous, and suicidal behavioru all decrease in adulthood

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18
Q

Acute stress disorder, how long does it go on for? (1)

A

<4 weeks

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19
Q

DSM-5 Cluster A personality disorders

A

(ODD/ EXXENTRIC)
paranoid
schizoid
schizotypical

rememebr the “clusters” are in DSM-5 and not in the ICDs

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20
Q

DSM-5 Cluster B personality disorders

A

(EMOTIONAL/ DRAMATIC)
antisocial
histrionic
narcissistic
boarderline

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21
Q

DSM-5 Cluster C personality disorders

A

(FEARFUL/ ANXIOUS)
avoidant
dependent
obsessive-compulsive

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22
Q

Depressive episode has to be at least X weeks? (1)

A

2 weeks

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23
Q

ASD typically becomes evident at what age (1)

A

<2 years

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24
Q

Delusional disorder - how long does it have to be present for? (1)

A

development of delusion for at least 3 months in the absence of manic, depressive or mixed mood episode

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25
'Significantly low body weight' BMI (1)
BMI 18.5 to 14
26
'Dangerously low body weight' BMI (1)
BMI < 14
27
How long does the nautral course of untreated mania last? (1) depression? (1)
MANIA= 4 months DEPRESSION= 6 months in elderly this becomes longer who show shorter periods of interepisodeic remission
28
What brain feature is poor prognosis of schizophrenia? (1)
enlarged ventricles
29
Are mood Sx a poor or good prognositc factor for schizophrenia? (1)
NEGATIVE Sx are poor prognostic factor, mood symptoms are actually positive prognostic factor
30
Male vs female sex: which has worse schizophrenia prognosis? (1)
MEN
31
Canabis use and schizophrenia: what increased likelihood? (1)
2-4 times
32
Facts about Rett syndrome
- dominant X linked - only GIRLS - age 1-4 yrs purposeful hand movements and spoken language lost - ataxia, facial grimacing, teeth grinding, loss of speech - irregular respiration - gait disturbance, scoliosis and seizures - sleep disturbances common
33
What type of hallucinations do you get in acute cannabis effect? (1)
kinaesthetic halucinations and passivity
34
in "Schizophrenia, continuous" can you have episodes of no voices? (1)
yes as long as brief relative to overall course
35
Aspergers syndrome: what happens to IQ and language
NORMAL (in some cases superior) you can get motor clumsiness and stereotyped motor activities
36
for DSM-5, ADHD core Sx must be present before what age
12
37
Is anorexia assocaited with social class? (1)
No (nor ethnicity or socioeconomic status)
38
When do symtpoms of adjustmnet disoder resolve? (1)
after 6 months
39
Which culture-bound syndrome refers to fear of turning into a cannibal
Windigo (qitiko psychosis)
40
Does specific phobia need to have avoidance? (1)
yes
41
Biopolar treatment options
1. fluoxetine combined with olanzapine 2. quetiapine 3. olanzapine or lamotrigine on its own
42
ADHD: most common co-morbid psychiatric disorder in children (1) - oppositional defiant disorder - conduct disorder - ASD - Tourettes - bipolar
oppositional defiant disorder (also common is learning disorders, ASD, Tourettes, les common is bipolar/ anxiety/ conduct) remember conduct disorder is more antisocial (ie. theft, hurting people etc)
43
Who first decribed bulimia nervosa? (1)
Russell
44
Who introduced interpersonal therapy? (1)
Klerman and Weissman
45
Brain injury and psychosis: what does it increase the risk of? (1)
non-affective psychosis more than affective (it causes a schizophrenia-like psychotic disorder after brain injury - a/w frontal and temporal damage) children are loss susceptible due to brain pllasticity does NOT increase chance of schizophrenia
46
Causes of catatonia: - neurological (7) - psychiatric disorders (2)
post-encephalitic states, parkinsonism, seizure disoder, bilateral globus pallidus disease, lesions of thalamus/parietl lobes, frontal lobe disease, general paresis - schiopzhrenia - depression
47
most children with selective mutism also meet diagnositc crtieria for what? (1)
social anxiety disorder
48
How long does acute delirium take to go away? (1) what diseases may make recover longer? (3)
4 weeks SABE (subacute bacterial endocarditis), carinoma, and chronic lung disease it can be up to 6 months
49
What type of delusions are least assocated with delusional disorders? (1)
bizarre disorders
50
hallmark symptom in schizophrenia (1)
lack of insight
51
duration criteria in ACI-11 for diagnosing personality disorders (1)
"over extended period of time (e.g. 2 years or more)" i.e. not a criterion
52
Difference between mild, moderate, severe, and profound intellectual disability?
MILD: only struggle academically MODERATE: basic self care, ADLs, need significant ongoing support to live independelty and maintain employment SEVERE: limited language, daily supervised support, may develop basic ADLs with intesne support and help PROFOUND: daily ADL support, very limited communication
53
In ICD-11 the first rank Sx have been de-emphasised. Instead, you need at least 2 of the seven symptom categories, and at least one of the four 'core' symtpoms. What are the core Sx? (4)
