A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity, beginning by early adulthood and present
A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
Is uncomfortable in situations in which he or she is not the center of attention.
Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
Displays rapidly shifting and shallow expression of emotions.
Consistently uses physical appearance to draw attention to self.
Has a style of speech that is excessively impressionistic and lacking in detail.
Shows self-dramatization, theatricality, and exaggerated expression of emotion.
Is suggestible (e.g., easily influenced by others or circumstances).
Considers relationships to be more intimate than they actually are.
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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:
Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.)
A Pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
Identity disturbance: markedly and persistently unstable self-image or sense of self.
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.)
Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
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).
Chronic feelings of emptiness.
Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
Transient, stress-related paranoid ideation or severe dissociative symptoms.
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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:
Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
Impulsivity or failure to plan ahead.
Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
Reckless disregard for safety of self or others.
Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
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
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:
Ideas of reference (excluding delusions of reference).
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).
Unusual perceptual experiences, including bodily illusions.
Odd thinking and speech (e.g., vague, circumstantial, metaphorical, over elaborate, or stereotyped).
Suspiciousness or paranoid ideation.
Inappropriate or constricted affect.
Behavior or appearance that is odd, eccentric, or peculiar.
Lack of close friends or confidants other than first-degree relatives.
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
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:
Neither desires nor enjoys close relationships, including being part of a family.
Almost always chooses solitary activities.
Has little, if any, interest in having sexual experiences with another person.
Takes pleasure in few, if any, activities.
Lacks close friends or confidants other than first-degree relatives.
Appears indifferent to the praise or criticism of others.
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
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
Palpitations ( pounding heart)
Sweating , tremors
Shortness of breadth
Feeling of choking
Nausea, abdominal distress
Light head, dizzy
Fear that you are losing control
Fear that you might die
Tingling sensation in the limbs
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
Certain chemicals can trigger off panic attacks.
Genetics: Panic disorder can run in families.
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.
Panic attack like symptoms can also occur with physical problems like hyperthyroidism.
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
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.
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.
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:
Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
Reads hidden demeaning or threatening meanings into benign remarks or events.
Persistently bears grudges (i.e., is unforgiving of insults, injuries, or slights).
Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
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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Contraceptive Injection
OBG
Contraceptive Injection
Contraceptive Injection
Effectiveness:
Over 99%effective. Less than I women in 100 will get pregnant in a year.
How it works:
Releases the hormone Progestogen slowly into the body. This stops ovulation, thickness cervical mucus to prevent sperm meeting an egg thins the lining of the womb to prevent an egg implanting.
Advantages:
Lasts for 12 weeks (Depo- provera) . May protect against cancer of the womb and offers some protection from pelvic inflammatory disease. You don’t have to think about contraception for as long as the injection works.
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General Personality Disorder
Psychiatry
General Personality Disorder
Diagnostic Criteria
An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s This pattern is manifested in two (or more)of the following areas :
Cognition (i.e., ways of perceiving and interpreting self, other people and events).
Affectivity(i.e., the range , intensity, lability, and appropriateness of emotional response).
Interpersonal functioning.
Impulse control.
The enduring pattern is inflexible and pervasive across a broad range of personal and social
The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning .
The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early
The enduring pattern is not better explained as a manifestation or consequence of another mental
The enduring pattern is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., head trauma).
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Selective Serotonin Reuptake Inhibitor (SSRI)
Psychiatry
SSRI
PATIENT INFORMATION ON SELECTIVE SEROTONIN REUPTAKE INHIBITOR (SSRI) ANTIDEPRESSANTS
By Manasvi Specialists / Mail Contact: manasvispecialists@infringement-takedown.com
The name of your medication is fluoxetine, sertraline, fluvoxamine, citalopram, escitalopram,
Paroxetine. Manasvi Specialists
Use
SSRI antidepressants are used in the treatment of a number of disorders including :
Major depressive disorder, depression associated with Manic Depressive illness (Bipolar Disorder)
Obsessive compulsive disorder
Panic disorder
Bulimia
These drugs have also been found effective in several other disorders, including dysthymia, premenstrual dysphoria or depression, and impulsive behavior, though they currently not approved for these indications.
HOW quickly will the drug start working?
Antidepressants begin to improve sleep and appetite and to increase energy within about one week; however, feelings of depression may take from 4 to 6 weeks to improve. Because antidepressants take time to work, do not decrease or increase the dose or stop the medication without discussing this with your doctor.
