We treat patients suffering from the following conditions:
ADD/ADHD Childhood
DSM V criteria includes:1. Inattention
a. A child who shows a pattern of inattention may often:
b. Fail to pay close attention to details or make careless mistakes in schoolwork
c. Have trouble staying focused in tasks or play
d. Appear not to listen, even when spoken to directly
e. Have difficulty following through on instructions and fail to finish schoolwork or chores
f. Have trouble organizing tasks and activities
g. Avoid or dislike tasks that require focused mental effort, such as homework
h. Lose items needed for tasks or activities, for example, toys, school assignments, pencils
i. Be easily distracted
j. Forget to do some daily activities, such as forgetting to do chores
2. Hyperactivity and impulsivity
a. A child who shows a pattern of hyperactive and impulsive symptoms may often:
b. Fidget with or tap his or her hands or feet, or squirm in the seat
c. Have difficulty staying seated in the classroom or in other situations
d. Be on the go, in constant motion
e. Run around or climb in situations when it’s not appropriate
f. Have trouble playing or doing an activity quietly
g. Talk too much
h. Blurt out answers, interrupting the questioner
i. Have difficulty waiting for his or her turn
j. Interrupt or intrude on others’ conversations, games or activities
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
ADD/ADHD Adult
DSM V criteria includes:For those age 17 and above:
Note: For older adolescents and adults (age 17 and older), at least five symptoms are required.
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2):
1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months
a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
b. Often has difficulty sustaining attention in tasks or play activities.
c. Often does not seem to listen when spoken to directly.
d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
e. Often has difficulty organizing tasks and activities.
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
g. Often loses things necessary for tasks or activities.
h. Is often easily distracted by extraneous stimuli.
i. Is often forgetful in daily activities.
2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months:
a. Often fidgets with or taps hands or feet or squirms in seat.
b. Often leaves seat in situations when remaining seated is expected.
c. Often runs about or climbs in situations where it is inappropriate.
d. Often unable to play or engage in leisure activities quietly.
e. Is often “on the go,” acting as if “driven by a motor”
f. Often talks excessively.
g. Often blurts out an answer before a question has been completed
h. Often has difficulty waiting his or her turn i. Often interrupts or intrudes on others
B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings
D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Agoraphobia
DSM V criteria includes:A. Marked fear or anxiety about 2+:
- Using public transportation
- Being in open spaces
- Being in enclosed spaces
- Standing in line or being in a crowd
- Being outside of the home alone
C. Situations almost always provoke fear or anxiety.
D. Actively avoided or endured with great fear and anxiety.
E. Out of proportion to the actual danger posed.
F. Persistent, lasting for 6 months or more strong.
G. Clinically significant distress or impairment in social, occupational and other important areas of functioning.
H. If another medical condition is present, the fear, anxiety, or avoidance is excessive.
I. Not better explained by another mental disorder.
Differential Diagnosis: SP, OCD, BDD, SAD
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Anorexia Nervosa
DSM V criteria includes:A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
B. Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight Coding: restricting type, binge-eating/purging type
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Bipolar I Disorder
DSM V criteria includes:
For a diagnosis of bipolar I disorder, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes. For a diagnosis of bipolar II disorder, it is necessary to meet the following criteria for a current or past hypomanic episode and the following criteria for a current or past major depressive episode.
Manic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep.
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility, as reported or observed.
6. Increase in goal-directed activity or psychomotor agitation.
7. Excessive involvement in activities that have a high potential for painful consequences.
C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
D. The episode is not attributable to the physiological effects of a substance or to another medical condition.
Hypomanic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep.
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility, as reported or observed.
6. Increase in goal-directed activity or psychomotor agitation.
7. Excessive involvement in activities that have a high potential for painful consequences.
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
F. The episode is not attributable to the physiological effects of a substance.
Major Depressive Episode
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day.
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or another medical condition.
Specifiers:
anxious distress, mixed features, rapid cycling, melancholic features, atypical features, mood-(in)congruent psychotic features, catatonia, peripartum onset, seasonal pattern, partial/full remission, Mild/moderate/severe
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Bulimia Nervosa
DSM V criteria includes:A. recurrent episodes of binge eating. characterized by both:
- eating, in a discrete period of time an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances
- sense of lack of control over eating during the episode
C. the binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months
D. self-evaluation is unduly influenced by body shape and weight
E. the disturbance does not occur exclusively during episodes of Anorexia Nervosa
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Dementia
DSM V criteria includes:
A. Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and
2. A substantial impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment.
B. The cognitive deficits interfere with independence in everyday activities (i.e., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
D. The cognitive deficits are not better explained
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Depressive Disorders
DSM V criteria includes:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly attributable to another medical condition.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
(Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or to another medical condition.
