Mood Personality Disorder PDF

Other Signs and Sex Socioeconomic Category Description Etiology Pathophysiology Unique Features Signs and Symptoms Age of Onset Diagnostics Treatment Management...

Other Signs and Sex Socioeconomic Category Description Etiology Pathophysiology Unique Features Signs and Symptoms Age of Onset Diagnostics Treatment Management Symptoms Distribution Factors A mood disorder Genetic, Dysregulation of Persistent Depressed mood, Difficulty Late teens More common Higher Clinical Antidepressan Medication characterized by environmental, neurotransmitters sadness, loss of interest, concentrating, to mid-20s in females prevalence in interview, ts, adherence, Major Depressive persistent feelings psychological (serotonin, feelings of fatigue, changes thoughts of death low DSM-5 psychotherapy lifestyle Disorder (MDD) of sadness and loss factors norepinephrine, worthlessness in appetite and or suicide socioeconomic criteria changes, therapy of interest dopamine) sleep status (anhedonia) A mood disorder with Genetic Abnormalities in Manic episodes, Elevated mood, Depressive Late teens Equal Higher Clinical Mood Medication alternating periods predisposition, brain structure and rapid cycling increased energy, episodes, to early 20s distribution prevalence in interview, stabilizers, adherence, Bipolar Disorder of depression and environmental function, risky behavior irritability, low mood charts, antipsychotic lifestyle mania triggers neurotransmitter sleep disturbances socioeconomic DSM-5 s, changes, therapy imbalances status criteria psychotherapy Dysthymia Chronic form of Genetic, Chronic dysregulation Long-lasting Chronic low mood, Poor appetite or Childhood to More common Higher Clinical Antidepressan Medication (Persistent depression with less environmental of neurotransmitters depression, fatigue, low self- overeating, early in females prevalence in interview, ts, adherence, Depressive severe but longer- factors less severe esteem insomnia or adulthood low DSM-5 psychotherapy lifestyle Disorder) lasting symptoms than MDD hypersomnia socioeconomic criteria changes, therapy status A mood disorder with Genetic Dysregulation of Chronic Periods of Irritability, Adolescence Equal Higher Clinical Mood Medication Cyclothymic chronic fluctuating predisposition, mood-regulating fluctuating hypomanic and sleep disturbances to early distribution prevalence in interview, stabilizers, adherence, Disorder mood disturbances environmental neurotransmitters mood depressive adulthood low mood charts, psychotherapy lifestyle factors symptoms socioeconomic DSM-5 changes, therapy status criteria A type of depression Reduced sunlight Disruption of Depression Depressed mood, Weight gain, Varies, More common Higher Clinical Light Light exposure, Seasonal Affective that occurs at a exposure, genetic circadian rhythms, during winter fatigue, changes social withdrawal often young in females prevalence in interview, therapy, medication Disorder (SAD) specific time of factors serotonin and months in sleep and adulthood low DSM-5 antidepressan adherence, year, usually in melatonin imbalances appetite socioeconomic criteria ts, lifestyle winter status psychotherapy changes Mood disorder after Hormonal changes, Hormonal changes Symptoms within Sadness, fatigue, Anxiety, Most common Primarily Higher risk with Clinical Antidepressan Support groups, Postpartum childbirth. stress, lack of affecting the first year sleep irritability, in women affects low evaluation, ts, lifestyle Depression support. neurotransmitters. postpartum. disturbances, difficulty bonding aged 20-40 women. socioeconomic screening psychotherapy changes, regular guilt, suicidal with baby. years. status, lack of tools (EPDS).. follow-up. Cluster A: Odd or Eccentric Disorders Other Signs & Sex Socioeconomic Incidence/ Treatment & Disorder Description Unique Features Signs & Symptoms Age Onset Diagnostics Symptoms Distribution Factors Prevalence Management Higher in Distrust and Interpreting Suspicion, 2-4% of the Clinical Psychotherapy, Hypersensitivity Early More common in lower Paranoid suspicion of others’ motives reluctance to general interview, medications for to setbacks. adulthood. males. socioeconomic others. as malevolent. confide in others. population. history. anxiety. groups. Higher in Detachment from Limited Preference for Indifference to Slightly more Less than 1% of Clinical Psychotherapy, Early lower Schizoid social emotional solitary praise or common in the general interview, social skills adulthood. socioeconomic relationships. expression. activities. criticism. males. population. history. training. groups. Higher in Acute discomfort in Cognitive or Social anxiety, Slightly more 3-4% of the Clinical Psychotherapy, Odd beliefs, Early lower Schizotypal close perceptual eccentric common in general interview, antipsychotic magical thinking. adulthood. socioeconomic