Possible Early Warning Signs of Schizophrenia Source
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Neuropsychiatric Masquerades: Is It a Horse Or a Zebra NCPA Annual Conference Winston-Salem, NC October 3, 2015
Neuropsychiatric Masquerades: Is it a Horse or a Zebra NCPA Annual Conference Winston-Salem, NC October 3, 2015 Manish A. Fozdar, M.D. Triangle Forensic Neuropsychiatry, PLLC, Raleigh, NC www.BrainInjuryExpert.com Consulting Assistant Professor of Psychiatry, Duke University Medical Center, Durham, NC Adjunct Associate Professor of Psychiatry, Campbell University School of Osteopathic Medicine Disclosures • Neither I nor any member of my immediate family has a financial relationship or interest with any proprietary entity producing health care goods or services related to the content of this CME activity. • I am a non-conformist and a cynic of current medical establishment. • I am a polar opposite of being PC. No offense intended if one taken by you. Anatomy of the talk • Common types of diagnostic errors • Few case examples • Discussion of selected neuropsychiatric masquerades When you hear the hoof beats, think horses, not zebras • Most mental symptoms are caused by traditional psychiatric syndromes. • Majority of patients with medical and neurological problems will not develop psychiatric symptoms. Case • 20 y/o AA female with h/o Bipolar disorder and several psych hospitalizations. • Admitted a local psych hospital due to decompensation.. • While at psych hospital, she develops increasing confusion and ataxia. • Transferred to general med-surg hospital. • Stayed for 2 weeks. • Here is what happened…. • Psych C-L service consulted. We did the consult and followed her throughout the hospital stay. • Initial work up showed Normal MRI, but was of poor quality. EEG was normal. • She remained on the hospitalist service. 8 different hospitalists took care of her during her stay here. • Her presentation was chalked off to “her psych disorder”, “Neuroleptic Malignant syndrome” etc. -
Mental Health Disorders: Strategies for Approach & Treatment
3/20/2019 Mental Health Disorders: Strategies for Approach & Treatment Transform 2019: OPTA Annual Conference Columbus, Ohio April 6th, 2019 Dawn Bookshar, PT, DPT, GCS Ian Kilbride, PT Marcia Zeiger, OTRL Objectives Participants will: • Understand the prevalence and impact of mental health disorders in client populations • Understand clinical conditions, and associated characteristics of common mental health diagnoses • Apply effective treatment approaches for clients with mental illness. • Produce effective clinical documentation to support intervention for clients with mental illness Mental Illness (MI) www.schizophrenia.com 1 3/20/2019 Mental Illness (MI) The term mental illness refers collectively to all diagnosable mental disorders defined as sustained abnormal alterations in thinking, mood, or behavior associated with distress and impaired functioning which substantially interferes with or limits one or more major life activities. National Institute of Mental Health Prevalence of MI • More than 50% will be diagnosed with a mental illness or disorder at some point in their lifetime. • 1 in 5 Americans will experience a mental illness in a given year. • 1 in 25 Americans lives with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. Centers for Disease Control & Prevention Prevalence of MI in LTC • 2/3 of people in nursing homes have a mental illness. • Nursing home residents with a primary diagnosis of mental illness range from 18.7% among those aged 65-74 years to 23.5% among those aged 85+ years. • Dementia, Alzheimer disease, and mood disorders are the most common diagnoses of mental illness in long-term care settings. Centers for Disease Control & Prevention 2 3/20/2019 Prevalence of MI in LTC Ohio • Residents with a diagnosis of schizophrenia and bipolar disorder increased from 9% to 16% between 2001 to 2016. -
Chapter 7 Mood Disorders
An Overview of Mood Disorders • Gross Deviations in Mood • 2 Fundamental states: Depression & Mania Chapter 7 • Depression: “The Low” – Major Depressive Episode •The most commonly diagnosed & most severe Mood Disorders depression •Depressed (or in children, irritable) mood state that lasts at least 2 weeks –Cognitive symptoms •Feelings of worthlessness or inappropriate guilt •Diminished ability to concentrate or indecisiveness – Dysthymic Disorder –Disturbed physical functions (vegetative •Similar symptoms to Major Depressive Episode, symptoms) (central to the disorder) but milder •Insomnia or hypersomnia nearly every day –Also fewer symptoms: need only 2 of the •Significant weight loss or gain or change in symptoms, as opposed to 5 in Major Depressive appetite Episode •Fatigue or loss of energy nearly every day •A persistently depressed (or, in children & •Psychomotor agitation or retardation adolescents, irritable) mood that continues for at –Nearly always accompanied by markedly least 2 years diminished interest or ability to experience pleasure –During those 2 years, the individual has never been (anhedonia) from life without the symptoms for more than 2 months at a • Average duration if untreated: 9 months time •Most people with Dysthymia eventually experience a major depressive episode • Mania: “The High” –Abnormally exaggerated elation, joy, or euphoria OR irritability (common toward the –Behavioral symptoms end of the episode) lasting at least 1 week •More talkative / pressured speech –Cognitive symptoms •Psychomotor agitation -