D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
E. There has never been a manic episode or a hypomanic episode.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Generalized Anxiety Disorder
DSM V criteria includes:
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months);
Note: Only one item is required in children.
1. Restlessness or feeling keyed up or on edge.
2. Being easily fatigued.
3. Difficulty concentrating or mind going blank.
4. Irritability.
5. Muscle tension.
6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
F. The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Hormonal imbalance
This often leads to mental health issues, such as anxiety, depression, and insomnia. Because the levels of these hormones may fluctuate daily, patients may experience a mix of such symptoms. Mood and sleep fluctuations may be self-perpetuating in that they cause patients to feel shaky and unstable and therefore more anxious and depressed. Common hormones which can affect mood include: estrogen, progesterone, testosterone, thyroid hormone, insulin, growth hormone and cortisol. Any form of hormone replacement should be conducted with care.Hypochondria Somatization
DSM V criteria includes:
Include:
A. Preoccupation with having or acquiring a serious illness.
B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or disproportionate.
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctor appointments and hospitals).
E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.
F. The illness-related preoccupation is not better explained by another mental disorder, such as somatic symptom disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Impulse Control Disorder
It is classified in DSM V as Disruptive, Impulse-control and Conduct disorders which refer to a group of disorders that include oppositional defiant disorder, conduct disorder, intermittent explosive disorder, kleptomania and pyromania. These disorders can cause people to behave angrily or aggressively toward people or property. They may have difficulty controlling their emotions and behavior and may break rules or laws.Insomnia and other sleep disorders
DSM V criteria includes: A. A predominant complaint of dissatisfaction witli sleep quantity or quality, associated with one (or more) of the following symptoms:- Difficulty initiating sleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.)
- Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention.)
- Early-morning awakening with inability to return to sleep.
C. The sleep difficulty occurs at least 3 nights per week.
D. The sleep difficulty is present for at least 3 months.
E. The sleep difficulty occurs despite adequate opportunity for sleep.
F. The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia).
G. The insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication). H. Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
LGBT people have higher rates of mental health challenges than the general population. LGBT people often struggle with depression, anxiety, trauma and self-acceptance as a result of facing ongoing discrimination over their lifetimes. LGBT youth are about three to four times as likely to attempt suicide as their peers.
There is evidence that these higher rates of mental health challenges are due to heightened and long-term exposure of LGBT people to societal and institutional prejudice and discrimination.There are many similarities in the effects of discrimination and how people respond to and cope with stress directly related to prejudice. It’s important to remember, however, that not all LGBT people have lived the same experiences, and that people respond to similar experiences in different ways. It’s also important to note that issues of sexual orientation (lesbian, gay and bisexual) are very different from the issues of gender identity (transgender).
Menopause & PCOS Related Mood Disorders
Menopause is the permanent cessation of menstruation resulting in the loss of ovarian follicle development. It is considered to occur when 12 menstrual cycles are missed.Menopausal transition, or perimenopause, is the period between the onset of irregular menstrual cycles and the last menstrual period. This period is marked by fluctuations in reproductive hormones 3 and is characterized by the following:
- Menstrual irregularities
- Prolonged and heavy menstruation intermixed with episodes of amenorrhea
- Decreased fertility
- Vasomotor symptoms
- Insomnia
Some of these symptoms may emerge 4 years before menses cease, with a perimenopausal mean age of onset of 47.5 years.During the menopausal transition, estrogen levels decline and levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) increase.
Postmenopause is the phase following the last menstrual period.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Menstrual Disorders
DSM V criteria includes:
A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
B. One (or more) of the following symptoms must be present:
- Marked affective lability (e.g., mood swings: feeling suddenly sad or tearful, or increased sensitivity to rejection).
- Marked irritability or anger or increased interpersonal conflicts.
- Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
- Marked anxiety, tension, and/or feelings of being keyed up or on edge.
C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
- Decreased interest in usual activities (e.g., work, school, friends, hobbies).
- Subjective difficulty in concentration.
- Lethargy, easy fatigability, or marked lack of energy.
- Marked change in appetite; overeating; or specific food cravings.
- Hypersomnia or insomnia.
- A sense of being ovenwhelmed or out of control.
- Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain. Note: The symptoms in Criteria A-C must have been met for most menstrual cycles that occurred in the preceding year.
D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).
E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders).
F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles. (Note: The diagnosis may be made provisionally prior to this confirmation.)
G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition (e.g., hyperthyroidism).
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Mood D-O Related to other Medical Conditions
DSM V criteria includes:
A. A prominent and persistent period of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture.
B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.
C. The disturbance is not better explained by another mental disorder.
D. The disturbance does not occur exclusively during the course of a delirium.
E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, or necessitates hospitalization to prevent harm to self or others, or there are psychotic features.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Obsessive Compulsive Disorder
DSM V criteria includes:
A. Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
Note: Young children may not be able to articulate the aims of these behaviors or mental acts.
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Panic Disorder
DSM V criteria includes:
A. recurrent unexpected panic attacks. Abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and has 4+:
1. palpitations, pounding heart, or accelerated heart rate
2. sweating
3. trembling or shaking
4. sensations of shortness of breath or smothering
5. feelings of choking
6. chest pain or discomfort
7. nausea or abdominal distress
8. chills or heat sensations
9. paresthesias (numbness or tingling)
10. derealization or depersonalization
12. fear of losing control or going crazy
13. fear of dying
B. at least one of the attacks followed by a month of 1. persistent concern or worry about additional panic attacks
2. significant maladaptive change in behavior related to the attacks and designed to avoid having panic attacks
C. not due to substance or medical condition
D. not better explained by another mental disorder
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Persistent Depressive Disorder / Dysthymia
DSM V criteria includes:A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.
B. Presence, while depressed, of two (or more) of the following:
- Poor appetite or overeating.
- Insomnia or hypersomnia.
- Low energy or fatigue.
- Low self-esteem.
- Poor concentration or difficulty making decisions.
- Feelings of hopelessness.
D. Criteria for a major depressive disorder may be continuously present for 2 years.
E. There has never been a manic episode or a hypomanie episode, and criteria have never been met for cyclothymic disorder.
F. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
G.The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g. hypothyroidism).
H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Peripartum disoder (formerly known as postpartum disorder)
It refers to depression occurring during pregnancy or after childbirth. The use of the term “peripartum” recognizes that depression associated with having a baby often begins during pregnancy. Peripartum depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference and/or anxiety, as well as changes in energy, sleep, and appetite. It carries risks for the mother and child.Premenstrual Dysphoric Disorder
DSM V criteria includes:
A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
B. One (or more) of the following symptoms must be present:
- Marked affective lability (e.g., mood swings: feeling suddenly sad or tearful, or increased sensitivity to rejection).
- Marked irritability or anger or increased interpersonal conflicts.
- Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
- Marked anxiety, tension, and/or feelings of being keyed up or on edge.
C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
- Decreased interest in usual activities (e.g., work, school, friends, hobbies).
- Subjective difficulty in concentration.
- Lethargy, easy fatigability, or marked lack of energy.
- Marked change in appetite; overeating; or specific food cravings.
- Hypersomnia or insomnia.
- A sense of being ovenwhelmed or out of control.
- Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain. Note: The symptoms in Criteria A-C must have been met for most menstrual cycles that occurred in the preceding year.
D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).
E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders).
F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles. (Note: The diagnosis may be made provisionally prior to this confirmation.) G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition (e.g., hyperthyroidism).
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Schizophrenia
DSM V criteria includes:
A. 2+ for 1 month (1, 2, or 3)
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms
B. Level of fx in one or more major life areas is below premorbid level.
C. Continuous signs of disturbance for 6 months (must include 1 month of criterion A symptoms, may include prodromal or residual phases)
Specifiers: First episode/acute, partial remission, full remission, Multiple edisodes/acute, partial remission, full remission, With catatonia
Differential Diagnosis: Schizoaffective disorder, Depressive/Bipolar with psychotic features, Substance abuse, Medical condition, Autis Spectrum/Communication Disorder (Additional diagnosis of Schizophrenia only made if prominent delusions or hallucinations are present for 1 month).
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Sexual Dysfunction
DSM V criteria includes:
Include:
delayed ejaculation, erectile disorder, female orgasmic disorder, female sexual interest/arousal disorder, genito-pelvic pain/penetration disorder, male hypoactive sexual desire disorder, premature (early) ejaculation, substance/medicationinduced sexual dysfunction, other specified sexual dysfunction, and unspecified sexual dysfunction.
