Behavioral Med Exam 5

Major Neurocognitive Disorder

Significant cognitive decline in one or more domains interfering with independence.

Minor Neurocognitive Disorder

Modest decline, does not interfere with capacity for independence.

Dementia

An umbrella term that can fall under both major and minor neurocognitive disorders.

Delirium

Acute, fluctuating disturbance in attention and awareness, often due to medical condition.

CAM

Confusion Assessment Method, a useful tool in diagnosing delirium.

MMSE

Mini-Mental State Examination, a useful tool in diagnosing delirium.

Depression

Rapid onset, fluctuates, patient aware and distressed by memory loss.

Vascular Dementia

Stepwise decline.

Alzheimer's Dementia

Memory loss is early sign.

Lewy Body Dementia

Visual hallucinations, Parkinsonism.

Frontotemporal Dementia

Personality and behavioral changes.

HIV Dementia

Cognitive, motor, and behavioral impairments in advanced HIV.

AD-8

A screening tool for cognitive impairment, particularly Alzheimer's disease.

First sign of Alzheimer's Dementia

Memory loss, especially short-term (recent) memory.

Signs of Alzheimer's Dementia

Gradual memory loss, disorientation, word-finding difficulty, personality changes.

Lewy Body Dementia characteristics

Fluctuating cognition, visual hallucinations, parkinsonism, sensitivity to antipsychotics.

Frontotemporal Dementia characteristics

Early changes in behavior, personality, or language with relatively preserved memory.

Signs of Frontotemporal Dementia

Disinhibition, apathy, compulsive behavior, loss of empathy, poor insight.

Former name for Frontotemporal dementia

Pick's disease.

Treatment of Vascular Dementia

Treat underlying vascular risk factors (HTN, DM, cholesterol).

Goal in management of vascular dementia

Prevent further strokes and slow progression.

Amnestic disorder

Impairment in memory with preserved other cognitive functions, not due to delirium or dementia.

Primary cause of amnesia

Most common: Psychological trauma.

Other causes of amnesia

TBI, stroke, infections, substance use, Wernicke-Korsakoff syndrome.

Vitamin for preventing amnesia in alcoholism

Thiamine (Vitamin B1) - prevents Wernicke-Korsakoff syndrome.

Confabulation

Fabricated or misinterpreted memories without intent to deceive, often seen in amnesia.

Dissociative Amnesia

Inability to recall important autobiographical info, often traumatic; may be localized, selective, or generalized.

Dissociative Fugue

Subtype of amnesia; person travels and may *******************.

Dissociative Identity Disorder

2+ distinct personality states, memory gaps, trauma-related, often in women.

Depersonalization/Derealization Disorder

Persistent feelings of unreality or detachment; intact reality testing.

Difference between depersonalization and derealization

Depersonalization: Unreality or detachment from oneself; Derealization: Unreality or detachment from surroundings.

Difference between dissociative amnesia, fugue, and identity disorder

Amnesia: Inability to recall personal info.

Amnesia

Inability to recall personal info.

Fugue

Amnesia + travel and possible new identity.

DID

2+ identities, with amnesia between states.

Autobiographical Memory

Combines episodic + semantic memory of personal life events.

Semantic Memory

Facts and concepts (e.g., vocabulary, world knowledge).

Episodic Memory

Events in specific time and context (e.g., birthday party).

Procedural Memory

Skills and tasks (e.g., riding a bike).

Generalized Amnesia

Loss of entire life history.

Amnesia/Dissociation

Psychological, usually stress-related, no structural brain damage.

Schizophrenia

>6 months, 2+ symptoms (delusions, hallucinations, disorganized speech, negative symptoms).

Schizophreniform

Same as schizophrenia but 1-6 months.

Brief Psychotic Disorder

<1 month, full return to baseline.

Delusional Disorder

1+ non-bizarre delusion >1 month, no other psychosis.

Schizoaffective Disorder

Schizophrenia + mood disorder; psychosis present 2+ weeks without mood sx.

Positive Symptoms

Hallucinations, delusions, disorganized speech, bizarre behavior.

Negative Symptoms

Flat affect, alogia, avolition, anhedonia, asociality.

Atypical antipsychotics

1st line for Schizophrenia: Risperidone, Olanzapine, Aripiprazole.

Typical antipsychotics

2nd line: Typical antipsychotics like Haloperidol.

Clozapine

Not first line due to risk of agranulocytosis and serious side effects.

Better prognosis in Schizophrenia

Female, older onset, mood sx, good social support.

Worse prognosis in Schizophrenia

Male, early onset, negative symptoms, poor premorbid function.

Substance/Medication-Induced Psychotic Disorder

Diagnosis if someone only has psychosis while on a substance.

Brief Psychotic Disorder Specifiers

With marked stressor, without marked stressor, with postpartum onset.

Ideas of Reference

Believing events refer to oneself.

Alogia

Poverty of speech.

Tangentiality

Going off-topic.

Loss of ego boundaries

Inability to differentiate self from others.

Echolalia

Repeating others' words.

Affect

Observable emotion.

Mood

Sustained internal feeling.

Psychosis

Loss of contact with reality.

Hallucinations

Sensory experiences without stimuli.

Delusions

Fixed false beliefs.

Loose associations

Illogical shifting of ideas.

Word salad

Disorganized speech.

Thought blocking

Sudden stop in thought.

Loss of abstraction

Concrete thinking.

Magical thinking

Belief that thoughts can cause events.

PTSD

After trauma; intrusive thoughts, hypervigilance, avoidance, >1 month.

Acute Stress Disorder

Similar to PTSD, lasts 3 days-1 month.

Acute reaction to stress

Immediate, short-term reaction, often resolves on its own.

Adjustment Disorder

Emotional/behavioral sx in response to identifiable stressor within 3 months, not meeting criteria for another disorder.

Adjustment Disorder Specifiers

With depressed mood, anxiety, mixed anxiety and depressed mood, disturbance of conduct, mixed disturbance of emotions and conduct, unspecified.

Groups more likely to develop PTSD

Women, especially with prior trauma history; individuals with lack of social support, ongoing stress, or concurrent mental illness.