Psychiatric Disorders & Differential Diagnosis

Vocabulary flashcards covering key psychiatric disorders, diagnostics, symptoms, and related concepts from the lecture notes.

Differential Diagnosis

Systematic process of ruling in/out disorders using symptom presentation, history, collateral data, labs, culture, substance use, and family dynamics.

Schizophrenia

Chronic psychotic disorder marked by delusions, hallucinations, disorganized speech/behavior, negative symptoms, ≥6-month duration with ≥1 month of active (positive) symptoms.

Symptoms (Schizophrenia)

Hallucinations, delusions, disorganized speech/thought, grossly disorganized or catatonic behavior.

Negative Symptoms (Schizophrenia)

Blunted/flat affect, anhedonia, avolition, alogia, asociality.

Catatonia

Marked decrease in motor activity or purposeless excessive motor activity; may accompany schizophrenia or mood disorders.

Flat Affect

Absence or near-absence of emotional expression; common in schizophrenia.

Schizophreniform Disorder

Same core symptoms as schizophrenia but episode lasts ≥1 month and <6 months.

Schizoaffective Disorder

Uninterrupted illness with schizophrenia symptoms plus major mood episode; ≥2 weeks of psychosis without mood symptoms.

Schizoaffective – Bipolar Type

Schizoaffective disorder in which manic (± depressive) episodes predominate.

Schizoaffective – Depressive Type

Schizoaffective disorder in which only major depressive episodes accompany psychosis.

Schizotypal Personality Disorder

Cluster A disorder with odd beliefs, magical thinking, social deficits, eccentric dress, possible brief psychotic episodes.

Brief Psychotic Disorder

Acute onset of delusions, hallucinations, or disorganized speech/behavior lasting ≥1 day but <1 month, often after extreme stress.

Delusional Disorder

One or more persistent non-bizarre or bizarre delusions ≥1 month with relatively intact functioning and no full-criteria schizophrenia.

Bipolar I Disorder

At least one manic episode (≥1 week or any duration if hospitalized) ± depressive episodes.

Manic Episode

Elevated/irritable mood and increased energy ≥1 week with ≥3 additional symptoms (grandiosity, decreased sleep, pressured speech, flight of ideas, distractibility, goal-directed activity, risky behavior).

Bipolar II Disorder

≥1 hypomanic episode (≥4 days) plus ≥1 major depressive episode; no full manic episodes.

Hypomanic Episode

Period of elevated/irritable mood ≥4 days with ≥3 manic symptoms, not severe enough for hospitalization.

Substance-Induced Psychotic Disorder

Delusions or hallucinations caused by intoxication or withdrawal from drugs, alcohol, medications, or toxins.

Shared Psychotic Disorder (Folie à deux)

Identical delusion shared by two people in close relationship.

Obsessive–Compulsive Disorder (OCD)

Intrusive obsessions and/or compulsions recognized as irrational, performed to reduce anxiety.

OCD Symptom Categories

Washers, Checkers, Doubters/Sinners, Counters/Arrangers, Hoarders.

Obsessive–Compulsive Personality Disorder (OCPD)

Cluster C disorder characterized by perfectionism, control, and rigidity; behaviors viewed as purposeful and egosyntonic.

OCD vs. OCPD

OCD sufferers recognize compulsions as distressing; OCPD individuals see their perfectionism as appropriate and lack true obsessions/compulsions.

Psychosis

Loss of contact with reality characterized by delusions, hallucinations, and/or disorganized thinking.

Post-Traumatic Stress Disorder (PTSD)

Re-experiencing trauma, avoidance, negative mood/cognition, hyperarousal ≥1 month after life-threatening event.

Acute Stress Disorder (ASD)

PTSD-like symptoms lasting 3 days–1 month following trauma.

PTSD vs. ASD

ASD duration ≤1 month; PTSD symptoms persist >1 month.

Adjustment Disorder

Maladaptive emotional/behavioral response to identifiable stressor within 3 months, resolving within 6 months after stress ends.

Major Depressive Disorder (MDD)

≥5 depressive symptoms for ≥2 weeks, including depressed mood or anhedonia.

Persistent Depressive Disorder (Dysthymia)

Depressed mood most days ≥2 years (≥1 year in youth) with <2 months symptom-free.

Cyclothymic Disorder

Chronic ≥2-year period of fluctuating sub-threshold hypomanic and depressive symptoms.

MDD with Psychotic Features

Major depressive episode accompanied by mood-congruent or incongruent delusions/hallucinations.