Life with Bipolar Fact Sheet.Pdf
Being so scared Having so Trying to You do not Exhilarating. You you’remisunderstood paralyzed much energy catch up to want the finally feel like that you stress your own high of the you’re normal, out your mind mind mania to until the anger and your body end; then sets in An amazing after the feeling that high of the leads to feeling Things are mania is horrible going You have no over, the Difficult to tell if great and inhibitions, and lows set in you can trust your it’s scary consequences and reality own perception because don’t apply to becomes a of reality You feel you know what you do problem everything at it will not once and then stay that you are numb way to the world Being on a see-saw Flipping a The of human emotion switch in future your mind “Normal” quickly people are goes Mania is speed. from annoying You must start and Being constantly in bright because finish everything activities that take up to you’ll never Productive, now—you can’t time with hardly any carefree, bleak have that stop moving results or satisfation and then stability exhausting Busy brain, When the mania busy Unending back burns out, you’ve senses, and forth with got nothing left Frightening to be so out of busy libido yourself in you control and off-balance Share what life with bipolar disorder feels like for you in words, images or video by tagging your social media posts with #mentalillnessfeelslike. Posts will be displayed at mentalhealthamerica.net/feelslike where you can also submit anonymously if you choose. -
Understanding the Mental Status Examination with the Help of Videos
Understanding the Mental Status Examination with the help of videos Dr. Anvesh Roy Psychiatry Resident, University of Toronto Introduction • The mental status examination describes the sum total of the examiner’s observations and impressions of the psychiatric patient at the time of the interview. • Whereas the patient's history remains stable, the patient's mental status can change from day to day or hour to hour. • Even when a patient is mute, is incoherent, or refuses to answer questions, the clinician can obtain a wealth of information through careful observation. Outline for the Mental Status Examination • Appearance • Overt behavior • Attitude • Speech • Mood and affect • Thinking – a. Form – b. Content • Perceptions • Sensorium – a. Alertness – b. Orientation (person, place, time) – c. Concentration – d. Memory (immediate, recent, long term) – e. Calculations – f. Fund of knowledge – g. Abstract reasoning • Insight • Judgment Appearance • Examples of items in the appearance category include body type, posture, poise, clothes, grooming, hair, and nails. • Common terms used to describe appearance are healthy, sickly, ill at ease, looks older/younger than stated age, disheveled, childlike, and bizarre. • Signs of anxiety are noted: moist hands, perspiring forehead, tense posture and wide eyes. Appearance Example (from Psychosis video) • The pt. is a 23 y.o male who appears his age. There is poor grooming and personal hygiene evidenced by foul body odor and long unkempt hair. The pt. is wearing a worn T-Shirt with an odd symbol looking like a shield. This appears to be related to his delusions that he needs ‘antivirus’ protection from people who can access his mind. -
Ulsd730704 Td Luis Madeira.Pdf
UNIVERSIDADE DE LISBOA FACULDADE DE MEDICINA BASIC-SELF DISORDERS BEYOND SCHIZOPHRENIA: ULTRA-HIGH-RISK STATES AND PANIC DISORDER Luis António Proença Duarte Madeira Orientadores: Prof. Doutora Maria Luísa Caruana Canessa Figueira da Cruz Filipe Prof. Doutor Louis Arnorsson Sass Tese especialmente elaborada para obtenção do grau de Doutor em Medicina Especialidade em Psiquiatria e Saúde Mental 2017 A impressão desta dissertação foi aprovada pelo Conselho Científico da Faculdade de Medicina da Universidade de Lisboa em reunião de 23/11/2016 UNIVERSIDADE DE LISBOA FACULDADE DE MEDICINA BASIC-SELF DISORDERS BEYOND SCHIZOPHRENIA: ULTRA-HIGH-RISK STATES AND PANIC DISORDER Luis António Proença Duarte Madeira Orientadores: Prof. Doutora Maria Luísa Caruana Canessa Figueira da Cruz Filipe Prof. Doutor Louis Arnorsson Sass Tese especialmente elaborada para obtenção do grau de Doutor em Medicina Especialidade em Psiquiatria e Saúde Mental Juri: Presidente: Prof. Doutor José Luis Bliebernicht Ducla Soares, Prof. Catedrático em regime de tenure e Vice-Presidente do Conselho Científico da Faculdade de Medicina da Universidade de Lisboa Vogais: Prof. Doutor Carlos Manuel Moreira Mota Cardoso, Professor Catedrático da Faculdade de Psicologia e Ciências da Educação da Universidade do Porto Prof. Doutor João Eduardo Marques Teixeira, Professor Associado da Faculdade de Psicologia e Ciências da Educação da Universidade do Porto Prof. Doutor Manuel Gonçalves Pereira, Professor Auxiliar da Faculdade de Ciências Médicas da Universidade Nova de Lisboa Prof. Doutor Daniel José Branco de Sampaio, Professor Catedrático Jubilado da Faculdade de Medicina da Universidade de Lisboa Prof. Doutora Maria Luísa Caruana Canessa Figueira da Cruz Filipe, Professora Catedrática Jubilada da Faculdade de Medicina da Universidade de Lisboa (orientador) Prof. -
Children's Mental Health Disorder Fact Sheet for the Classroom
