Category: Psychiatry

Borderline Personality Disorder

Borderline Personality Disorder

Psychiatry

Borderline Personality Disorder

Diagnostic Criteria

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
  2. A Pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphasia, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

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Antisocial Personality Disorder

Antisocial Personality Disorder

Psychiatry

Antisocial Personality Disorder

Diagnostic Criteria

A) A pervasive  pattern  of  disregard  for  and  violation  of  the  rights  of  others,  occurring  since  age  15 years,  as  indicated  by  three (or  more) of  the  following:

  1. Failure  to  conform  to  social  norms  with  respect  to  lawful  behaviors,  as   indicated  by  repeatedly  performing  acts  that  are  grounds  for  arrest.
  2. Deceitfulness,  as  indicated  by  repeated  lying,  use  of  aliases,  or  conning  others  for  personal  profit  or  pleasure.
  3. Impulsivity or failure to plan ahead.
  4. Irritability  and  aggressiveness,  as  indicated  by  repeated  physical  fights  or  assaults.
  5. Reckless disregard for safety of self or others.
  6. Consistent  irresponsibility,  as  indicated  by  repeated  failure  to  sustain  consistent  work  behavior  or  honor  financial  obligations.
  7. Lack  of  remorse,  as  indicated  by  being  indifferent  to or  rationalizing  having  hurt,   mistreated,  or  stolen  from  another.

B) The individual is at least age 18 years.

C) There  is  evidence  of  conduct  disorder  with  onset  before  age 15  years.

D) The  occurrence of  antisocial  behavior  is  not  exclusively  during  the  course  of  schizophrenia  or  bipolar  disorder.

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Schizotypal Personality Disorder

Schizotypal Personality Disorder

Psychiatry

Schizotypal Personality Disorder

Diagnostic Criteria

A) A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Ideas of reference (excluding delusions of reference).
  2. Odd  beliefs  or  magical  thinking  that  influences  behavior  and  is  inconsistent  with  sub cultural    norms  (e.g., superstitions,  belief  in  clairvoyance,  telepathy,  or  ‘’sixth  sense”; in  children  and  adolescents,  bizarre  fantasies  or  preoccupations).
  3. Unusual perceptual experiences, including bodily illusions.
  4. Odd thinking  and  speech  (e.g.,  vague,  circumstantial,  metaphorical,  over elaborate,  or  stereotyped).
  5. Suspiciousness or paranoid ideation.
  6. Inappropriate or constricted affect.
  7. Behavior or appearance that is odd, eccentric, or peculiar.
  8. Lack  of  close  friends  or  confidants  other  than  first-degree  relatives.
  9. Excessive  social  anxiety  that  does  not  diminish  with  familiarity  and  tends  to  be  associated  with   paranoid  fears  rather  than  negative  judgments  about  self.

B) Does  not  occur  exclusively  during  the   course  of  schizophrenia,  a bipolar  disorder  or  depressive  disorder  with  psychotic  features,  another  psychotic   disorder,  or  autism  spectrum  disorder.

Note:  If criteria are met prior to the onset of schizophrenia, add “premorbid,” e.g., “Schizotypal personality disorder (premorbid).”

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Schizoid Personality Disorder

Schizoid Personality Disorder

Psychiatry

Schizoid Personality Disorder

Diagnostic Criteria

A) A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Neither desires nor enjoys close relationships, including being part of a family.
  2. Almost always chooses solitary activities.
  3. Has little, if any, interest in having sexual experiences with another person.
  4. Takes pleasure in few, if any, activities.
  5. Lacks close friends or confidants other than first-degree relatives.
  6. Appears indifferent to the praise or criticism of others.
  7. Shows emotional coldness, detachment, or flattened affectivity.

B) Dose not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not attributable to the physiological effects of another medical condition.

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Panic Disorder

Panic Disorder

Psychiatry

Panic Disorder

Panic disorder occurs in 1-3 % of the population. It is twice as more common in women as men. It can exist with other psychiatry disorders.

A. What are symptoms of panic attacks?

There are definite criteria for diagnosing panic disorder.

Some of the symptoms are

  1. Palpitations ( pounding heart)
  2. Sweating , tremors
  3. Shortness of breadth
  4. Feeling of choking
  5. Nausea, abdominal distress
  6. Light head, dizzy
  7. Fear that you are losing control
  8. Fear that you might die
  9. Tingling sensation in the limbs
  10. Anticipating another attack

Each attack lasts for a few minutes and patient is worried that he might get another attack again. Above symptoms come in episodes with patient avoiding situations which might trigger an episode and restricting their lifestyle.

Many patients fear that they may die and go to hospitals repeatedly.

B. Causes of panic attacks?

Panic disorder is caused by a number of factors

  1. Certain chemicals can trigger off panic attacks.
  2. Genetics: Panic disorder can run in families.
  3. Psychological reasons: Patients with panic disorder tend to catastrophise normal body symptoms there by leading the body to trigger of chemicals which cause symptoms of panic attacks.
  4. Panic attack like symptoms can also occur with physical problems like hyperthyroidism.
  5. Symptoms can also occur as side effects to medications taken for other conditions.

C. What is the treatment for Panic disorder?

Panic disorder can be treated with medications and Cognitive Behaviour therapy

  1. Medications are very effective in treating symptoms of Panic disorder. Numerous medications like SSRI, benzodiazepine and older antidepressants can be used to treat panic disorder.
  2. Cognitive Behaviour is very effective in treating panic disorder. It requires the patient to be motivated and brave to work through the problem. It is used along with medications and at times alone to treat panic disorder.
    The response to medication and CBT is good for panic disorder and patients do well after treatment. It is advisable to seek treatment earlier rather than later.

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Paranoid Personality Disorder

Paranoid Personality Disorder

Psychiatry

Paranoid Personality Disorder

Diagnostic Criteria

A) A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
  4. Reads hidden demeaning or threatening meanings into benign remarks or events.
  5. Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
  6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

B) Dose not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.

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