Overview
This lecture reviews key psychiatric disorders and mnemonics to remember their diagnostic criteria, focusing on high-yield conditions for exam preparation.
Mood Disorders
- Major depressive disorder: Remember "SIGECAPS" for Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal thoughts (5/9 for 2 weeks).
- Mania (bipolar): "DIG FAST" - Distractibility, Impulsivity, Grandiosity, Flight of ideas, Activity, Sleep (decreased), Talkativeness (half or more for 1 week).
Psychotic Disorders
- Schizophrenia: "High Def BS Network" - Hallucinations, Delusions, Disorganized behavior, Disorganized speech, Negative symptoms (2+ for 6 months).
Substance Use Disorders
- "Time to Cut Down, Pal" - 11 criteria, but focus on repeated use, positive reinforcers, and repercussions ("three reapers").
Anxiety Disorders
- Generalized Anxiety Disorder: "Eek, ADS, I'm Miserable" – Excessive anxiety most days (6+ months), plus 3/6 symptoms (Muscle tension, Irritability, Sleep, Energy, Restlessness, Attention).
- Panic Disorder: "Surprise" – Sudden, unexpected, recurrent attacks, plus chronic worry about future attacks.
OCD and Related Disorders
- OCD: "I MURDER" - Intrusive, Mind-based, Unwanted, Resistant, Distressing, Egodystonic, Recurrent; compulsions are "calm-pulsions" to reduce distress.
- Body Dysmorphic Disorder: "Fix Me Doc" – Fixation, Medical seeking, Ego-syntonic, Disabling, OCD-like patterns, Compulsive behaviors.
Trauma and Dissociative Disorders
- PTSD: "TRAUMA" – Traumatic event, Re-experiencing, Arousal, Unable to function (1+ month), Avoidance.
- Dissociation: "Deeper DREAMS" – Depersonalization, Derealization, (retrograde) Amnesia, Errors in memory, Absorption, Motor automaticity, Suggestibility.
Personality Disorders
- Clusters:
- Cluster A (odd, avoidant): "Schizoid avoids," "Schizotypal is a type of schizo."
- Cluster B (dramatic): Attend party, risk being banned (focus on Borderline).
- Cluster C (anxious): "Party is DOA," due to dependency, perfectionism, avoidance.
- Borderline: "I DESPAIR" – Identity, Dysphoria, Emotional instability, Suicidal, Psychotic, Anger, Impulsivity, Relationships (unstable).
Somatic Symptom and Related Disorders
- Somatic Symptom Disorder: "SOME ATTIC" – Somatic symptoms, anxiety, time-consuming, impaired, chronic.
- Conversion Disorder: "CANT version" – Neurologic symptoms, no organic cause, not faked, sometimes triggered by stress.
- Factitious vs. Malingering: Factitious ("comes back"), Malingering ("leaves when need met").
Eating Disorders
- Anorexia nervosa: "Underrexia" – Underweight, Nervous about gaining weight, Distorted perception, Exercise/Purging, Restricting food.
- Bulimia nervosa: "Bowl of ice cream" – Binge eating, Compensatory purging, Self-esteem linked to weight (weekly for 3 months).
Neurodevelopmental Disorders
- Autism Spectrum Disorder: "ASD" – Autistic Aloneness, Sameness, early Developmental onset.
- ADHD: "FIDGETY" – Functionally impairing Inattention/Disinhibition, Greater than expected, Exclude other causes, Two+ settings, Young onset (<12).
- Tic Disorders: "A TICK" – Acute, Transient, Irreversible Contraction, "Turret syndrome" (Tourette's): 2+ motor, 1+ vocal tics.
Neurocognitive Disorders
- Dementia (Major Neurocognitive Disorder): "DIRE" – Decline, Impairment, Rule out other causes, Exclude delirium/depression.
- Delirium: "Where the F am I" – Disorientation, Transient, Fluctuating, Acute, Medical/Intoxicant cause.
Comprehensive Mnemonic
- "A Map to Mind Space" – Addiction, Mood, Anxiety, Psychotic, Trauma/Dissociative, OCD, Medical, Intoxication, Normalcy, Delirium, Somatoform, Personality, ADHD/Autism, Cognitive, Eating disorders.
Key Terms & Definitions
- Mnemonic — a memory aid, usually an acronym or phrase, to recall diagnostic criteria.
- Egodystonic — thoughts or impulses that are inconsistent with one's self-perception.
- Egosyntonic — thoughts or impulses aligned with one's self-perception.
- Splitting — seeing people as all good or all bad, common in borderline personality disorder.
- Compulsions — repetitive behaviors done to reduce distress from obsessions.
Action Items / Next Steps
- Review each mnemonic and practice recalling criteria.
- Prepare to apply these criteria in clinical vignettes or exam questions.
- Read further about disorders not covered in detail, especially in DSM-5.