PSYCHIATRY MNEMONICS

Source:  PSYCHIATRY MNEMONICS    Tag:  psychomotor retardation symptoms
FIG1

FIG2
Depression: major depression criteria
DEAD SWAMP:
Depressed mood most of the day
Energy loss or fatigue
Anhedonia
Death thoughts (recurrent), suicidal ideation or attempts
Sleep disturbances (insomnia, hypersomnia)
Worthlessness or excessive guilt
Appetite or weight change
Mentation decreased (ability to think or concentrate, indecisiveness)
Psychomotor agitation or retardation
Schizophrenia: negative features
4 A's:
Ambivalence
Affective incongruence
Associative loosening
Autism

 
Erikson's developmental stages
"The sad tale of Erikson Motors":
· The stages in order by age group:
Mr. Trust and MsTrust had an auto they were ashamed of. She took the initiative to find the guilty party. She found the industry wasinferior. They were making cars with dents [identity] and rolling fuses [role confusion]. Mr. N.T. Macy [intimacy] isolated the problem,General TVT absorbed the cost. In the end, they found the tires were just gritty and the should have used de- spare!

SEE FIG1

 
Conduct disorder vs. Antisocial personality disorder
Conduct disorder is seen in Children.
Antisocial personality disorder is seen in Adults.

 
Parasomnias: time of onset
SLeep terrors and SLeepwalking occur during SLow-wave sleep (stages 3 & 4).
NightmaRE occurs during REM sleep (and is REMembered).
Depression: symptoms and signs (DSM-IV criteria)
AWESOME:
Affect flat
Weight change (loss or gain)
Energy, loss of
Sad feelings/ Suicide thoughts or plans or attempts/ Sexual inhibition/ Sleep change (loss or excess)/ Social withdrawal
Others (guilt, loss of pleasure, hopeless)
Memory loss
Emotional blunting
Biological symptoms in psychiatry
SCALED:
Sleep disturbance
Concentration
Appetite
Libido
Energy
Diurnal mood variation
Psychiatric review of symptoms
"Depressed Patients Seem Anxious, SClaim Psychiatrists":
Depression and other mood disorders (major depression, bipolar disorder, dysthymia)
Personality disorders (primarily borderline personality disorder)
Substance abuse disorders
Anxiety disorders (panic disorder with agoraphobia, obssessive-compulsive disorder)
Somatization disorder, eating disorders (these two disorders are combined because both involve disorders of bodily perception)
Cognitive disorders (dementia, delirium)
Psychotic disorders (schizophrenia, delusional disorder and psychosis accompanying depression, substance abuse or dementia)
Depression
UNHAPPINESS:
Understandable (such as bereavement, major stresses)
Neurotic (high anxiety personalities, negative parental upbringing
Hypochondriasis
Agitation (usually organic causes such as dementia
Pseudodementia
Pain
Importuniing (whingeing, complaining)
Nihilistic
Endogenous
Secondary (ie cancer at the head of the pancreas, bronchogenic cancer)
Syndromal
Depression: melancholic features (DSM IV)
MELANcholic:
Morning worsening of symptoms/ psychoMotor agitation, retardation/ early Morning wakening
Excessive guilt
Loss of emotional reactivity
ANorexia/ ANhedonia


Substance dependence: features (DSM IV)
"WITHDraw IT":
· 3 of 7 within 12 month period:
Withdrawal
Interest or Important activities given up or reduced
Tolerance
Harm to physical and psychosocial known but continue to use
Desire to cut down, control
Intended time, amount exceeded
Time spent too much
Dementia: main causes
VITAMIN D VEST:
Vitamin deficiency (B12, folate, thiamine)
Intracranial tumour
Trauma (head injury)
Anoxia
Metabolic (diabetes)
Infection (postencephalitis, HIV)
Normal pressure hydrocephalus
Degenerative (Alzheimer's, Huntington's, CJD, etc)
Vascular (multi infarct dementia)
Endocrine (hypothyroid)
Space occupying lesion (chronic subdural haematoma)
Toxic (alcohol)


SEE FIG2
Mania: cardinal symptoms
DIG FAST:
Distractibility
Indiscretion (DSM-IV's "excessive involvement in pleasurable activities")
Grandiosity
Flight of ideas
Activity increase
Sleep deficit (decreased need for sleep)
Talkativeness (pressured speech)