Improvement in symptoms of obsessive compulsive disorder, panic disorder and bulimia also occur gradually.
How long should you take this medication?
Following the first episode of depression it is recommended that antidepressants be continued for a minimum of one year; this decreases the chance of being ill again. The doctor may then decrease the drug slowly and monitor for any symptoms of depression; if none occur, the drug can gradually be stopped.
For individuals who have had several episodes of depression, antidepressant medication should be continued indefinitely.
Long-term treatment is generally recommended for obsessive compulsive disorder, panic disorder and bulimia.
Side effects
Side effects occur, to some degree, with all medication. They are usually not serious and do not occur in all individuals. They may sometimes occur before beneficial effects of the medication are noticed. If a side effect continues, speak to your doctor about appropriate treatment.
Common side effects that should be reported to your doctor at the next appointment include:
Drowsiness and lethargy – This problem goes away with time. Use of other drugs that make you drowsy will worsen the problem. Avoid driving a car or operating machinery if drowsiness persists.
Energizing/agitated feeling- Some individuals may feel nervous or have difficulty sleeping for a few days after starting this medication. Report this to your doctor; he/she may advise you to take the medication in the morning.
Headache- This tends to be temporary and can be managed by taking analgesics (aspirin, acetaminophen , paracetamol ) when required.
Nausea or heartburn- If this happens, take the medication with food.
Muscle tremor, twitching- Speak to your doctor as this may require an adjustment in your dosage.
Changes in sex drive or sexual performance- Discuss this with your doctor.
Blurred vision – This usually occurs at start of treatment and tends to be temporary. Reading under a bright light or at a distance may help; a magnifying glass can be of temporary use. If the problem continues, advise your doctor.
Dry mouth- Sour candy and sugarless gum help increase saliva in your mouth; try to avoid sweet, calorie- laden beverages. Drink, water and brush your teeth regularly.
Constipation- Increase bulk foods in your diet ( e.g., salads, bran ) and drink plenty of fluids. Some individuals find a bulk laxative or a stool softener helps regulate their bowels. If these remedies are not effective, consult your doctor or pharmacist.
Nightmares- Can be managed by changing the dosing schedule.
Loss of appetite.
Rare side effects you should report to your doctor IMMEDIATELY include:
Soreness of the mouth, gums, or throat
Skin rash or itching, swelling of the face
Any unusual bruising or bleeding
Nausea, vomiting, loss of appetite, lethargy, weakness, fever, or flu- like symptoms
Yellow tinge in the eyes or to the skin; dark-colored urine
Inability to pass urine (more than 24 hours)
Tingling in the hands and feet, severe muscle twitching
Severe agitation or restlessness
Switch in mood to an unusual state of happiness, excitement, irritability, or a marked disturbance in sleep
Let your doctor know as soon as possible if you miss your period or suspect you may be pregnant.
What should you do if you forget to take a dose of your medication?
If you take your total dose of antidepressant in the morning and you forget to take it for more than 6 hours, skip the missed dose and continue with your schedule the next day. DO NOT DOUBLE THE DOSE. If you take the drug several times a day, take the missed dose when you remember, then continue with your regular schedule.
Interactions with other medication
Because SSRI antidepressant drugs can change the effect of other medication, or may be affected by other medication , always check with your doctor or pharmacist before taking other drugs, including over-the-counter medication such as cold remedies. Always inform any doctor or dentist that you see that you are taking an antidepressant drug.
Precautions
Do not increase or decrease your dose without consulting your doctor.
Take your drug with meals or with water, milk, orange or apple juice; avoid grapefruit juice as it may interfere with the effect of the drug.
This drug may impair the mental and physical abilities required for driving a car or operating machinery. Avoid these activities if you feel drowsy or slowed down.
This drug may increase the effects of alcohol, making you more sleepy, dizzy and lightheaded.
Do not stop your drug suddenly as this may result in withdrawal symptoms such as muscle aches, chills, tingling in your hands or feet, nausea, vomiting, and dizziness.
Report any changes in mood or behavior to your physician.
This drug may interact with medication prescribed by your dentist, so let him/her know the name of the drug you are taking.
Store your medication in a clean, dry area at room temperature. Keep all medication out of the reach of children.
If you have any questions regarding this medication, do not hesitate to contact your doctor, pharmacist, or nurse.c
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