relationships. distortions. behavior. males. population. history. medications. groups. Cluster B: Dramatic, Emotional, or Erratic Disorders Other Signs & Sex Socioeconomic Incidence/ Treatment & Disorder Description Unique Features Signs & Symptoms Age Onset Diagnostics Symptoms Distribution Factors Prevalence Management Higher in Irresponsibility 1-4% of the Clinical Disregard for Deceitfulness, Aggressiveness, More common in lower Psychotherapy, Antisocial , criminal Before age 15. general interview, others’ rights. impulsivity. lack of remorse. males. socioeconomic behavioral therapy. behavior. population. history. groups. Higher in Instability in Impulsivity, Fear of Self-harm, 1.6-5.9% of the Clinical Dialectical Early More common in lower Borderline relationships, emotional abandonment, suicidal general interview, behavior therapy, adulthood. females. socioeconomic self-image. instability. intense emotions. behavior. population. history. medications. groups. Higher in Excessive Need to be the 1.8% of the Clinical Psychotherapy, Inappropriate Rapidly shifting Early More common in lower Histrionic emotionality, center of general interview, cognitive- seductive behavior. emotions. adulthood. females. socioeconomic attention-seeking. attention. population. history. behavioral therapy. groups. Higher in Less than 1% of Clinical Psychotherapy, Grandiosity, need Arrogance, sense of Exploitative Early More common in higher Narcissistic Lack of empathy. the general interview, cognitive- for admiration. entitlement. behavior. adulthood. males. socioeconomic population. history. behavioral therapy. groups. Cluster C: Anxious or Fearful Disorders Other Signs & Sex Socioeconomic Incidence/ Treatment & Disorder Description Unique Features Signs & Symptoms Age Onset Diagnostics Symptoms Distribution Factors Prevalence Management Higher in Social inhibition, Hypersensitivity 2.4% of the Clinical Psychotherapy, Avoidance of social Fear of Early Equal in males lower Avoidant feelings of to negative general interview, medications for interactions. rejection. adulthood. and females. socioeconomic inadequacy. evaluation. population. history. anxiety. groups. Higher in Submissive, 0.6% of the Clinical Psychotherapy, Excessive need to Difficulty making Fear of Early More common in lower Dependent clinging general interview, assertiveness be taken care of. decisions. separation. adulthood. females. socioeconomic behavior. population. history. training. groups. Higher in Preoccupation with 2.1-7.9% of the Clinical Psychotherapy, Obsessive- Control, Excessive attention Inflexibility, Early More common in higher orderliness, general interview, medications for Compulsive rigidity. to details. stubbornness. adulthood. males. socioeconomic perfectionism. population. history. anxiety. groups.  Other Signs and Sex Socioeconomic Incidence/ Treatment and Other Relevant Category Example Disorder Description/Etiology Unique Features Signs and Symptoms Age Onset Diagnostics Symptoms Distribution Factors Prevalence Management Information Chronic, excessive Persistent worry, Fatigue, muscle Irritability, Late More common in Stressful life Clinical interview, CBT, SSRIs, Often co-occurs Generalized worry about various restlessness tension, sleep difficulty adolescence to females events, low GAD-7 scale lifestyle with depression Anxiety Disorder 3.1% annually aspects of life disturbances concentrating early socioeconomic changes (GAD) adulthood status Recurrent unexpected Sudden onset of Palpitations, Shortness of Late More common in High stress, Clinical interview, CBT, SSRIs, Often leads to Panic Disorder panic attacks intense fear sweating, trembling breath, chest pain adolescence to females family history 2-3% annually Panic Disorder benzodiazepines agoraphobia Anxiety mid-30s Severity Scale Disorders Intense fear of Fear of Blushing, sweating, Nausea, difficulty Early More common in Low socioeconomic Clinical interview, CBT, SSRIs, Can lead to Social Anxiety social situations embarrassment, trembling speaking adolescence females status, family 7% annually Social Phobia beta-blockers social isolation Disorder scrutiny history Inventory Intense fear of Avoidance behavior Immediate anxiety Sweating, Childhood to More common in Traumatic Clinical interview, Exposure Often co-occurs Specific Phobias specific objects or response trembling, adolescence females experiences, 7-9% annually Specific Phobia therapy, CBT with other situations dizziness family history Questionnaire anxiety disorders Recurrent, intrusive Obsessions and Contamination Hoarding, symmetry Late Slightly more High stress, Clinical interview, CBT, SSRIs, ERP Often co-occurs Obsessive- thoughts and compulsions fears, checking obsessions adolescence to common in family history Yale-Brown with anxiety and Obsessive- Compulsive repetitive behaviors behaviors early males in 1-2% annually Obsessive