Sexual dysfunctions are a heterogeneous group of disorders that are typically characterized by a clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure. An individual may have several sexual dysfunctions at the same time. In such cases, all of the dysfunctions should be diagnosed.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Social Phobia
DSM V criteria includes:
A. A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others.
The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.
B. Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.
C. The person recognizes that this fear is unreasonable or excessive.
D. The feared situations are avoided or else are endured with intense anxiety and distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Thyroid and Diabetes Related Mood Disorders
DSM V criteria includes:
Cyclothymia (Thyroid Disorders)
A. At least 2 years numerous periods of hypomanic sx that don’t meet criteria for episode and numerous periods with depressive sx that don’t meet criteria for episode
B. Present at least half the time and not been without for more than 2 months at a time
C. Criteria for MD, manic, or hypomanic episode never met.
Specifiers: with anxious distressComorbidity of diabetes and psychiatric disorders can present in different patterns.
- The two can present as independent conditions with no apparent direct connection. In such a scenario both are an outcome of independent and parallel pathogenic pathways.
- The course of diabetes can be complicated by emergence of psychiatric disorders. In such cases, diabetes contributes to the pathogenesis of psychiatric disorders. Various biological and psychological factors mediate the emergence of psychiatric disorders in such context.
- Certain psychiatric disorders like depression and schizophrenia act as significant independent risk factors for the development of diabetes.
- There could be an overlap between the clinical presentation of hypoglycemic and ketoacidosis episodes and conditions such as panic attacks.
- Impaired glucose tolerance and diabetes could emerge as a side effect of the medications used for psychiatric disorders. Treatment of psychiatric disorders could influence diabetes care in other ways also as discussed in subsequent sections.Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Gender Dysmorphic Disorder
Some transgender individuals suffer because of conflicted gender identity , and struggles with acceptance. Many transgender individuals are comfortable with their identify but need help with hormone replacement, and other issues associated with a smooth female to female, or female to male transition.
ADD/ADHD Childhood
DSM V criteria includes:
1. Inattention
a. A child who shows a pattern of inattention may often:
b. Fail to pay close attention to details or make careless mistakes in schoolwork
c. Have trouble staying focused in tasks or play
d. Appear not to listen, even when spoken to directly
e. Have difficulty following through on instructions and fail to finish schoolwork or chores
f. Have trouble organizing tasks and activities
g. Avoid or dislike tasks that require focused mental effort, such as homework
h. Lose items needed for tasks or activities, for example, toys, school assignments, pencils
i. Be easily distracted
j. Forget to do some daily activities, such as forgetting to do chores
2. Hyperactivity and impulsivity
a. A child who shows a pattern of hyperactive and impulsive symptoms may often:
b. Fidget with or tap his or her hands or feet, or squirm in the seat
c. Have difficulty staying seated in the classroom or in other situations
d. Be on the go, in constant motion
e. Run around or climb in situations when it’s not appropriate
f. Have trouble playing or doing an activity quietly
g. Talk too much
h. Blurt out answers, interrupting the questioner
i. Have difficulty waiting for his or her turn
j. Interrupt or intrude on others’ conversations, games or activities
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
ADD/ADHD Adult
DSM V criteria includes:
For those age 17 and above:
Note: For older adolescents and adults (age 17 and older), at least five symptoms are required.
A. A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, as characterized by (1) and/or (2):
1. Inattention: Six (or more) of the following symptoms have persisted for at least 6 months
a. Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities.
b. Often has difficulty sustaining attention in tasks or play activities.
c. Often does not seem to listen when spoken to directly.
d. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace.
e. Often has difficulty organizing tasks and activities.
f. Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort.
g. Often loses things necessary for tasks or activities.
h. Is often easily distracted by extraneous stimuli.
i. Is often forgetful in daily activities.
2. Hyperactivity and impulsivity: Six (or more) of the following symptoms have persisted for at least 6 months:
a. Often fidgets with or taps hands or feet or squirms in seat.
b. Often leaves seat in situations when remaining seated is expected.
c. Often runs about or climbs in situations where it is inappropriate.
d. Often unable to play or engage in leisure activities quietly.
e. Is often “on the go,” acting as if “driven by a motor”
f. Often talks excessively.
g. Often blurts out an answer before a question has been completed
h. Often has difficulty waiting his or her turn i. Often interrupts or intrudes on others
B. Several inattentive or hyperactive-impulsive symptoms were present prior to age 12 years.
C. Several inattentive or hyperactive-impulsive symptoms are present in two or more settings
D. There is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of schizophrenia or another psychotic disorder and are not better explained by another mental disorder
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Agoraphobia
DSM V criteria includes:
A. Marked fear or anxiety about 2+:
- Using public transportation
- Being in open spaces
- Being in enclosed spaces
- Standing in line or being in a crowd
- Being outside of the home alone
B. Individual fears or avoids these situations because of the thoughts escape will be severe, or help is not available in the event of developing panic-like symptoms, or other incapacitating or embarrassing moments.