CORE: 1. delusions 2. hallucinations 3. experiences of influence, passivity, or control 4. disorganised thinking (FTD)
54
mimum duration of diagnosis of hypomania
several days
55
Histrionic personality disorder
overly dramatic/ theatrical considering relationships to be more intimate than they are using physical appearance to draw attention to onself speaking in way that is excessively impressionistic and lacking detail shallow and shiting eotions sexually provocative feeling uncomfortable when not the centre of attention being suggestive and easily influenced
56
Who described schiophrenia as two major forms? (1) who then added 'simple schizophrenia'? (1)
Emil Kraepelin --> Bleuler
57
What term refers to the neglect of all leisure and other alternative forms of pleasure apart from alcohol? (1)
salience (/primacy of alcohol-seeking behaviour) may also diminish moral snese (leading to criminal activitiy and fraud)
58
delirium tremens symptoms: conciousness? (1) fluctuating or constant? (1)
clouded consciousness disorientation amnesia psychomotor agitation visual/ auditory/ tactile hallucinations fluctuations hour by hour
59
when did ICD-11 come into practice
2022
60
Dream-like (oneiroid) states are visual hallucinations most associated with what feature (1)
catatonic featurres
61
Clinical features of obsessive-compulsive personality disorder
perfectionism interfering with completion of tasks miserly spending and hoarding of money inability to discard worthless objects excesive devotion to work and productivity preoccupation with details, rules and lists inflexibility about morality and ethids rigidity and stubborness
62
What is included in the ICD-11 'Schizophrenia or Other Primary Psychotic Disorders' grouping? (5)
Schizophrenia Schizoaffective Schizotypal disorder Delusional disorder Acute and transiet psychotic disorder
63
What is "rapid cycling disorder"?
at least 4 episoders of bipolar disorder occur within a period of 1 year
64
Who was key proponent of the view that mental disease are diseases of the brain? (1) - Wilhelm Griesinger - Adolf Meye - Emil Kraepelin - Karl Jaspers - Carcot
Wilhelm Griesinger
65
Jules Angst - what did he do? (1)
bipolarity of mood disorders
66
Narcolepsy characteristics
excessive sleepiness cataplexy (loss of muscle tone) sleep paralysis hypgognic hallucinations (vivid on falling asleep) hypnopompic hallucinations (vivid on waking up)
67
What did Edward and Gross develop the criteria for? (1)
alcohol dependence
68
Fugue state has been recognised as a type of...
dissociative amnesia (loss of personal identiy and sudden travel away from home, work, or significant others). A new identify may be assumed.
69
which historical type of schizophrenia was associated with the worst prognosis? (1) - residual - catatonic - post schizophrenic - hebephrenic - paranoid
hebephrenic (characterized by prominent disorganization of thought, behavior, and affect, rather than by prominent delusions or hallucinations)
70
minimum symptom duration in ICD-11 for schizophrenia diagnosis
1 month +
71
most vocationally disabiling personality disorder
boarderline (or schizotypal)
72
what is biopolar III disorder
hypomania or mania precipitated by antidepressant drugs
73
who termed schizoaffective psychosis
Kasanin
74
the concept that overwhelming stress could produce mental illness led to what term being introduced in early 20th century? (1)
war neurosis
75
In DSM-5, what is included in the autism spectrum disorder group?
autistic disorder asperger's disorder pervasive developmental disorder-NOS childhood disintegrative disorder (Hellers syndrome)
76
in DSM-5, what defines caffine intoxication?
>250mg
77
PTSD; what features a/w poor prognosis
sense of numbing chronicity of distres impaired interpresonal functioning lower overall quality of life
78
What is Ganser syndrome
approximate answers, disorientation, clouding of conciousness, hallucinations/ pseudo-hallucinations, motor disturbance, anxiety/ apathy incldued in ICD-11 as 'other specified dissociative disorders'
79
when do PTSD Sx start?
within 6 months of the event (10% have late onset)
80
what % of non-schizophrenic patients with psychosis get first rank Sx? (1)
10-20% (first rank Sx were developed by Kurt Schneider)
81
how is anorexia associated with monozygotic/ dizygotic twins? (1)
concordance rate higher for monozygotic twins
82
how is the onset of frontotemporal lobe dementia described in ICD-11
incidious onset and gradual progression
83
Myalgic encephalomyelitis is also know as... (1) criteria for diagnosis (3)
chronic fatigue syndrome 6+ months unexplainable, new fatigue not due to ongoing exertion not relieved by rest additional criteria: sore throat, impaired memory and/or concentration, joint and muscle pain, headaches, unrefreshng sleep, post-exertional malaise
84
what BMI excludes myalgic encephalomyelitis (Chronic fatigue syndrome)? (1)
BMI > 45
85
what are the five axes in the multi-axial System of DSM-IV? (5) how does this differ to the ICD system? (1)
I- clinical disorders II- personality disorders III- general medical conditions IV- psychosocial and environmental problems V- global assessment of functioning the ICD system only had 3 axes (mental disodrder, degree of disability, and current psychosocial problems)
86
in ICD-11, acute and transient psychotic disoder is acute onset within a period of X weeks? (1)
2 weeks
SPMM Part A(1)
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