mood disorders Disorder (OCD) adulthood childhood, Compulsive Scale Compulsive and equal in Related Preoccupation with Repetitive Excessive grooming, Avoidance of social Adolescence More common in Low self-esteem, Clinical interview, CBT, SSRIs High risk of Disorders Body Dysmorphic perceived physical behaviors, mirror skin picking situations females high stress Body Dysmorphic comorbid 2.4% annually Disorder flaws checking Disorder depression Examination Post-Traumatic Exposure to traumatic Flashbacks, Hypervigilance, Emotional numbness, Any age More common in High stress, low Clinical interview, CBT, EMDR, SSRIs Often co-occurs Trauma and Stress Disorder events nightmares avoidance irritability females socioeconomic 3.5% annually PTSD Checklist with depression Stressor-Related (PTSD) status and anxiety Short-term response Similar to PTSD but Intrusive memories, Sleep disturbances, Any age More common in High stress, low 20% after Clinical interview, CBT, short-term Can progress to Disorders Acute Stress to traumatic events shorter duration dissociation irritability females socioeconomic traumatic Acute Stress medication PTSD Disorder status events Disorder Scale Presence of two or Memory gaps, Depersonalization, Self-harm, mood Childhood More common in Severe trauma, Clinical interview, Psychotherapy, High risk of Dissociative more distinct identity confusion derealization swings females abuse history Dissociative medication for comorbid PTSD Identity Disorder 1.5% annually identities Experiences Scale comorbid (DID) Dissociative conditions Disorders Depersonalization/ Persistent feelings Feeling like an Emotional numbness, Anxiety, depression Adolescence to Equal High stress, Clinical interview, CBT, SSRIs Often co-occurs of detachment from outside observer altered perception early distribution trauma history Cambridge with anxiety and Derealization 2% annually self or surroundings adulthood Depersonalization depression Disorder Scale Restriction of energy Significantly low Distorted body Osteoporosis, Adolescence More common in High stress, Clinical interview, CBT, nutritional High mortality 0.5-1% Anorexia Nervosa intake, intense fear body weight image, amenorrhea electrolyte females cultural factors Eating Disorder rehabilitation rate annually of gaining weight imbalances Inventory Recurrent binge Normal weight or Self-induced Electrolyte Adolescence to More common in High stress, Clinical interview, CBT, SSRIs Often co-occurs eating followed by overweight vomiting, laxative imbalances, dental early females cultural factors 1-1.5% Eating Disorder with mood Bulimia Nervosa compensatory use erosion adulthood annually Examination disorders Feeding and behaviors Eating Disorders Consumption of non- Compulsive eating Eating non-food Abdominal pain, Most common in Affects all Higher risk with Prevalence Clinical Behavioral Can lead to food items. of non-food items. items (e.g., dirt, constipation, children and ages and malnutrition, varies widely, evaluation, patient therapy, serious health Nutritional clay, paper). bloating, nausea. pregnant sexes, more poverty, and more common in history. nutritional complications. Pica deficiencies, mental women. common in certain cultural developing deficiencies, health disorders, children and practices. countries. safe pregnancy, cultural pregnant environment, factors. women. underlying Persistent deficits Restricted, Sensory Language delays, Early More common in Genetic factors, Clinical interview, Behavioral Wide range of Autism Spectrum in social repetitive sensitivities, intellectual childhood males prenatal 1 in 54 Autism Diagnostic therapy, functioning Disorder (ASD) communication and behaviors fixated interests disability environment children Observation educational levels Neurodevelopment interaction Schedule support al Disorders Attention- Persistent pattern of Difficulty Impulsivity, Academic Childhood More common in Genetic factors, 5% of Clinical interview, Behavioral Often co-occurs Deficit/Hyperactiv inattention and/or sustaining forgetfulness difficulties, low males prenatal ADHD Rating Scale therapy, with learning children, 2.5% ity Disorder hyperactivity- attention, self-esteem environment stimulants disabilities of adults (ADHD) impulsivity hyperactivity General term for Varies by type Memory loss, Personality Late adulthood More common in Age, family Clinical interview,Depends on type; High caregiver cognitive decline (e.g., Alzheimer’ confusion, changes, difficulty females history, neuroimaging, may include burden, various affecting memory, s, vascular difficulty with with daily cardiovascular 5-8% of people cognitive tests medications, types with Dementia thinking, and social dementia) communication activities risk factors over 65 supportive care, different abilities lifestyle etiologies12 changes Progressive Amyloid plaques, Memory loss, Personality Late adulthood