Psychiatric Disorders Quiz

Part I: Classification of Mental Disorders

• Mental disorder: abnormal behavior following a period of normal functioning.
• Personality disorder: consistently exhibiting abnormal behavior from early adulthood.
• Learning disability: intellectual impairment present from early life.
• Diagnostic systems are primarily "syndromal" grouping symptoms for recognizable conditions, not based on etiology.
• Diagnoses are based on clinical features, natural history, and treatment response.
• International Classification of Disease (ICD-10): a general medical classification system created by the World Health Organization (WHO), used worldwide (excluding the USA) since the 1990s.
• Diagnostic and Statistical Manual of Mental Disorders (DSM-V): created by the American Psychiatric Association (APA).

Etiology and Pathogenesis of Mental Disorders

• Biological factors:
  • Genetics play a significant role in susceptibility (multiple genes, not just one, in- teract with other factors).
  • Prenatal damage (oxygen deprivation during birth) or early development, causing brain trauma.
  • Imbalance of neurotransmitters (ex. low serotonin).
• Psychological factors:
  • Severe trauma (emotional, physical, sexual abuse) in childhood.
  • Important early losses.
  • Neglect.
• Environmental factors:
  • Death
  • Divorce.
  • Social or cultural expectations
  • Substance abuse by the individual or parents
  • Difficulty changing jobs or schools
  • Feelings of inadequacy, low self-esteem, anxiety, anger, loneliness

Symptoms in Disorders of Consciousness, Orientation and Attentiveness

• Symptoms in disorders of consciousness:
  • Consciousness is the awareness of and responsiveness to one's surroundings and self.
  • Attention is the ability to focus consciousness on something.
  • Quantitative disorders include lethargy/somnolence (abnormal drowsiness), stupor (unnaturally deep sleep), and coma (prolonged unconsciousness).
  • Qualitative disorders include delirium (confusional state) ,obnubilation(clouded mental state), and alterations during sleep.
• Symptoms in disorders of orientation:
  • Orientation is the ability to accurately identify time, place, person, and situation.
• Symptoms in disorders of attentiveness:
  • Attention is the ability to focus consciousness on a particular object or action.
  • Related to focus, range, tenacity, concentration, and vigility of attention.

3: Symptoms in disorder of perception

• Perception is the translation of physical stimuli into psychological information.
• Eidetic image: vivid re-creation of sense experiences.
• Synesthesia: associating one sensation with another (ex. hearing a sound as a color).
• Illusions: misinterpretations of real stimuli.
• False imagery: previous experiences.
• Pareidolia: perceiving patterns or forms in random stimuli..
• Quantitative disorders of perception include: increased perception (low accuracy), and decreased perception (reduced intensity/clarity).
• Qualitative disorders of perception include hallucination (false sensory perception not related to an external stimuli and illusions)

4: Symptoms in disorders of thinking

• Thinking(cognition) is a complex mental function including past, present, future, inter- connection, relationships.
• Speed of thinking:
  • Psychomotor retardation: slowed mental function (depression).
  • Mutism: lack of speech, but thinking present.
  • Accelerated thinking: fast, often inaccurate though processes (mania, intoxication).
  • Psychomotor acceleration: many cognitive functions accelerated (mania).
  • Pseudoincoherence: thought is fast but the speech is not;
  • Logorrhea: fluency of speech based on racing thoughts.
• Structure of thinking:
  • Perseveration: getting stuck on one idea.
  • Circumstantiality: circling around the thought, relevant info added before origi- nal point brought up.
  • Tangentiality: deviation of the conversation and failing to return back to origin- al topic.
• Content of thinking:
  • Delusions: false beliefs.
  • Expansive: inflated ego.
  • Depressive: negative outlook on self and life
  • Religous: related to religious themes and beliefs.
  • Persecutory: belief that others are out to get the patient.

5. Symptoms in disorders of emotions

• Affect: short-term emotion associated with physical symptoms and behaviors.
• Mood: long lasting or persistent emotional state.
• Lower emotions: related to bodily perception like pain, hunger, etc.
• Higher emotions: related to social perceptions.
• Euthymic mood: normal range of mood

6. Symptoms in disorders of volition and behavior

• Symptoms in disorders of volition:
  • Will: the ability to choose a goal directed action;
  • Abulia: lack of will
  • Hypobulia: lessened will
  • Hyperbulia: increased will
• Disorders of behavior:
  • Impulsiveness: acting on a sudden urge.
  • Compulsivity: repetitive, stereotyped behaviors. (Ex. checking something a lot).
  • Various other types are discussed and identified.

7. Symptoms in disorders of instincts

• Disorders of self-preservation instinct:
  • Suicide: self-inflicted death
  • Suicidal attempts
  • Self-harm/self-mutilation

8. Disorders in memory and intellect

• Memory disorders:
  • Amnesia: selective or total memory loss
  • Hyomnesia: weakened memory
  • Hypermnesia: strengthened memory (excessive)
  • Pseudologia phantastica: fabrication of non-existent memories.
• Intellectual disorders:
  • Intellectual disability: deficit in intellectual function from early life.