C. Situations almost always provoke fear or anxiety.
D. Actively avoided or endured with great fear and anxiety.
E. Out of proportion to the actual danger posed.
F. Persistent, lasting for 6 months or more strong.
G. Clinically significant distress or impairment in social, occupational and other important areas of functioning.
H. If another medical condition is present, the fear, anxiety, or avoidance is excessive.
I. Not better explained by another mental disorder.
Differential Diagnosis: SP, OCD, BDD, SAD
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Anorexia Nervosa
DSM V criteria includes:
A. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
B. Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain, even though at a significantly low weight.
C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight Coding: restricting type, binge-eating/purging type
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Bipolar I Disorder
DSM V criteria includes:
For a diagnosis of bipolar I disorder, it is necessary to meet the following criteria for a manic episode. The manic episode may have been preceded by and may be followed by hypomanic or major depressive episodes. For a diagnosis of bipolar II disorder, it is necessary to meet the following criteria for a current or past hypomanic episode and the following criteria for a current or past major depressive episode.
Manic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day.
B. During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep.
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility, as reported or observed.
6. Increase in goal-directed activity or psychomotor agitation.
7. Excessive involvement in activities that have a high potential for painful consequences.
C. The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.
D. The episode is not attributable to the physiological effects of a substance or to another medical condition.
Hypomanic Episode
A. A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
B. During the period of mood disturbance and increased energy and activity, three (or more) of the following symptoms (four if the mood is only irritable) have persisted, represent a noticeable change from usual behavior, and have been present to a significant degree:
1. Inflated self-esteem or grandiosity.
2. Decreased need for sleep.
3. More talkative than usual or pressure to keep talking.
4. Flight of ideas or subjective experience that thoughts are racing.
5. Distractibility, as reported or observed.
6. Increase in goal-directed activity or psychomotor agitation.
7. Excessive involvement in activities that have a high potential for painful consequences.
C. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.
D. The disturbance in mood and the change in functioning are observable by others.
E. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization. If there are psychotic features, the episode is, by definition, manic.
F. The episode is not attributable to the physiological effects of a substance.
Major Depressive Episode
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day.
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
9. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or another medical condition.
Specifiers:
anxious distress, mixed features, rapid cycling, melancholic features, atypical features, mood-(in)congruent psychotic features, catatonia, peripartum onset, seasonal pattern, partial/full remission, Mild/moderate/severe
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Bulimia Nervosa
DSM V criteria includes:
A. recurrent episodes of binge eating. characterized by both:
- eating, in a discrete period of time an amount of food that is definitely larger than what most individuals would eat in a similar period of time under similar circumstances
- sense of lack of control over eating during the episode
B. recurrent inappropriate compensatory behaviors in order to prevent weight gain, such as self-induced vomiting misuse of laxatives, diuretics, or other medications; fasting or excessive exercise
C. the binge eating and inappropriate compensatory behaviors both occur, on average, at least once a week for 3 months
D. self-evaluation is unduly influenced by body shape and weight
E. the disturbance does not occur exclusively during episodes of Anorexia Nervosa
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Dementia
DSM V criteria includes:
A. Evidence of significant cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual-motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a significant decline in cognitive function; and
2. A substantial impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment.
B. The cognitive deficits interfere with independence in everyday activities (i.e., at a minimum, requiring assistance with complex instrumental activities of daily living such as paying bills or managing medications).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
D. The cognitive deficits are not better explained
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Depressive Disorders
DSM V criteria includes:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly attributable to another medical condition.
1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
(Note: In children, consider failure to make expected weight gain.)
4. Insomnia or hypersomnia nearly every day.
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day.
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The episode is not attributable to the physiological effects of a substance or to another medical condition.
D. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders.
E. There has never been a manic episode or a hypomanic episode.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Gender Dysmorphic Disorder
Some transgender individuals suffer because of conflicted gender identity , and struggles with acceptance. Many transgender individuals are comfortable with their identify but need help with hormone replacement, and other issues associated with a smooth male to female, or female to male transition.