More common in Age, family Clinical interview, Cholinesterase High caregiver neurodegenerative neurofibrillary confusion, changes, difficulty females history, low neuroimaging (MRI, inhibitors, burden, ongoing Neurocognitive Alzheimer’s disorder tangles disorientation with daily education level 10% of people PET), cognitive supportive care, research into new disorders Disease characterized by activities over 65 tests lifestyle treatments12 memory loss and changes cognitive decline Progressive disorder Lewy bodies, Tremors, Postural Late adulthood More common in Age, family Clinical interview, Levodopa, Ongoing research of the nervous system dopamine deficiency bradykinesia, instability, speech males history, exposure neurological dopamine into new Parkinson’s affecting movement rigidity changes to toxins 1% of people examination, agonists, treatments, high Disease over 60 imaging tests (DAT physical caregiver scan) therapy, deep burden12 brain Schizophrenia Chronic mental Delusions, Disorganized Social withdrawal, Late More common in Low socioeconomic Clinical interview, Antipsychotics, High risk of Spectrum and disorder with hallucinations speech, catatonia cognitive deficits adolescence to males status, family Positive and CBT comorbid Schizophrenia 1% annually Other Psychotic psychosis early history Negative Syndrome substance use Disorders adulthood Scale disorders Features of both Delusions, Depressive or manic Social withdrawal, Early More common in Low socioeconomic Clinical interview, Antipsychotics, Often Schizoaffective schizophrenia and hallucinations episodes cognitive deficits adulthood females status, family 0.3% annually Schizoaffective mood stabilizers misdiagnosed as Disorder mood disorders history Disorder Scale bipolar disorder Problematic pattern Craving, loss of Withdrawal Liver disease, Adolescence to More common in High stress, Clinical interview, CBT, medication- High risk of Substance- Alcohol Use of alcohol use control symptoms, tolerance cognitive early males family history 5.8% annually AUDIT assisted comorbid mental Disorder Related and impairment adulthood treatment health disorders Addictive Opioid Use Problematic pattern Craving, loss of Withdrawal Respiratory Adolescence to More common in High stress, Clinical interview, CBT, medication- High risk of Disorders of opioid use control symptoms, tolerance depression, early males family history 0.8% annually Opioid Risk Tool assisted overdose Disorder overdose adulthood treatment Excessive focus on High health anxiety Frequent medical Pain, fatigue Adolescence to More common in Low socioeconomic Clinical interview, CBT, SSRIs Often co-occurs Somatic Symptom physical symptoms visits, multiple early females status, high 5-7% annually Somatic Symptom with anxiety and Somatic Symptom Disorder symptoms adulthood stress Scale depression and Related Preoccupation with High health Frequent medical Avoidance of Early Equal High stress, Clinical interview, CBT, SSRIs Often co-occurs Disorders Illness Anxiety having a serious anxiety, minimal visits, reassurance health-related adulthood distribution family history 1-2% annually Health Anxiety with anxiety and Disorder illness (old name: symptoms seeking information Inventory depression hypochondriasis)  Incidence/ Age & Gender Classic Signs & Other Signs & Etiolog Condition Unique Features Diagnostics Management Prevalence Distribution Symptoms Symptoms y Clinical 1 in 4 Acute onset More common Confusion, Agitation, sleep assessment, CAM Treat underlying Deliriu older and in elderly, disorientation, disturbances, (Confusion cause, supportive m adults in fluctuating both genders hallucinations mood changes Assessment care hospitals course Method) Medications Memory loss, Language More common Progressive (e.g., Dementi 50 million impaired judgment, difficulties, Cognitive tests, in elderly, cognitive cholinesterase a worldwide personality apathy, brain imaging both genders decline inhibitors), changes depression Wandering, mood supportive care Memory loss, Medications 60-70% of More common Amyloid swings, Cognitive tests, Alzheim confusion, (e.g., dementia in elderly, plaques and difficulty PET scans, CSF er’s difficulty with donepezil), cases both genders tau tangles recognizing analysis daily tasks lifestyle changes people Tremors, rigidity, 1% of More common Lewy bodies Speech changes, Clinical Medications Parkins bradykinesia, people over in elderly, in the writing changes, assessment, (e.g., levodopa), on’s postural 60 both genders brain sleep problems DaTscan physical therapy instability Affects both Chorea, Weight loss, Medications Genetic Genetic testing, Hunting 5-10 per genders, psychiatric sleep (e.g., mutation clinical ton’s 100,000 typically 30- symptoms, disturbances, tetrabenazine), (HTT gene) assessment 50 years old cognitive decline impulsivity supportive care Multipl More common Fatigue, motor