Psychiatry & Eating-Disorder Review

Vocabulary flashcards summarizing key disorders, features, risk factors, investigations, and treatments from the lecture notes.

Anorexia nervosa

Eating disorder marked by BMI < 18.5, intense fear of weight gain, body-image distortion, caloric restriction, possible purging or excessive exercise.

High-risk professions for anorexia

Fashion models, ballet dancers—careers that emphasize low body weight and appearance.

Lanugo hair

Fine, downy hair on trunk/limbs that develops in anorexia due to malnutrition.

Russell’s sign

Scarred or calloused knuckles/hand from self-induced vomiting.

Amenorrhea in anorexia

Estrogen & progesterone fall (↓FSH/LH) causing cessation of menses and breast atrophy.

Osteoporosis in anorexia

Low estrogen leads to reduced bone mass; stress fractures common (e.g., tibia).

Urgent lab in anorexia

Serum electrolytes—hypokalemia may provoke fatal arrhythmias.

Indications for involuntary admission (anorexia)

BMI < 14, critical vitals (bradycardia, hypotension, hypothermia), severe hypokalemia, suicidal ideation.

Bulimia nervosa

Recurrent binge eating with compensatory behaviors (vomiting, laxatives, exercise) but normal/high BMI and intense guilt.

Family history of obesity

Major risk factor predisposing to bulimia nervosa.

Bulimia dental findings

Enamel erosion & enlarged parotid glands from chronic vomiting.

Bulimia treatment

Cognitive-behavioral therapy plus SSRI—fluoxetine is FDA-approved.

Binge-eating disorder

Recurrent binges without compensatory behaviors, causing distress; patients often overweight or obese.

Body dysmorphic disorder

Preoccupation with perceived physical flaw (commonly face) despite normal appearance; repetitive mirror checking, normal BMI.

BMI threshold for anorexia

Body mass index below 18.5 kg/m² is diagnostic key word.

Paranoid personality disorder

Pervasive distrust & suspicion; interprets others’ motives as malevolent; socially isolated, emotionally cold.

Schizoid personality disorder

Detached loners uninterested in relationships, praise, or criticism; flattened affect.

Schizotypal personality disorder

Social deficits plus odd beliefs, magical thinking, ideas of reference; eccentric appearance.

Avoidant personality disorder

Social inhibition, hypersensitivity to rejection, feelings of inadequacy; desires relationships but fears criticism.

Borderline personality disorder

Female-predominant; unstable affect, impulsivity, self-injury, frantic efforts to avoid abandonment; defense: splitting.

Dialectical behavior therapy

Evidence-based psychotherapy of choice for borderline personality disorder.

Narcissistic personality disorder

Grandiosity, need for admiration, entitlement, fragile self-esteem, lack of empathy.

Antisocial personality disorder

Adult pattern of rule violation, deceit, aggression, lack of remorse; preceded by conduct disorder before age 15.

Conduct disorder

< 18 y; aggression to people/animals, property destruction, theft, serious rule violations.

Oppositional defiant disorder

Angry, argumentative, vindictive behavior toward authority without serious violations or cruelty.

Obsessive-compulsive personality disorder

Perfectionism, orderliness, control that impairs efficiency; ego-syntonic (unlike OCD).

Dependent personality disorder

Excessive need to be cared for, difficulty making decisions, fear of abandonment, risk of abuse.

Histrionic personality disorder

Excessive emotionality & attention seeking; seductive appearance, dramatic speech, shallow relationships.

Attention-deficit/hyperactivity disorder (ADHD)

Onset < 12 y (classically 5-7 y); inattention, hyperactivity, impulsivity in ≥2 settings; poor academics.

First-line ADHD medication

Methylphenidate; use long-acting form if midday dosing problematic.

Drug-seeking red flag for methylphenidate

Adult requesting prescription after being off medication—evaluate for abuse.