Generalized Anxiety Disorder
DSM V criteria includes:
A. Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months, about a number of events or activities (such as work or school performance).
B. The individual finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms having been present for more days than not for the past 6 months);
Note: Only one item is required in children.
1. Restlessness or feeling keyed up or on edge.
2. Being easily fatigued.
3. Difficulty concentrating or mind going blank.
4. Irritability.
5. Muscle tension.
6. Sleep disturbance (difficulty falling or staying asleep, or restless, unsatisfying sleep).
D. The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., hyperthyroidism).
F. The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder).
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Hormonal imbalance
This often leads to mental health issues, such as anxiety, depression, and insomnia. Because the levels of these hormones may fluctuate daily, patients may experience a mix of such symptoms. Mood and sleep fluctuations may be self-perpetuating in that they cause patients to feel shaky and unstable and therefore more anxious and depressed. Common hormones which can affect mood include: estrogen, progesterone, testosterone, thyroid hormone, insulin, growth hormone and cortisol. Any form of hormone replacement should be conducted with care.
Hypochondria Somatization
DSM V criteria includes:
Include:
A. Preoccupation with having or acquiring a serious illness.
B. Somatic symptoms are not present or, if present, are only mild in intensity. If another medical condition is present or there is a high risk for developing a medical condition (e.g., strong family history is present), the preoccupation is clearly excessive or disproportionate.
C. There is a high level of anxiety about health, and the individual is easily alarmed about personal health status.
D. The individual performs excessive health-related behaviors (e.g., repeatedly checks his or her body for signs of illness) or exhibits maladaptive avoidance (e.g., avoids doctor appointments and hospitals).
E. Illness preoccupation has been present for at least 6 months, but the specific illness that is feared may change over that period of time.
F. The illness-related preoccupation is not better explained by another mental disorder, such as somatic symptom disorder, panic disorder, generalized anxiety disorder, body dysmorphic disorder, obsessive-compulsive disorder, or delusional disorder, somatic type.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Impulse Control Disorder
It is classified in DSM V as Disruptive, Impulse-control and Conduct disorders which refer to a group of disorders that include oppositional defiant disorder, conduct disorder, intermittent explosive disorder, kleptomania and pyromania. These disorders can cause people to behave angrily or aggressively toward people or property. They may have difficulty controlling their emotions and behavior and may break rules or laws.
Insomnia and other sleep disorders
DSM V criteria includes:
A. A predominant complaint of dissatisfaction witli sleep quantity or quality, associated with one (or more) of the following symptoms:
- Difficulty initiating sleep. (In children, this may manifest as difficulty initiating sleep without caregiver intervention.)
- Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings. (In children, this may manifest as difficulty returning to sleep without caregiver intervention.)
- Early-morning awakening with inability to return to sleep.
B. The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning.
C. The sleep difficulty occurs at least 3 nights per week.
D. The sleep difficulty is present for at least 3 months.
E. The sleep difficulty occurs despite adequate opportunity for sleep.
F. The insomnia is not better explained by and does not occur exclusively during the course of another sleep-wake disorder (e.g., narcolepsy, a breathing-related sleep disorder, a circadian rhythm sleep-wake disorder, a parasomnia).
G. The insomnia is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication). H. Coexisting mental disorders and medical conditions do not adequately explain the predominant complaint of insomnia.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
LGBT people have higher rates of mental health challenges than the general population. LGBT people often struggle with depression, anxiety, trauma and self-acceptance as a result of facing ongoing discrimination over their lifetimes. LGBT youth are about three to four times as likely to attempt suicide as their peers.
There is evidence that these higher rates of mental health challenges are due to heightened and long-term exposure of LGBT people to societal and institutional prejudice and discrimination.There are many similarities in the effects of discrimination and how people respond to and cope with stress directly related to prejudice. It’s important to remember, however, that not all LGBT people have lived the same experiences, and that people respond to similar experiences in different ways. It’s also important to note that issues of sexual orientation (lesbian, gay and bisexual) are very different from the issues of gender identity (transgender).
Menopause & PCOS Related Mood Disorders
Menopause is the permanent cessation of menstruation resulting in the loss of ovarian follicle development. It is considered to occur when 12 menstrual cycles are missed.Menopausal transition, or perimenopause, is the period between the onset of irregular menstrual cycles and the last menstrual period. This period is marked by fluctuations in reproductive hormones 3 and is characterized by the following:
- Menstrual irregularities
- Prolonged and heavy menstruation intermixed with episodes of amenorrhea
- Decreased fertility
- Vasomotor symptoms
- Insomnia
Some of these symptoms may emerge 4 years before menses cease, with a perimenopausal mean age of onset of 47.5 years.During the menopausal transition, estrogen levels decline and levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) increase.
