Lecturio: Study for Medical School, USMLE, MCAT & MBBS

Videos
Questions
Articles

You want to keep on challenging yourself? Create your free account to access more questions.

Obsessive-Compulsive Disorder (OCD) — Clinical Features and Treatment

Obsessive-compulsive disorder (OCD) is a disorder in which patients experience either obsessions (intrusive, senseless and anxiety provoking thoughts) alone or a combination of obsessions and compulsions (anxiety releasing rituals) due to which an individual's level of functioning is affected. Genetic factors, a proposed biological model, and a proposed cognitive behavioral model are seen to play a role in the pathogenesis of OCD. The diagnosis of OCD is purely clinical and no investigations are needed. A thorough history of the patient's obsessions and compulsions and their comparison with certain 'identifiable themes' will aid in diagnosis. The management of OCD can be done with a combination of cognitive behavior therapy and physical treatments (tricyclic anti-depressants, selective serotonin reuptake inhibitors, anti-glutamatergic agents, deep brain stimulation and psychosurgery) and OCD is related to a number of medical comorbidities.

Panic Disorder — Clinical Features and Management

A panic disorder is when recurrent and episodic panic attacks occur abruptly without a trigger. Diagnosing a panic disorder may become challenging because panic attacks can also occur with other anxiety and mental disorders. However, by following the correct approach, which first includes ruling out other disorders (by taking a thorough history and performing relevant investigations) and then following the proposed diagnostic criteria for panic disorder, one can reach a diagnosis. The pathogenesis of panic disorder is a combination of an underlying predisposition that triggered by a life stress (e.g. separations during childhood or interpersonal loss in adulthood). Management includes both psychological treatments as well as medical treatment.

Cognitive Behavioral Therapy — General Principles and Specific Techniques

Cognitive therapy changes a person's thinking towards a situation by telling him the other less negative possibilities he can think of. Behavioral therapy changes a person's thinking towards a situation by modifying the way he behaves in that situation. Therefore, both cognitive and behavioral therapy aims at changing the way a person thinks. Cognitive and behavioral therapies can be used singly or combined to treat a number of psychiatric conditions. The specific techniques in cognitive behavioral therapy include relaxation, exposure, social skills training (assertiveness training and anger management), enuresis alarms and dialectic behavioral therapy.

Psychological Factors Affecting Other Medical Conditions

The DSM-5 has always faced criticism over the term “psychological factors affecting other medical conditions” because the clinical application was always unclear. The simplest way to define this term might be the presence of psychological or behavioral factors that adversely affect an organic medical condition in a patient with confirmed medical illness other than a mental disorder. These psychological factors should show a positive temporal relationship with disease’s exacerbations or delayed recovery.

Somatic Symptom Disorder — Pathophysiology and Treatment Options

Somatic Symptom Disorder is a condition that is characterized by the presence of one or more somatic symptoms that are associated with excessive thoughts and feelings about them which lead to excessive behaviors. This should be associated with significant distress in the everyday life of the patient. Patients who are diagnosed with somatic symptom disorder should be given full medical care whenever they present to the emergency department and proper exclusion of life-threatening conditions such as a myocardial infarction is needed. Patients with good insight into their condition respond well to cognitive-behavioral therapy.

Somatic Pain Disorder — Diagnostic Criteria and Brain Imaging

Somatic pain disorder is very common in the general population, especially in females. The previous history of sexual, physical or emotional abuse might increase the risk of chronic pain syndrome and somatic pain disorders. The diagnosis is based on the DSM-IV criteria. Brain imaging studies have identified novel therapeutic targets which are very promising in the management of chronic pain. The current treatment options include antidepressants, group psychotherapy, and the proper explanation of the nature of the symptoms and the most likely cause.

Malingering — Causes and Detection

Malingering is not a medical diagnosis. It is a condition that is characterized by providing intentional false information about non-existent symptoms or by exaggerating real symptoms to get some gain. This gain is usually in the form of financial compensation, avoiding work, or avoiding criminal prosecution. Symptom validity tests are used to detect cases of malingering. Once the possibility of malingering is confirmed, the best approach should be the confrontation of the subject.

Dissociative Fugue — Causes and Treatment Options

A dissociative fugue is a specific form of dissociative amnesia that is characterized by the memory loss of one’s identity and past life, in addition to the unexpected and purposeful travel away from home. The patient might also create a new identity to compensate for the severe memory loss. Fugue has been suggested to be caused by severe traumatic life events or stressors. Patients with fugue might respond to cognitive therapy or hypnosis. Barbiturates might be used for a medicated-interview to reveal more information about a suppressed traumatic trigger.

