DSM IV TR cards, part Flashcards

Selective serotonin reuptake inhibitor
Terms Definitions
which axis?
Diagnostic categories
Axis I
Which axis?
Psychosocial and environmental problems
Axis IV
Describe somatization disorder.
Multiple, unexplained symptoms (including pain and mood symptoms). Found almost exclusively in women.
T or F Substance-induced sexual dysfunction should be diagnosed instead of substance intoxication only if the sexual symptoms are serious enough to warrant independent clinical evaluation and exceed those that would be expected for syndrome of intoxicatio
Which axis?
Personality disorders and mental retardation
Axis II
Describe ORGASMIC disorders
Female orgasmic disorder (despite normal period of sexual excitement, woman's climax either delayed, or not at all). Male orgasmic disorder (Same as female). Premature ejaculation (man experiences repeated instances of climax before, during, or just after penetration.
Describe Transvestic Fetishism, Voyeurism, and Paraphilia NOS.
Transvestic Fetishism: A heterosexual man has sexual urges related to cross-dressing. Voyeurism: Pt has urges related to viewing some unsuspecting person disrobing, naked, or engaging in sexual activity.
Describe obsessive-compulsive disorder.
Patients bothered by repeated thoughts or behaviors that appear senseless.
Describe substance-induced anxiety disorder.
Anxiety symptoms that don't necessarily fulfill criteria for any of the former mentioned disorders.
Describe panic disorder.
Repeated attacks with worry about additional attacks. Usually occurs with agoraphobia.
Describe posttraumatic stress disorder.
Patients repeatedly relive a severely traumatic event, such as combat or natural disaster.
Describe agoraphobia.
The fear of situations or places where there may be trouble obtaining help when anxious.
Which disorder causes pt. to strongly avoid activities, coversations, feelings, people places, or thoughts reminiscent of a traumatic event?
Acute stress disorder.
Describe dissociative identity disorder
One or more additional identities intermittently seize control of the patient's behavior
Pt. must repeatedly re-experience the event of acute stress disorder in one or more of the following ways.
Recollections (dreams, flashbacks, illusions, etc.), Sense of reliving the event, mental distress as reaction to reminds of event.
List criteria for substance-induced anxiety disorder.
Pt. has prominent anxiety, compulsions, obsessions, or panic attacks.
List Obsessions criteria for obsessive-compulsive disorder.
Obsessions: recurring thoughts, etc. which cause anxiety, ideas not just extreme worries about ordinary things, pt. tries to neutralize by thoughts or behavior, pt. aware that ideas are product of pt.'s own mind.
Describe criteria for hypochondriasis.
Pt. becomes preoccupied with fears of having serious illness. Appropriate medical investigation does not relieve the ideas. Ideas are not delusional or restricted to body appearance. Symptoms cause distress that impairs functioning. Lasted six months or longer. Not better explained by GAD, MDD, OCD, Panic disorder, SAD, or different somatoform disorder. Specify when: with poor insight.
Describe SUBSTANCE-INDUCED sexual dysfunction
Many of these problems caused by intoxication or wtihdrawal from alcohol or other substances
T or F With the exception of thse that bear gender-specific names, any of the sexual dysfunctions can apply to both males and females
Describe substance-induced disorders
Use of alcohol or other substances may produce blackouts, in which the pt. does not recall what happened while intoxicated. Alternatively, there may be state-dependent learning: important information learned while intoxicated is only recalled the next time the pt. is intoxicated.
Describe somatization disorder
Pts. who have long history of many somatic symptoms that cannot be explained on baiss of known disease mechanisms can also forget important aspects of personal history.
Describe Malingering with regard to other causes of severe memory loss
Some patients consciously feign symptoms of memory loss. There object is material gain, avoiding punishment or obtaining money or drugs.
Describe generalized anxiety disorder.
No episodes of acute panic. Patients feel tense or anxious much of the time.
Describe other causes of anxiety symptoms.
Avoidance behavior associated with sexual aversion (classified with sexual dysfunctions).
List criteria for FEMALE ORGASMIC disorder
After normal phase of sexual excitement, orgasm is delayed or missing (judgement based on sexual experience, adequate foreplay, and norms for her age). Other Axis I disorders ruled out. Organicity ruled out. it causes marked distress/problems.
