SCHIZOPHRENIA: Schizophrenia is a thought disorder that impairs Judgement,Behavior,and the ability to interpret reality. The symptoms must be present for at least 6 months and it must affect functioning. there is equal incidence in men and women but it affects men earlier due to earlier age of onset. Urine drug screen ins important in-order to rule out cocaine or amphetamine use.
Panic disorder: Panic disorder is the experience of intense anxityy along with feelings of dread and doom. This is accompanied by at-least 4 symptoms of autonomic hyperactivity, such as diaphoresis, trembling, chest pain, fear of dying, chills,palpitations, shortness of breath, nausea, dizziness, dissociative symptoms, and paresthesias. these sensations typically last less than 30 minutes and may be accompanied by agoraphobia, defined as the fear of places where escape is felt to be difficult.
Panic disorder typically seen in woman, can occur at any time, and usually has no specific stressor. it is to ensure that thyroid disease, hypoglycemia, and cardiac disease have been ruled out.
Phobia’s: A phobia is a fear of an object or situation and the need to avoid it. Phobias may be learned and involve 2 types i.e., Specific Phobias such as fear of heights and Social phobias such as fear of public speaking.
Obsessive Compulsive Disorder: OCD is a disorder where patients typically experience either obsessions alone or, most commonly, a combination of obsessions and compulsions typically affect the individuals levels of functioning. Obsessions are the thoughts that are intrusive, senseless, and distressing to the patient, thus increasing anxiety. these include fear of contamination. Compulsions are rituals, such as counting and checking, that are performed to neutralize obsessive thoughts. These are time consuming and tend to lower anxiety.
Hoarding Disorder: Individuals with hoarding disorder have problems discarding their possessions, leading to persistent accumulations of possessions such that the home is overwhelmed by clutter. The hoarding affects the individual’s level of functioning and impairs his or her ability to maintain safe environment.
Post Traumatic Disorder: PTSD and Acute Stress Disorder, individuals have been exposed to a stressor to which they react with fear and helplessness. Patients continually relieve the event and avoid anything that reminds them of the event. these stressors are usually overwhelming and involve such events as war,rape, hurricanes or earthquakes. the symptoms adversely affect the patient’s level of functioning. other symptoms include startle response, hypervigilance, sleep disturbances, anger outbursts, and concentration difficulties.
Generalized Anxiety Disorder: this is a disorder in which patients experience excessive anxiety and worry about most things, lasting more than 6 months. typically, anxiety is out of proportion to the event. this is accompanied by fatigue, concentration difficulties, sleep problems, muscle tension and restlessness. patients are usually women and complain of feeling anxious as long as they can remember.
Somatic Symptom Disorder (Formerly Somatoform Disorder): it is characterized by the presence of one or more somatic symptoms that are distressing and cause impairment in functioning. the patient has excessive thoughts, feelings, or behaviors related to somatic symptoms that are manifested by disproportionate and persistent thoughts about the seriousness of the symptoms, intense anxiety about the symptoms and excessive time devoted to the symptoms or health concerns. a patient must be symptomatic for more than 6 months to be diagnosed with somatic symptom disorder. the disorder most frequently seen in young women and usually has some psychological component of which the patient is unaware. psychotherapy is the treatment of choice given the psychological source of symptoms.
Factitious Disorder: in this disorder, an individual fakes an illness, in-order to get attention and emotional support in the patient role. this can be either a psychological or physical illness. psychological symptoms include hallucinations, delusions, depression, and bizarre behavior. Physical symptoms include abdominal pain, fever, nausea, vomiting or hematomas. at times, these individuals may inflict life threatening injuries on themselves in-order to get attention. this behavior may be compulsive at times.
Adjustment disorder: is characterized by a maladaptive reaction to an identifiable stressor, such as loss of job, divorce or failure in school. the symptoms usually occur within 3 months of the stressor and must remit within 6 months of removal of the stressor. the symptoms include anxiety, depression, or disturbances of conduct. they are severe enough to cause impairment in functioning. psychotherapy is the treatment of choice. both individual and group therapy have been used effectively.
Personality Disorders: this is a group of disorders characterized by personality patterns that are pervasive, inflexible and maladaptive.
Personality disorders are difficult to treat especially antisocial personality disorder.
Anorexia Nervosa: anorexia is characterized by failure to maintain normal body weight, and body image disturbance. there is an unrealistic self-evaluation as over weight. these patients tend to deny their emaciated condition. they show great concern with appearance and frequently examine and weigh themselves. they typically lose weight by maintaining strict caloric control, excessive exercise, purging and fasting, with laxative and diuretic abuse.
Bulimia Nervosa: is characterized by frequent binge eating, as evidenced by eating large amounts of food in discrete amount of time, as well as lack of control of overeating episodes. This is accompanied by a compensatory behavior to prevent weight gain in the form of purging, misuse of laxatives and diuretics, fasting and excessive exercise. the patient’s self evaluation is unduly influenced by body shape and weight.
Binge Eating Disorder: the essential feature of binge eating disorder is recurrent episodes of binge eating that occur at-least 3 times per week for more than 3 months. patients are overweight, and they usually lack a sense of control over their eating habits. the binge eating episodes are associated with eating faster than usual, eating until feeling uncomfortably full, eating large amounts of food in absence of hunger, eating alone, and feeling disgusted with oneself after eating episode.
Narcolepsy: characterized by excessive day time sleepiness and abnormalities of REM Sleep.
Sleep Apnoea: is a disorder characterized by cessation of airflow at the nose or mouth during sleep due to obstruction of the upper airway.
Insomnia: is a disorder characterized by inability to initiate or maintain sleep.
Reference:Conrad Fishcer, Master the Boards, USMLE, Step 2 CK-3rd edition,