9. Symptoms in disorders of decision-making (volition) and behavior

• Will: the ability to choose goals and pursue them.
• Symptoms: abulia (lack of will), hypobulia(reduced will) , hyperbulia(increased will).
• Disordered volition involves impulsive actions (kleptomania, pyromania), difficulty in making choices or completing tasks.
• Various forms of impulsive or compulsiveness can display issues with behaviour.

10. Major syndromes in psychiatry

• Some common psychiatric syndromes are included such as delirium (confusion) status epilepticus (seizure), and other urgent/non-life threatening/non-specific psychiatric states.

11. Laboratory and ancillary tests in psychiatry

• Includes genetic tests (for specific disorders), blood tests (glucose, electrolyte), and neurological exams (EEG, MRI).

12. Specific syndromes

• Specific syndromes like Serotonin syndrome, delirium tremens, Neuroleptic malignant syndrome.

13. Ethical issues in psychiatry

• Ethics of informed consent and the rights of individuals with mental illness.

14. Legal issues in psychiatry

• Defines appropriate legal processes, safeguards, protections, and appropriate responses to various behaviors.

15. Transcultural psychiatry

• Recognizes cultural and social factors in mental illness and diversity.
• Includes culture-bound syndromes that are unique to particular cultures.

16. Research in psychiatry

• Aims to identify causes, treatments, and prevalence rates for different mental disorders.
• Include epidemiological, genetic, and pharmacological studies.

Part II: Alzheimer's disease and dementia in Alzheimer's disease

• Alzheimer’s disease is the most well-known cause of dementia and is seen in 50-70% of cases.
• Course: Often develops gradually. Early stages are often overlooked.
• Risk Factors: Age is the greatest. Genetics, head injuries, vascular disorders, lifestyle are also important factors.
• Types: Sporadic (95%) or familial (5%).
• Pathophysiology: Degeneration leads to brain shrinkage; accumulation of amyloid-beta plaques and neurofibrillary tangles (twisted protein fibers) disrupt brain communication.

2. Other organic mental disorders apart from Alzheimer's Disease and Dementia.

• Vascular dementia: commonly caused by cerebrovascular events affecting regions of the brain, with symptoms like memory impairment, reduced cognitive functionality, and disruption of daily activities.
• Frontotemporal dementia: characterized by the progressive degeneration of the frontal and temporal lobes of the brain, leading to changes in personality, behavior, and language. In many cases, there is a familial predisposition.
• Lewy body dementia (LBD): a progressive brain disorder characterized by deposits of abnormal protein called Lewy bodies. LBD can cause problems in memory, thinking, and behaviour.
• Creutzfeldt-Jakob disease (CJD): is a rare, progressive, and fatal neurodegenerative disease caused by prion protein misfolding.
• Huntington's disease: A genetic neurodegenerative disorder resulting in movement disorders, cognitive impairments, & behavioural issues.

17. Addictive and impulsive disorders, Munchhausen syndrome

• Pathological Gambling: Compulsive gambling despite negative consequences
• Pyromania: compulsive fire-setting
• Kleptomania: compulsive stealing
• Munchhausen syndrome (by proxy): fabricating or exaggerating illness symptoms in themselves or someone else
• Munchhausen syndrome: fabricating symptoms for attention.

18. Gender Identity Disorders and Sexual Preferences

• Disorders related to gender identity and sexual preference (Transgender, dysgen- deria).

19. Intellectual disabilities

• Mild/moderate: difficulties with basic functions, poor judgment.
• Severe/ profound: severe cognitive impairment, reliance on others.

20. Pervasive developmental disorders

• Autism: difficulties in sensory processing, social interaction, and often autistic behavior.
• Asperger's syndrome: milder form of autism, fewer language and social commu- nication problems, often with specific interests.
• These are now considered on a spectrum of severity.

21. Hyperkinetic disorders

• Attention-deficit hyperactivity disorder (ADHD):
• Conduct disorder:
• Oppositional defiant disorder.

22. Separation anxiety disorder, elective mutism, tic disorders,

nonorganic enuresis, stuttering

23. Psychiatric symptoms in somatic diseases

• Parathyroid disorders:
• Thyroid disorders:
• Pancreatic disorders:
• Hepatic encephalopathy (liver disease):
• Uremic encephalopathy (kidney disease):

Part III: Pharmacotherapy.

• Antidepressants:
• Antipsychotics:
• Mood stabilizers:
• Cognitive enhancers:

6. Psychopharmacology in pregnancy and lactation

• Overview of psychopharmacology in pregnancy and lactation.

12. Serotonin syndrome

• Overview, treatment.

13. Electroconvulsive therapy (ECT).

• Indications:
• Procedure:
• Precautions and contraindications.

7. Other Neurostimulation Methods

• Overview of techniques and common use
• Including Repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS).

14. Emergency Psychiatry: Acute Clinical States and First Aid

• Acute/urgent/emergent psychiatric states including acute psychosis, intoxication with substance abuse, etc.

Test your knowledge on various psychiatric disorders and their characteristics. This quiz covers conditions like OCD, catatonic states, and the impact of stigma on mental health. Understand key concepts and terminology essential for psychiatric practice.