1 Children’s Mental Health Disorder Fact Sheet for the Classroom1 Disorder Symptoms or Behaviors About the Disorder Educational Implications Instructional Strategies and Classroom Accommodations Anxiety Frequent Absences All children feel anxious at times. Many feel stress, for example, when Students are easily frustrated and may Allow students to contract a flexible deadline for Refusal to join in social activities separated from parents; others fear the dark. Some though suffer enough have difficulty completing work. They worrisome assignments. Isolating behavior to interfere with their daily activities. Anxious students may lose friends may suffer from perfectionism and take Have the student check with the teacher or have the teacher Many physical complaints and be left out of social activities. Because they are quiet and compliant, much longer to complete work. Or they check with the student to make sure that assignments have Excessive worry about homework/grades the signs are often missed. They commonly experience academic failure may simply refuse to begin out of fear been written down correctly. Many teachers will choose to Frequent bouts of tears and low self-esteem. that they won’t be able to do anything initial an assignment notebook to indicate that information Fear of new situations right. Their fears of being embarrassed, is correct. Drug or alcohol abuse As many as 1 in 10 young people suffer from an AD. About 50% with humiliated, or failing may result in Consider modifying or adapting the curriculum to better AD also have a second AD or other behavioral disorder (e.g. school avoidance. Getting behind in their suit the student’s learning style-this may lessen his/her depression). -
Chapter 4, and 2) the “Form” of Thought
Pridmore S. Download of Psychiatry, Chapter 6. Last modified: February, 2020. 1 CHAPTER 6 FORM OF THOUGHT Introduction In the psychiatric examination, two aspects of thought are considered: 1) “content” - abnormal the content of thought (delusions) is described in Chapter 4, and 2) the “form” of thought. Form means the “arrangement of parts”. When the “arrangement of the parts” of thought are out of order, the logical connections between the ideas are lost – the thought is difficult to follow. Disorder in the form of thought (or formal thought disorder – FTD) is frequently, for the sake of brevity, referred to as ‘thought disorder’. Theoretically, ‘thought disorder’ could refer to disordered content (delusions), but in practice it is generally used to refer to FTD. [For the sake of convenience, “flight of ideas” and “poverty of thought”, which strictly speaking are not disorders of connection, but disorders of speed or amount of thought, will also be described in the paragraphs of this chapter.] FTD is diagnostically significant, and detection is important. While many health and social services workers can give a good account of some aspects of the mental state of a patient, the assessment of FTD requires special training and experience. The general public may comment that the patient’s speech is “odd”, he/she is ‘difficult to follow’, or ‘gets off the track’. The form of thought is mainly assessed by examining the speech of the patient. It is necessary to take the conventions of conversation into account when examining ‘form’. In everyday conversation we tend to ignore changes of subject and direction; we pay more attention to content and ‘the bottom line’. -
Syllabus Psychiatry Clerkship
OM 7080 June 2021 Syllabus Psychiatry Clerkship Course No.: OM 7080 Course Title: Psychiatry Credit Hours: 4 weeks, 4 credit hours for each Course Director: Yadi Fernandez Sweeny, rotation Department Chair: PsyD, MS, CRNA CRNA-UCLA School of Medicine Term - Variable in OMS III academic year Level: OMS III Dates: Department of Clinical Education Contact Information POMONA CAMPUS: OREGON CAMPUS: Stephanie White, DO Derrick Sorweide, DO Assistant Dean of Clinical Education, Pomona Director of Clinical Education, Oregon Email: [email protected] Email: [email protected] Phone: (909) 469-8414 Phone: (541) 259-0243 Marisa Orser, M.Ed. Kim Ketcham Associate Director of Clinical Education Assistant Director of Clinical Education Phone: (909) 469-5253 Phone: (541) 259-0666 Students contact Rotations Department staff by Students contact Rotations Department staff by submitting a TDX ticket submitting a TDX ticket Preceptors may email: [email protected] Preceptors may email: [email protected] Educational Goal Description: The onsite and/or virtual rotation in Psychiatry will be offered during the third year and may, in rare instances, be taken later, or as an elective. Successful completion will be required for graduation with the D.O. degree. This will be a four-week onsite or online/virtual rotation during which the student will 1 OM 7080 June 2021 demonstrate and apply concepts of diagnosis and treatment to virtual patients with mental/emotional disorders. The course is intended as a practical application and demonstration of concepts cover in the first and second year courses of classroom study in Behavioral Science and Psychiatry. Purpose of the Rotation: The purpose of the clinical psychiatric rotation is to provide the student both didactic and virtual experience in the recognition and management of the patient with psychiatric illness. -
Schizoaffective Disorder?