Autism spectrum disorder

Before age 3; impaired social interaction, delayed language, repetitive behaviors, restricted interests.

Asperger’s syndrome

Autism-like social impairment & repetitive interests without language or cognitive delay.

Tourette syndrome

Motor AND vocal tics for > 1 year; often with ADHD/OCD; treatment: CBT, clonidine, antipsychotics.

Chronic tic disorder

Motor OR vocal tics persisting > 1 year (not both).

Urge-tic-relief cycle

Pre-monitory urge relieved by performing tic; tics can be voluntarily suppressed briefly.

Selective mutism

Consistent failure to speak in specific social settings (e.g., school) despite normal speech at home.

Masturbation

Normal human behavior; only considered abnormal if it interferes with daily functioning.

Paraphilia

Intense sexual interest in atypical objects, situations, or individuals causing impairment or distress.

Exhibitionism

Sexual arousal from exposing genitals to an unsuspecting stranger.

Voyeurism

Sexual arousal from observing unsuspecting individuals naked or having sex.

Fetishism

Sexual use of nonliving objects (e.g., shoes) for arousal.

Frotteurism

Rubbing one’s genitals against a non-consenting person (often in crowds).

Pedophilia

Sexual activity or fantasies involving prepubescent children.

Sexual sadism

Arousal from inflicting physical or psychological suffering on a partner.

Sexual masochism

Arousal from being humiliated, beaten, bound, or otherwise made to suffer.

Transvestic fetishism

Male achieves sexual arousal by cross-dressing while fully identifying as male.

Gender identity disorder (transsexualism)

Persistent discomfort with one’s biological sex; belief of being in wrong body; desire for transition.

Somatization disorder

Multiple chronic somatic complaints across systems with no organic cause; female; treat with CBT & single physician.

Conversion disorder

Acute neurologic symptom (paralysis, blindness) after stress; normal exam; la belle indifference common.

La belle indifference

Apparent lack of concern about neurologic deficits in conversion disorder.

Identification (conversion)

Unconscious adoption of symptoms modeled on a significant person’s illness.

Hypochondriasis

Preoccupation with having serious disease despite reassurance; now termed illness anxiety disorder.

BMI criterion for severe anorexia

BMI < 14 kg/m² = marker for possible involuntary admission.

Electrolyte hallmark in bulimia

Hypokalemic metabolic alkalosis from vomiting and diuretic abuse.

Stress fracture in anorexia

Pathologic fracture (often tibia) due to low bone density and heavy exercise.

Family history of athleticism

Risk factor linked to development of anorexia nervosa.

Childhood sexual abuse

Psychosocial risk factor frequently associated with later anorexia nervosa.

Splitting

Primitive defense mechanism: viewing others as all-good or all-bad; characteristic of borderline PD.

VIP demand (personality)

Requesting special treatment due to self-perceived superiority—narcissistic PD clue.

Conduct disorder prognosis

Many progress to antisocial personality disorder in adulthood.

Clonidine for tics

Alpha-2 agonist now considered first-line pharmacotherapy for Tourette’s syndrome.

Oppositional defiant vs conduct

ODD lacks aggression toward animals/people or serious rule violations present in conduct disorder.

Differential: deafness vs ADHD

Hearing loss may mimic inattention; perform audiologic testing before ADHD diagnosis.

Normal variant homosexuality

Same-sex orientation is not a psychiatric disorder; gays statistically less stable relationships than lesbians.

Excessive exercise impairing HPO axis

Leads to hypothalamic amenorrhea and features overlapping with anorexia.

Obsessive-compulsive disorder (OCD)

Ego-dystonic obsessions & compulsions; distinct from obsessive-compulsive personality disorder.

CBT for somatoform disorders

Cognitive-behavioral therapy is cornerstone treatment for somatization, conversion, hypochondriasis.

Psychodynamic/dialectical therapy

Combined approach effective for borderline personality disorder to manage affect & self-harm.