 
Depression criteria/symptoms
A SAD FACES:
Appetite, weight changes
Sleep changes
Anhedonia
Dysphoria (low mood)
Fatigue
Agitation (psychomotor)
Concentration
Esteem
Suicide
Mania: diagnostic criteria
Must have 3 of MANIAC:
Mouth (pressure of speech)/ Moodl
Activity increased
Naughty (disinhibition)
Insomnia
Attention (distractability)
Confidence (grandiose ideas)
Neuroleptic side effects onset
The rule of 4's:
Dystonia: 4 hours-4 days
Akathesia: 4 days-40 days
Extrapyramidal symptoms: 4 days-4 weeks
Tardive dyskinesia: 4 months (greater than)
· Note that tardive is obviously the latest one to happen (tardive=tardy/late).
· Note that the first letters of these four classic symptoms spell "DATE", and this mnemonic is the dates when they occur.
Anxiety disorders: physical illnesses mimicking them
"Physical Health Hazards That Appear Panciky":
Phaeochromocytoma
Hyperthyroidism
Hypoglycaemia
Temporal lobe epilepsy
Alcohol
Paroxysmal arrhythmias
Ganser syndrome: key diagnostic feature
The word "Ganser" is close to but not quite the word "Answer".
Ganser's syndrome is when patient gives an answer that is close to, but not quite. For example 2+2=5.
Conversion disorder: etiology
Conversion disorder: convert a conflict to a symptom.
Hallucinations: hypnogogic vs. hypnopompic definition
"Hypnogogic = go to sleep":
Hypnogogic hallucinations arise when go to sleep, hypnopompic arise when awaken.


Yalom's therapeutic factors
ICU CAGES:
I still hope (installation of hope)
I'm part of information (imparting information)
Imitate behavior
Interpersonal learning
Corrective recapitulation of primary
Universality
Catharsis
Altruism
Group cohesiveness (glue)
Existential factors
Socializing techniques development
Borderline personality: traits
PRAISE:
Paranoid ideas
Relationship instability
Affective instability/ Abandonment fears/ Angry outbursts
Impulsiveness/ Identity disturbance
Suicidal behaviour/ Self-harming behaviour
Emptiness


HM: this classic patient's lesion
HM had Hippocampus Missing.
Hippocampus and surrounding areas were removed surgically: prevented formation of new memories.
Cluster personality disorders
Cluster A Disorder = Atypical. Unusual and eccentric.
Cluster B Disorder = Beast. Uncontrolled wildness.
Cluster C Disorder = Coward [avoidant type], Compulsive [obsessive-compulsive type], or Clingy [dependent type].
Gain: primary vs. secondary vs. tertiary
Primary: Patient's Psyche improved.
Secondary: Symptom Sympathy for patient.
Tertiary: Therapist's gain.
Depression: major episode characteristics
SPACE DIGS:
Sleep disruption
Psychomotor retardation
Appetite change
Concentration loss
Energy loss
Depressed mood
Interest wanes
Guilt
Suicidal tendencies
Impotence causes
PLANE:
Psychogenic: performance anxiety
Libido: decreased with androgen deficiency, drugs
Autonomic neuropathy: impede blood flow redirection
Nitric oxide deficiency: impaired synthesis, decreased blood pressure
Erectile reserve: can't maintain an erection
Sleep stages: features
DElta waves during DEepest sleep (stages 3 & 4, slow-wave).
dREaM during REM sleep.
AIDS Dementia Complex (ADC): features
AIDS:
Atrophy of cortex
Infection/ Inflammation
Demyelination
Six months death
Kubler-Ross dying process: stages
"Death Always Brings Great Acceptance":
Denial
Anger
Bargaining
Grieving
Acceptance
REM: features
REM:
Rapid pulse/ Respiratory rate
Erection
Mental activity increase/ Muscle paralysis
Depression: symptoms
BAD CRISES:
Behavioural change (slowing down or agitation)
Appetite change (weight loss or weight gain in the young)
Depressed look (looking down)
Concentration decrease (does not do serial 7s well)
Ruminations (constant negative thoughts, hopelessness good indicator of suicidality)
Interest (reduced interest in what is normally pleasurable)
Sleep change (insomnia or hypersomnia, sleeping early, waking up at night, waking up feeling tired)
Energy change (fatigue)
Suicide


Male erectile dysfunction (MED): biological causes
MED:
Medicines(propranalol, methyldopa, SSRI, etc.)
Ethanol
Diabetes mellitus
Middle adolescence (14-17 years): characteristics
HERO:
Heterosexual crushes/ Homosexual Experience
Education regarding short term benefits
Risk taking
Omnipotence
· And there is interest in being a Hero (popular).
Autistic disorder: features
AUTISTICS:
Again and again (repetitive behavior)
Unusual Abilities
Talking (language) delay
IQ subnormal
Social development poor
Three years onset
Inherited component [35% concordance]
Cognitive impairment
Self injury
Male Erectile Dysfunction (MED): drugs causing it
"STOP erection":
SSRI (fluoxtine)
Thioridazone
methyldOpa
Propranalol
Premature ejaculation: treatment
2 S's:
SSRIs [eg: fluoxitime]
Squeezing technique [glans pressure before climax]
· More detail with 2 more S's:
Sensate-focus excercises [relieves anxiety]
Stop and start method [5-6 rehearsals of stopping stimulation before climax]
Narcolepsy: symptoms, epidemiology
CHAP:
Cataplexy
Hallucinations
Attacks of sleep
Paralysis on waking
· Usual presentation is a young male, hence "chap".
Reinforcement schedules: variable ratio
SLOT machines show SLOwesT extinction.
Depression: major episode DSM-IV criteria
· First, of course depressed mood is one. Then:
SIG E CAPS:
Sleep disturbance
Interest loss
Guilt (or intense worthlessness)
Energy loss
Concentration loss
Appetite changes
Psychomotor agitation or retardation
Suicidal tendency