and Cognitive Medications e 2.8 million in women, Demyelinati sensory impairment, MRI, lumbar (e.g., Scleros worldwide typically 20- on in CNS disturbances, bladder puncture interferons), is 40 years old vision problems dysfunction, pain physical therapy vascular dementia  Sign/Symptom Description Unique Features Less Common Manifestation Most Seen In Caregiver Alert Provide a structured Easily distracted, difficulty environment, minimize 1 Distractibility Difficulty focusing attention concentrating, poor task Impulsivity, hyperactivity ADHD, Anxiety Disorders distractions, break tasks into completion smaller steps Antisocial Personality Disorder, Violent fantasies, threats, or Impulsive or planned acts of Report to authorities, ensure 2 Homicidal Ideation Thoughts of harming others attempts violence Schizophrenia, Bipolar safety, seek professional help Disorder (manic phase) Provide a calm environment, Restlessness, pacing, Agitated behaviors, impulsive Anxiety Disorders, Bipolar 3 Psychomotor Agitation Increased motor activity fidgeting, hand-wringing actions Disorder (manic phase) offer distractions, limit stimulation Encourage independent speech, Repetition of words or phrases Mimicking speech patterns, Difficulty initiating speech, Autism Spectrum Disorder, model appropriate language, 4 Echolalia spoken by others repeating questions delayed language development Schizophrenia provide patience and understanding Increased energy, elevated Irritability, difficulty Bipolar Disorder (hypomanic Monitor for escalation, 5 Hypomania Less severe form of mania mood, increased productivity concentrating phase) encourage rest, set limits Elevated mood, increased Grandiosity, impulsivity, Psychotic symptoms, Set limits, provide structure, 6 Mania energy, racing thoughts decreased need for sleep aggression Bipolar Disorder (manic phase) monitor for safety Provide a calm environment, Restlessness, pacing, Increased energy, difficulty Physical aggression, property Bipolar Disorder (manic 7 Agitation irritability sitting still, verbal outbursts damage phase), Anxiety Disorders offer distractions, limit stimulation Rapid, pressured speech, Loud, rapid, tangential speech, Racing thoughts, difficulty Bipolar Disorder (manic Provide a calm environment, 8 Pressured Speech difficulty interrupting flight of ideas concentrating phase), Anxiety Disorders listen actively, avoid interrupting Inflated self-esteem, Excessive self-focus, Bipolar Disorder (manic Set realistic limits, redirect 9 Grandiosity exaggerated beliefs about grandiose plans, disregard for Delusions of grandeur phase), Narcissistic attention, avoid enabling abilities consequences Personality Disorder Rapid speech, jumping from Pressured speech, racing Bipolar Disorder (manic Redirect attention, provide 10 Flight of Ideas Rapid shifting of thoughts topic to topic, difficulty staying thoughts phase), Schizophrenia structure, limit distractions on one subject Bipolar Disorder, Borderline Set limits, provide a calm Short temper, impatience, Aggressive outbursts, verbal 11 Irritability Easily annoyed or angered hostility abuse Personality Disorder, Anxiety environment, offer coping Disorders strategies Sudden changes from Validate feelings, teach emotion Impulsive behavior, difficulty Borderline Personality 12 Emotional Lability Rapid shifts in mood euphoria to sadness, anger to regulating emotions Disorder, Bipolar Disorder regulation techniques, provide calm support Borderline Personality Acting on urges without Reckless behavior, substance Disorder, Bipolar Disorder Set limits, provide structure, 13 Impulsivity thinking abuse, risky sexual behavior Self-harm, suicide attempts encourage impulse control (manic phase), Antisocial Personality Disorder Clumsy movements, unsteady Ensure safety, provide Impaired coordination and Difficulty with speech, Cerebellar disorders, stroke, 14 Ataxia balance gait, difficulty with fine motor swallowing, or eye movements multiple sclerosis assistance with activities of daily skills living, physical therapy Feeling unreal, out-of-body Difficulty recognizing oneself in Dissociative Disorders, Validate feelings, provide 15 Depersonalization Feeling detached from oneself experiences, distorted sense of the mirror Depressive Disorders reassurance, ground techniques time World seems unreal or Feeling detached from one's Difficulty recognizing familiar Dissociative Disorders, Validate feelings, provide 16 Derealization surroundings dreamlike, distorted places Depressive Disorders reassurance, ground techniques perceptions Grimacing, lip smacking, Reduce medication dosage, Involuntary movements of the Difficulty speaking, eating, or Long-term use of antipsychotic 17 Tardive Dyskinesia face, tongue, and limbs tongue protrusion, repetitive swallowing medication switch medications, consult with movements a doctor Major Depressive Disorder, Take all threats