Postmenopause is the phase following the last menstrual period.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Menstrual Disorders
DSM V criteria includes:
A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
B. One (or more) of the following symptoms must be present:
- Marked affective lability (e.g., mood swings: feeling suddenly sad or tearful, or increased sensitivity to rejection).
- Marked irritability or anger or increased interpersonal conflicts.
- Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
- Marked anxiety, tension, and/or feelings of being keyed up or on edge.
C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
- Decreased interest in usual activities (e.g., work, school, friends, hobbies).
- Subjective difficulty in concentration.
- Lethargy, easy fatigability, or marked lack of energy.
- Marked change in appetite; overeating; or specific food cravings.
- Hypersomnia or insomnia.
- A sense of being ovenwhelmed or out of control.
- Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain. Note: The symptoms in Criteria A-C must have been met for most menstrual cycles that occurred in the preceding year.
D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).
E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders).
F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles. (Note: The diagnosis may be made provisionally prior to this confirmation.)
G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition (e.g., hyperthyroidism).
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Mood D-O Related to other Medical Conditions
DSM V criteria includes:
A. A prominent and persistent period of abnormally elevated, expansive, or irritable mood and abnormally increased activity or energy that predominates in the clinical picture.
B. There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.
C. The disturbance is not better explained by another mental disorder.
D. The disturbance does not occur exclusively during the course of a delirium.
E. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning, or necessitates hospitalization to prevent harm to self or others, or there are psychotic features.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Obsessive Compulsive Disorder
DSM V criteria includes:
A. Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.
2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).
Compulsions are defined by (1) and (2):
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
Note: Young children may not be able to articulate the aims of these behaviors or mental acts.
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Panic Disorder
DSM V criteria includes:
A. recurrent unexpected panic attacks. Abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and has 4+:
1. palpitations, pounding heart, or accelerated heart rate
2. sweating
3. trembling or shaking
4. sensations of shortness of breath or smothering
5. feelings of choking
6. chest pain or discomfort
7. nausea or abdominal distress
8. chills or heat sensations
9. paresthesias (numbness or tingling)
10. derealization or depersonalization
11. fear of losing control or going crazy
12. fear of dying
B. at least one of the attacks followed by a month of 1. persistent concern or worry about additional panic attacks
2. significant maladaptive change in behavior related to the attacks and designed to avoid having panic attacks
C. not due to substance or medical condition
D. not better explained by another mental disorder
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Peripartum disoder (formerly known as postpartum disorder)
It refers to depression occurring during pregnancy or after childbirth. The use of the term “peripartum” recognizes that depression associated with having a baby often begins during pregnancy. Peripartum depression is a serious, but treatable medical illness involving feelings of extreme sadness, indifference and/or anxiety, as well as changes in energy, sleep, and appetite. It carries risks for the mother and child.
Persistent Depressive Disorder / Dysthymia
DSM V criteria includes:
A. Depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least 2 years. Note: In children and adolescents, mood can be irritable and duration must be at least 1 year.
B. Presence, while depressed, of two (or more) of the following:
- Poor appetite or overeating.
- Insomnia or hypersomnia.
- Low energy or fatigue.
- Low self-esteem.
- Poor concentration or difficulty making decisions.
- Feelings of hopelessness.
C. During the 2-year period (1 year for children or adolescents) of the disturbance, the individual has never been without the symptoms in Criteria A and B for more than 2 months at a time.
D. Criteria for a major depressive disorder may be continuously present for 2 years.
E. There has never been a manic episode or a hypomanie episode, and criteria have never been met for cyclothymic disorder.
F. The disturbance is not better explained by a persistent schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
G.The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g. hypothyroidism).
H. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Premenstrual Dysphoric Disorder
DSM V criteria includes:A. In the majority of menstrual cycles, at least five symptoms must be present in the final week before the onset of menses, start to improve within a few days after the onset of menses, and become minimal or absent in the week postmenses.
B. One (or more) of the following symptoms must be present:
- Marked affective lability (e.g., mood swings: feeling suddenly sad or tearful, or increased sensitivity to rejection).
- Marked irritability or anger or increased interpersonal conflicts.
- Marked depressed mood, feelings of hopelessness, or self-deprecating thoughts.