Depressive Disorder Due to Medical Condition

Prominent depressed mood/anhedonia directly caused by another medical illness (e.g., stroke, hypothyroidism, MS).

Somatic Symptom Disorder

Distressing somatic symptoms plus excessive thoughts/behaviors about health, typically >6 months.

Conversion Disorder

Neurologic symptom (e.g., paralysis, blindness) incompatible with medical findings, precipitated by psychological stress.

Briquet’s Syndrome

Historical term for chronic, multisystem somatic symptom disorder.

Illness Anxiety Disorder

Preoccupation with having/acquiring serious illness despite minimal/no somatic symptoms for ≥6 months.

Factitious Disorder

Intentional feigning or induction of illness to assume sick role, without external incentives.

Malingering

Deliberate fabrication/exaggeration of symptoms for external gain (e.g., money, avoidance).

Insomnia Disorder

Difficulty initiating/maintaining sleep or early awakening ≥3 nights/week for ≥3 months causing distress/impairment.

Shift-Work Sleep Disorder

Circadian rhythm sleep disturbance due to working non-traditional hours (e.g., night shift).

Drug-Induced Insomnia

Sleep disturbance caused by stimulants, caffeine, certain medications, or substances.

Sleep Hygiene – Stimulant Cutoff

Avoid caffeine, nicotine, alcohol at least 4 hours before bedtime; begin wind-down 1–2 hours before sleep.

Medical Comorbidities with Psychiatric Illness

Common overlaps include CVD/stroke, diabetes, metabolic syndrome, sleep disorders, lung/liver disease, cancer, neuro-cognitive disorders.

Sertraline (Zoloft)

SSRI often preferred for MDD in patients with cardiovascular disease or post-stroke.

Personality Disorder Clusters

Cluster A (odd/eccentric), Cluster B (dramatic/erratic), Cluster C (anxious/fearful).

Antisocial Personality Disorder

Pervasive disregard for others’ rights since age ≥15; diagnosis requires patient age ≥18.

Narcissistic Personality Disorder

Grandiose sense of self-importance, need for admiration, lack of empathy.

Histrionic Personality Disorder

Excessive emotionality and attention-seeking; uncomfortable when not center of attention.

Borderline Personality Disorder (BPD)

Instability in relationships, self-image, affect, marked impulsivity, fear of abandonment, recurrent self-harm or suicidality.

Dialectical Behavior Therapy (DBT)

Evidence-based treatment emphasizing mindfulness, distress tolerance, emotion regulation, used for BPD.

Avoidant Personality Disorder

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

Dependent Personality Disorder

Excessive need to be taken care of, leading to submissive, clinging behavior and fear of separation.

Obsessive–Compulsive Personality Disorder (OCPD)

Preoccupation with orderliness, perfectionism, control at expense of flexibility and efficiency.

Schizoid Personality Disorder

Detachment from social relationships and restricted emotional expression; prefers solitary activities.

Paranoid Personality Disorder

Pervasive distrust and suspiciousness of others; interprets motives as malevolent without delusions.

Histrionic vs. Narcissistic PD

Histrionic craves approval/attention; narcissistic has inflated self-importance and exploits others.

Medical Causes of Personality Change

Head trauma, cerebrovascular disease, tumors, epilepsy, Huntington’s, MS, endocrine disorders, neurosyphilis, AIDS, dementia.

Genetic Counseling

Process of reviewing family history, ordering/interpreting genetic tests, educating clients for informed medical decisions.

Schizoaffective vs. Bipolar with Psychotic Features

Schizoaffective: psychosis occurs with or without mood symptoms; Bipolar w/ psychosis: psychotic features occur only during mood episodes.

Avolition

Decrease in motivated purposeful activities; negative symptom of schizophrenia.

Anhedonia

Inability to experience pleasure; seen in depression and schizophrenia.

Alogia

Poverty of speech or thought; negative symptom in schizophrenia.

Asociality

Lack of interest in social interactions; negative symptom in schizophrenia.

Grandiosity

Inflated self-esteem or superiority; symptom of mania and narcissistic traits.

Flight of Ideas

Rapid, loosely connected thoughts; classic manic symptom.

Distractibility

Inability to concentrate due to shifting attention; manic symptom.

Goal-Directed Activity (Increased)

Excessive involvement in purposeful tasks; hallmark of mania/hypomania.

Prazosin

Alpha-1 blocker used off-label to reduce PTSD-related nightmares and flashbacks.