seriously, seek Passive or active suicidal Overt or covert suicidal 18 Suicidal Ideation Thoughts of death or self-harm thoughts, plans, or attempts behaviors Bipolar Disorder, Borderline professional help, establish Personality Disorder safety plans Loss of interest or pleasure in Reduced motivation, apathy, Difficulty experiencing positive Major Depressive Disorder, Encourage activities, offer 19 Anhedonia activities social withdrawal emotions Schizophrenia support, validate feelings Decreased energy, fatigue, Major Depressive Disorder, Encourage activity, provide 20 Psychomotor Retardation Slowed movement and speech difficulty initiating activities Catatonia, mutism Schizophrenia structure, offer support Difficulty identifying objects, Neurodegenerative disorders Use simple language, provide Inability to recognize familiar Visual agnosia, auditory 21 Agnosia objects or stimuli people, or sounds despite agnosia, tactile agnosia (e.g., Alzheimer's disease), visual cues, use alternative intact sensory function stroke, brain injury communication methods Difficulty identifying specific Neurodegenerative disorders, Safety concerns (e.g., gas 22 Anosmia Loss of sense of smell Inability to detect odors smells head injury, viral infections leaks), dietary changes Obsessive thoughts about Recurrent, unwanted thoughts, Obsessive-Compulsive Encourage exposure therapy, 23 Obsessions Persistent, intrusive thoughts images, or urges harm, contamination, or Disorder, Anxiety Disorders cognitive-behavioral therapy perfection Repetitive behaviors or mental Ritualistic behaviors, checking, Hoarding, excessive Obsessive-Compulsive Encourage gradual exposure, 24 Compulsions acts cleaning, counting handwashing Disorder, Anxiety Disorders challenge compulsive thoughts Palpitations, sweating, Intense fear or discomfort, trembling, shortness of breath, Fear of dying, losing control, or Panic Disorder, Anxiety Provide reassurance, breathing 25 Panic Attacks physical symptoms chest pain, nausea, dizziness, going crazy Disorders exercises, relaxation techniques chills, numbness, tingling Provide a calm environment, Sudden interruption of thought Abrupt cessation of speech Difficulty completing thoughts, Schizophrenia, Anxiety 26 Thought Blocking or speech mid-sentence, blank stare impaired concentration Disorders encourage expression of thoughts and feelings Persistent repetition of words, Repeating phrases, ideas, or Difficulty shifting attention, rigid Schizophrenia, Autism Redirect attention, provide 27 Perseveration thoughts, or actions behaviors thinking Spectrum Disorder structure, offer support False beliefs not based on Grandiose, persecutory, Schizophrenia, Bipolar 28 Delusions reality Fixed and unshakeable somatic, religious Disorder Validate feelings, avoid arguing Monitor for safety, provide basic Marked decrease in reactivity Stupor, mutism, waxy flexibility, Excited catatonia (agitation, Schizophrenia, Bipolar 29 Catatonia to the environment negativism hyperactivity) Disorder (depressive phase) needs, involve in simple activities Loose associations, tangential Difficulty following a train of Schizophrenia, Bipolar Provide clear and simple 30 Disorganized Thinking speech, word salad thought, illogical connections Mutism, poverty of speech Disorder (manic phase) instructions, patience Listen patiently, avoid Thoughts associated by sound Disorganized speech, difficulty Schizophrenia, Bipolar 31 Clang Associations rather than meaning Rhyming, alliteration, puns communicating Disorder (manic phase) interrupting, redirect conversation Going off on tangents, never Difficulty staying on topic, Difficulty with goal-directed Schizophrenia, Bipolar Gently redirect conversation, 32 Tangentiality returning to the main point irrelevant responses thinking Disorder (manic phase) focus on main points Reduced emotional Blunted affect, alogia, avolition, expression, decreased speech, Social withdrawal, poor Schizophrenia, Major Encourage social interaction, 33 Negative Symptoms anhedonia lack of motivation, inability to hygiene Depressive Disorder provide motivation, offer support experience pleasure Reduced emotional Difficulty initiating and Schizophrenia, Major Encourage activities, provide 34 Apathy Lack of motivation and interest responsiveness, social completing tasks Depressive Disorder structure, offer support withdrawal, poor hygiene Encourage social interaction, Brief, simple responses, lack of Difficulty initiating and Schizophrenia, Major 35 Poverty of Speech Reduced amount of speech spontaneous speech maintaining conversations Depressive Disorder provide opportunities for communication Avoidance of social situations, Schizophrenia, Major Difficulty forming and Encourage social interaction, 36 Social Withdrawal Reduced social interaction isolation, decreased interest in maintaining relationships Depressive Disorder, Social gradual exposure, offer