- Marked anxiety, tension, and/or feelings of being keyed up or on edge.
C. One (or more) of the following symptoms must additionally be present, to reach a total of five symptoms when combined with symptoms from Criterion B above.
- Decreased interest in usual activities (e.g., work, school, friends, hobbies).
- Subjective difficulty in concentration.
- Lethargy, easy fatigability, or marked lack of energy.
- Marked change in appetite; overeating; or specific food cravings.
- Hypersomnia or insomnia.
- A sense of being ovenwhelmed or out of control.
- Physical symptoms such as breast tenderness or swelling, joint or muscle pain, a sensation of “bloating,” or weight gain. Note: The symptoms in Criteria A-C must have been met for most menstrual cycles that occurred in the preceding year.
D. The symptoms are associated with clinically significant distress or interference with work, school, usual social activities, or relationships with others (e.g., avoidance of social activities; decreased productivity and efficiency at work, school, or home).
E. The disturbance is not merely an exacerbation of the symptoms of another disorder, such as major depressive disorder, panic disorder, persistent depressive disorder (dysthymia), or a personality disorder (although it may co-occur with any of these disorders).
F. Criterion A should be confirmed by prospective daily ratings during at least two symptomatic cycles. (Note: The diagnosis may be made provisionally prior to this confirmation.)
G. The symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication, other treatment) or another medical condition (e.g., hyperthyroidism).
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you. Reference: American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher. Text citation: (American Psychiatric Association, 2013).
Schizophrenia
DSM V criteria includes:
A. 2+ for 1 month (1, 2, or 3)
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms
B. Level of fx in one or more major life areas is below premorbid level.
C. Continuous signs of disturbance for 6 months (must include 1 month of criterion A symptoms, may include prodromal or residual phases)
Specifiers: First episode/acute, partial remission, full remission, Multiple edisodes/acute, partial remission, full remission, With catatonia
Differential Diagnosis: Schizoaffective disorder, Depressive/Bipolar with psychotic features, Substance abuse, Medical condition, Autis Spectrum/Communication Disorder (Additional diagnosis of Schizophrenia only made if prominent delusions or hallucinations are present for 1 month).
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Sexual Dysfunction
DSM V criteria includes:
Include:
delayed ejaculation, erectile disorder, female orgasmic disorder, female sexual interest/arousal disorder, genito-pelvic pain/penetration disorder, male hypoactive sexual desire disorder, premature (early) ejaculation, substance/medicationinduced sexual dysfunction, other specified sexual dysfunction, and unspecified sexual dysfunction.
Sexual dysfunctions are a heterogeneous group of disorders that are typically characterized by a clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure. An individual may have several sexual dysfunctions at the same time. In such cases, all of the dysfunctions should be diagnosed.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Social Phobia
DSM V criteria includes:
A. A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others.
The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.
B. Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.
C. The person recognizes that this fear is unreasonable or excessive.
D. The feared situations are avoided or else are endured with intense anxiety and distress.
E. The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
F. In individuals under age 18 years, the duration is at least 6 months.
G. The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder.
Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).
Thyroid and Diabetes Related Mood Disorders
DSM V criteria includes:
Cyclothymia (Thyroid Disorders)
A. At least 2 years numerous periods of hypomanic sx that don’t meet criteria for episode and numerous periods with depressive sx that don’t meet criteria for episode
B. Present at least half the time and not been without for more than 2 months at a time
C. Criteria for MD, manic, or hypomanic episode never met.
Specifiers: with anxious distressComorbidity of diabetes and psychiatric disorders can present in different patterns.
- The two can present as independent conditions with no apparent direct connection. In such a scenario both are an outcome of independent and parallel pathogenic pathways.
- The course of diabetes can be complicated by emergence of psychiatric disorders. In such cases, diabetes contributes to the pathogenesis of psychiatric disorders. Various biological and psychological factors mediate the emergence of psychiatric disorders in such context.
- Certain psychiatric disorders like depression and schizophrenia act as significant independent risk factors for the development of diabetes.
- There could be an overlap between the clinical presentation of hypoglycemic and ketoacidosis episodes and conditions such as panic attacks.
- Impaired glucose tolerance and diabetes could emerge as a side effect of the medications used for psychiatric disorders. Treatment of psychiatric disorders could influence diabetes care in other ways also as discussed in subsequent sections.Speak to your psychiatrist about symptoms and work closely with your psychiatrist to find the best treatment for you.
Reference:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Publisher.
Text citation: (American Psychiatric Association, 2013).