List criteria for depersonalization disorder
Lasting or recurring feeling of being detached from one's own body as if in a dream. Reality testing in tact (pt. knows it's not true). Causes impaired personal functioning. Doesn't occur solely in course of another mental disorder (ASD, PD, Schizophrenia, different dissociative disorder). Organicity ruled out.
Obsessions and/or compulsions of OCD are associated with at least one of the following:
They cause severe distress.
They take up time (more than 1 hr. per day).
They interfere with pt.'s normal routines.
Explain how pt. avoids the trauma-related stimuli and reflects general numbing (3 or more for diagnosis)
Tries to avoid feelings, activities that recall the event. Cannot recall important features of event, experiences marked loss of interest in former activities, feels detached from other people, restricted ability to love, feels life will be brief or unfulfilled.
List the symptoms of hyperarousal that are not present prior to witnessing a traumatic event.
Insomnia, angry outbursts, poor concentration, excessive vigilance, increased startle response.
List criteria for DYSPAREUNIA, a SEXUAL PAIN disorder.
Pt. often experiences genital pain with intercourse. Vaginismus and inadequate lubrication ruled out. Other Axis I disorders ruled out (except for another sexual dysfunction). Organicity ruled out. Causes marked distress/problems.
List symptoms of panic attack.
chest pain, chills or hot flashes, choking sensation, derealization or depersonalization, dizzy, fear of dying, fears of loss on control, heart pounding, nausea, numbness, sweating, shortness of breath, trembling.
List criteria for FEMALE SEXUAL AROUSAL disorder
Pt. cannot lubricate enough. Other Axis I disorders ruled out. Organicity ruled out. It causes marked distress/problems
Describe Posttraumatic Stress Disorder
A MONTH OR MORE following a severe trauma, the pt. may not remember important aspects of personal history
List criteria for body dysmorphic disorder.
Pt. preoccupied with imaginary defect of appearance or slight physical flaw. Impairs personal functioning. Another disorder (Anorexia Nervosa) does not better explain preoccupation.
Describe criteria for somatization disorder
Starts before age 30 with physical complaints over several yrs. Pt sought tx for symptoms or symptoms impaired functioning.
Describe the physical complaints of undifferentiated somatoform disorder
Trouble breathing, chest pain, painful urination, fatigue, etc.
List the criteria for factitious disorder.
Pt. intentionally feighns physical or mental symptoms. Pt. motive is to occupy sick role. No other motives are apparant (malingering...financial gain, revenge, avoiding legal responsibility)
Out of the following: restlessness, tires easily, trouble concentrating, irritability, increased muscle tension, trouble sleeping, how many must a child have to be diagnosed with GAD?
One out of the six mentioned symptoms.
Describe the following Dissociative Disorder NOS: Conditions similar to DID
Some pts. may not fully meet criteria for DID. They may not have two FULLY formed personality states or may not have amnesia
Describe agoraphobia w/o history of panic disorder.
A codable form of agoraphobia related to FEAR of developing panic-like symptoms. Full criteria for panic disorder not met.
History, physical exam, or laboratory tests substantiate that either one of two conditions reveal that a substance-induced anxiety disorder is likely.
The symptoms have developed within a month of substance intoxication or withdrawal. Medication use has caused the symptoms.
List criteria for dissociative amnesia
Pts. main problem is at least one episode of inability to recall important personal information. Information usually concerns trauma or stress. Symptoms cause impaired personal functioning. DA does not ocur solely during DID, DF, PTSD, ASD, or SD.
Describe anxiety disorders due to general medical condition.
Panic attacks or GAD symptoms can be caused by numerous medical conditions.
List criteria for SEXUAL AVERSION disorder
Pt. dislikes and avoids all or nearly all genital contact with sex partner. Other Axis I disorders ruled out. It causes marked distress/problems
Woman has repeated spasms of vaginal muscles which interferes with sex. Causes marked distress/problems. Other Axis I disorders ruled out (except for another sex dysfunction). Organicity ruled out.
T or F. The symptoms of OCD are directly caused by a general medical condition or by use of substances, including meds.
F. They are NOT directly caused...including meds.
T or F. Conversion disorder occurs solely during somatization disorder.
F It DOES NOT occur solely during somatization disorder, and no other mental disorder better explains it.
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