support social activities Anxiety Disorder  Difficulty getting to the point, Encourage direct and concise Excessive detail and irrelevant Difficulty with concise Schizophrenia, Obsessive- 37 Circumstantiality information tangential speech, over- communication Compulsive Disorder communication, set time limits explanation for conversations Auditory (most common), Sensory experiences without Complex hallucinations Schizophrenia, Schizoaffective Ensure safety, validate 38 Hallucinations external stimuli visual, tactile, olfactory, involving multiple senses Disorder experiences, avoid arguing gustatory Made-up words, phrases, or Difficulty understanding and Schizophrenia, Schizoaffective Validate feelings, use simple 39 Neologisms Creation of new words combinations of words using language Disorder language, avoid correcting Provide a calm environment, Incoherent mixture of words Disorganized and illogical Difficulty understanding and Schizophrenia, Severe Bipolar 40 Word Salad and phrases speech, lack of meaning being understood Disorder (manic phase) use simple language, validate feelings Reduce medication dosage, Restlessness and inability to sit Constant movement, pacing, Side effect of antipsychotic 41 Akathisia still fidgeting Agitation, anxiety, insomnia medication adjust medication, offer physical outlets for energy Acute dystonia (sudden, painful muscle spasms), Reduce medication dosage, Involuntary muscle Muscle spasms, abnormal Side effect of antipsychotic 42 Dystonia contractions postures, difficulty moving tardive dyskinesia (involuntary medication adjust medication, movements of the face, anticholinergic medication tongue, and limbs) Language impairment affecting Difficulty expressing thoughts, Broca's aphasia (expressive), Use simple language, patience, Stroke, brain injury, 43 Aphasia speaking, understanding, understanding language, Wernicke's aphasia neurodegenerative disorders alternative communication reading, or writing reading, or writing (receptive), global aphasia methods Poor handwriting, spelling Stroke, brain injury, Provide writing aids, speech 44 Agraphia Difficulty writing errors, inability to form letters Difficulty with grammar, syntax neurodegenerative disorders therapy, assistive technology or words Ideomotor apraxia (difficulty Difficulty performing motor performing motor acts on Break down tasks into smaller Clumsy movements, difficulty Stroke, brain injury, 45 Apraxia tasks, despite understanding with coordinated activities command), ideational apraxia neurodegenerative disorders steps, provide physical the task (difficulty carrying out a assistance, use visual cues sequence of motor acts) PSYCHOTIC PATIENTS Do Don't Caregiver Notes & Alerts Validate feelings: Acknowledge their experiences, even Argue with delusions or hallucinations: This can Use a calm and reassuring tone of voice. if they seem irrational. escalate distress. Use simple language: Avoid complex sentences and Reinforce delusions or hallucinations: This can worsen Be patient and understanding. abstract concepts. symptoms. Set limits: Establish clear boundaries to prevent Isolate the patient: Social interaction can be beneficial, Monitor for signs of agitation or aggression. disruptive behavior. but in a controlled environment. Provide structure: Create a consistent routine to reduce Overwhelm with information: Keep things simple and Be mindful of your body language and tone of anxiety. focused. voice. Encourage activities: Engage them in activities they Neglect personal hygiene: Assist with grooming and Seek professional help for medication enjoy to distract from negative thoughts. bathing as needed. management and therapy. PATIENTS WITH DEMENTIA Do Don't Caregiver Notes & Alerts Be patient and understanding: Remember, dementia is Argue or correct: This can lead to frustration and Use simple language and clear instructions. a disease, not a choice. agitation. Create a safe environment: Remove potential hazards Overwhelm with choices: Limit options to reduce Establish a consistent routine. and clutter. confusion. Provide reassurance: Offer comfort and support, Be mindful of your body language and tone of Shaming or blaming: This can damage the relationship. especially during times of distress. voice. Encourage independence: Allow them to do as much Take away their independence: This can lead to Provide appropriate assistance and as possible on their own. feelings of helplessness and frustration. supervision. Use memory aids: Visual cues, calendars, and notes Expect perfection: Be patient and understanding of Seek professional help for support and can be helpful. mistakes. guidance. NEURODEVELOPMENTAL DISORDERS Do Don't Caregiver Notes & Alerts Be patient and understanding: Neurodevelopmental Get frustrated or impatient: This can escalate Use positive reinforcement to encourage disorders can impact communication and behavior. behavioral