Dissociative Identity Disorder (DID) — Causes and Diagnostic Criteria

Dissociative identity disorder is a rare condition that is characterized by the presence of two or more distinct personality identities in the patient. The condition resembles possession. Dissociation is an essential part in the diagnosis and without it, the diagnosis cannot be made. Treatment of dissociative identity disorder involves the identification of the most likely childhood trauma that caused the split, and fusion therapy to fuse as many personalities as we can into one coherent personality.

Overview of Dissociative Disorders: Dissociative Identity Disorder, Dissociative Amnesia and Dissociative Fugue

Dissociative disorders are a group of psychiatric conditions that are characterized by dissociation. Dissociation is defined as forgetting or abandoning one’s own identity and the loss of certain autobiographical memories in the process. Based on this definition, the most important dissociative disorders to study are dissociative identity disorder, dissociative amnesia, and fugue. Multiple personality disorder with dissociation or amnesia is now known as dissociative disorder, non-specified.

Depersonalization Disorder (DPD) and Depersonalization-Derealization Syndrome — Causes and Diagnostic Criteria

Depersonalization or Derealization symptoms are common in the general population but the recurrent or almost persistent episodes of depersonalization or derealization which are the cornerstone for the diagnosis of this disorder is reported in about 2 % of the population. These recurrent episodes are characterized by experiencing unreality about one’s own self, i.e. depersonalization, or one’s surroundings, i.e. derealization. Crisis intervention therapy during the acute episodes combined with psychodynamic therapy when asymptomatic is the main treatment for depersonalization/derealization disorder.

Dissociative Amnesia (Psychogenic Amnesia) — Causes and Treatment

Dissociative amnesia is a common psychiatric disorder among certain populations such as sex workers and drug abusers. Additionally, dissociative amnesia is more common in patients with other comorbid psychiatric illness such as depression and conversion disorder. Dissociative amnesia might be global or localized. The most common type is the localized loss of certain life events that are usually traumatic and unpleasant. The diagnosis of dissociative amnesia is based on the clinical evaluation of the patient and the DSM-5 criteria. Brain imaging showed some metabolic derangements, especially in the frontal and medial temporal lobes. Treatment includes psychotherapy, antidepressants, and drug-assisted interviews to help the patient recall the traumatic and most likely causative event of their amnesia.

Body Dysmorphic Disorder (BDD) — Signs ans Treatment

Body dysmorphic disorder is a common psychiatric condition that is characterized by the preoccupation with false ideas about one’s own physical appearance. This preoccupation leads to repetitive compulsive behavior that aims to fix the perceived physical defects. Patients with body dysmorphic disorder might have good insight, poor insight or completely absent insight. When patients have poor insight or completely absent insight into their condition, cognitive-behavioral therapy might fail. Patients with good insight who know that their beliefs about their body appearance are probably wrong usually respond well to intensive cognitive-behavioral therapy. Serotonin-reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and some antiepileptic medications have been used for the pharmacotherapy management of body dysmorphic disorder.

Major Depressive Disorder (MDD, Depression) — Definition and Treatment

Major depressive disorder (MDD) is a unipolar mood disorder characterized by persistent low mood and loss of interest in association with somatic symptoms. The overall incidence of the disease is 6.7 % with prevalence increasing with age. Monoamine oxidase deficiency and amine neurotransmission abnormalities are the incriminated causes of the disease. Psychotherapy, pharmacotherapy and electroconvulsive therapy (ECT) are the modalities used to treat the disease. Its leading cause of mortality is suicide, which is more common among the elderly population.

Psychiatric Assessment 01:04 h / 7 videos 2 free

Psychiatric Assessment 0 articles 0 free

Psychiatric Assessment 31 questions 9 free
Personality Disorders 00:57 h / 9 videos 3 free

Personality Disorders 0 articles 0 free

Personality Disorders 42 questions 13 free
Major Psychiatric Disorders 03:37 h / 27 videos 6 free

Major Psychiatric Disorders 4 articles 4 free

Major Psychiatric Disorders 128 questions 21 free
Control Disorders 01:12 h / 14 videos 5 free

Control Disorders 0 articles 0 free

Control Disorders 33 questions 26 free
Age-Related Disorders 01:04 h / 13 videos 4 free

Age-Related Disorders 0 articles 0 free

Age-Related Disorders 0 questions
Dissociative Disorders and Somatoform Disorders 01:14 h / 13 videos 4 free

Dissociative Disorders and Somatoform Disorders 10 articles 10 free

Dissociative Disorders and Somatoform Disorders 0 questions
Forensic Psychiatry 00:24 h / 4 videos 1 free

Forensic Psychiatry 0 articles 0 free

Forensic Psychiatry 0 questions

5 Stars		8
4 Stars		1
3 Stars		0
2 Stars		0
1 Star		1

5 Stars		8
4 Stars		1
3 Stars		0
2 Stars		0
1 Star		1

Psychiatry

Review Psychiatry with the Best!

Course Details

Content

Your Educators of course Psychiatry

Helen Farrell, MD

User reviews