issues. desired behaviors. Establish routines: Consistent routines can provide Overwhelm with change: Transition slowly and prepare Use visual aids to help with understanding comfort and reduce anxiety. them for changes in advance. and communication. Break down tasks: Divide complex tasks into smaller, Expect perfection: Mistakes are common, especially in Celebrate small victories. manageable steps. children with neurodevelopmental disorders. Provide a calm and structured environment: Minimize Criticize or shame: This can damage self-esteem and Offer positive feedback and encouragement. distractions and sensory overload. motivation. Encourage social interaction: Facilitate opportunities for Isolate the individual: Social interaction can help Be patient and supportive during social social activities with peers. develop social skills and reduce loneliness. interactions. Seek professional help: Early intervention and therapy Neglect the individual's needs: Regular check-ups and Be proactive in addressing challenges and can significantly improve outcomes. therapy sessions are crucial. seeking support.  Signs and Brief Commonly Caregiver/Nurse Best Caregiver/Nurse Caregiver/Nurse Common Examples Other Examples Rationale Symptoms Description Encountered in Approach Response Alert Involuntary, Grimacing, tongue Lip smacking, Antipsychotic Reflects a side Ensure safety, provide Encourage use of Monitor for signs Tardive repetitive body movements rapid eye Medication Side effect of a supportive relaxation techniques, of distress or 67 Dyskinesia movements blinking Effect medication environment offer support worsening symptoms Motor Inability to sit Pacing, fidgeting Antipsychotic Reflects a side Provide a calm Encourage relaxation Monitor for signs restlessness still, constant medication side effect of environment, offer techniques, offer of distress or 4 Akathisia movement effect, Anxiety medication or reassurance support medication side Disorders anxiety effects Excessive motor Pacing, wringing Fidgeting, Anxiety Reflects heightened Provide a calm Encourage relaxation Monitor for signs Psychomotor activity hands inability to sit Disorders, arousal or anxiety environment, offer techniques, offer of distress or 50 Agitation associated with still Bipolar Disorder reassurance support exhaustion a feeling of (Mania) Difficulty Trouble naming Word-finding Aphasia, Reflects a Provide a supportive Encourage use of Monitor for signs recalling names objects, people difficulty Alzheimer’s disruption in environment, use descriptive language, of frustration or 8 Anomia or words Disease language processing alternative offer support withdrawal communication methods Difficulty Trouble Limited emotional Autism Spectrum Reflects a Provide a supportive Encourage expression Monitor for signs identifying and describing awareness Disorder, PTSD disruption in environment, validate of emotions, offer of emotional 5 Alexithymia expressing feelings emotional feelings support distress or emotions processing withdrawal Imitation of Mimicking Copying body Autism Spectrum Reflects a Do not criticize, Acknowledge without Monitor for another person’ gestures or language Disorder, disruption in provide a calm reinforcing, redirect distress or 29 Echopraxia s movements actions Schizophrenia voluntary motor environment behavior frustration control Repetitive, Twirling hair, Rocking, hand Autism Spectrum Reflects a Do not criticize, Acknowledge without Monitor for habitual tapping fingers flapping Disorder, disruption in motor provide a calm reinforcing, redirect distress or 41 Mannerisms movements Schizophrenia control or coping environment behavior frustration mechanism Repetition of a Repeating the Repeating the Autism Spectrum Reflects difficulty Do not criticize, Acknowledge without Monitor for 48 Perseveration particular same word or same action Disorder, in shifting provide a calm reinforcing, redirect distress or response despite phrase Schizophrenia thoughts or actions environment conversation frustration the absence of a Repetitive, Hand flapping, Repeating the Autism Spectrum Reflects a Do not criticize, Acknowledge without Monitor for fixed patterns rocking same phrase Disorder, disruption in motor provide a calm reinforcing, redirect distress or 53 Stereotypy of physical Schizophrenia control or coping environment behavior frustration action or speech mechanism Repetition of Repeating the Echoing own Autism Spectrum Reflects a Do not criticize, Acknowledge without Monitor for one’s own words last word or speech Disorder, disruption in provide a calm reinforcing, redirect distress or 46 Palilalia or phrases phrase spoken Tourette Syndrome speech control environment conversation frustration Repetition of Repeating Echoing TV or Autism Spectrum May be a coping Do not criticize, Acknowledge without Monitor for words or phrases questions instead radio phrase