WHAT IS SCHIZOAFFECTIVE DISORDER? BASIC FACTS • SYMPTOMS • FAMILIES • TREATMENTS RT P SE A Mental Illness Research, Education and Clinical Center E C I D F I A C VA Desert Pacific Healthcare Network V M R E E Long Beach VA Healthcare System N T T N A E L C IL L LN A E IC S IN Education and Dissemination Unit 06/116A S R CL ESE N & ARCH, EDUCATIO 5901 E. 7th street | Long Beach, CA 90822 basic facts Schizoaffective disorder is a chronic and treatable psychiatric Causes illness. It is characterized by a combination of 1) psychotic symp- There is no simple answer to what causes schizoaffective dis- toms, such as those seen in schizophrenia and 2) mood symptoms, order because several factors play a part in the onset of the dis- such as those seen in depression or bipolar disorder. It is a psychi- order. These include a genetic or family history of schizoaffective atric disorder that can affect a person’s thinking, emotions, and be- disorder, schizophrenia, or bipolar disorder, biological factors, en- haviors and can impact all aspects of daily living, including work, vironmental stressors, and stressful life events. school, social relationships, and self-care. Research shows that the risk of schizoaffective disorder re- Schizoaffective disorder is considered a psychotic disorder sults from the influence of genes acting together with biological because of its prominent features of hallucinations and delusions. and environmental factors. A family history of schizoaffective dis- Therefore, people with this illness have periods when they have order does not necessarily mean children or other relatives will difficulty understanding the reality around them. -
Identifying Schizophrenia and Bipolar Disorder from a Sea of Mimics
Identifying Schizophrenia and Bipolar Disorder from a Sea of Mimics Michael Sean Stanley, MD Assistant Professor OHSU Department of Psychiatry Identifying Schizophrenia and Bipolar Disorder from a Sea of Mimics No Disclosures. • Objectives: – Understand the clinical presentation and approach to treatment of Schizophrenia and Bipolar Disorder Psychotic disorders are: Mood Disorders are: • primarily problems of • Primarily problems of sensory processing prolonged extreme and association, not emotional tone (mood). emotion • Exhibit excessive high or • Exhibit profound low mood/motivation disconnection from from normal state sensory reality Psychosis Schizophrenia • a neurodevelopmental syndrome • associated with functional impairments Schizophrenia • no single unifying cause • emerges when environmental accelerants act upon genetic predisposition • May be at the more severely impairing end of a spectrum of disorders. + - C Positive Symptoms Negative Symptoms Cognitive Symptoms New abnormal sx Loss of normal fxn Accompany and likely - Hallucinations - Affective flattening precede +/- sx (auditory most - Anhedonia - Attentional problems commonly) - Asociality - Slower processing - Delusions - Alogia - Difficulty with - Significant planning/prob disorganization of solving thought/behavior - Memory problems May come and go A stable loss, do not Prodromal sx? fluctuate significantly once lost. May decrease to some May be responsive to Minimally responsive to degree with tx of pos sx, antipsychotic meds antipsychotic meds if at but rarely completely. -
Racing and Crowded Thoughts in Mood Disorders: a Data-Oriented Theoretical Reappraisal Gilles Bertschy, Sebastien Weibel, Anne Giersch, Luisa Weiner
Racing and crowded thoughts in mood disorders: A data-oriented theoretical reappraisal Gilles Bertschy, Sebastien Weibel, Anne Giersch, Luisa Weiner To cite this version: Gilles Bertschy, Sebastien Weibel, Anne Giersch, Luisa Weiner. Racing and crowded thoughts in mood disorders: A data-oriented theoretical reappraisal. L’Encéphale, Elsevier Masson, 2020, 46 (3), pp.202-208. 10.1016/j.encep.2020.01.007. hal-02935003 HAL Id: hal-02935003 https://hal.archives-ouvertes.fr/hal-02935003 Submitted on 15 Sep 2020 HAL is a multi-disciplinary open access L’archive ouverte pluridisciplinaire HAL, est archive for the deposit and dissemination of sci- destinée au dépôt et à la diffusion de documents entific research documents, whether they are pub- scientifiques de niveau recherche, publiés ou non, lished or not. The documents may come from émanant des établissements d’enseignement et de teaching and research institutions in France or recherche français ou étrangers, des laboratoires abroad, or from public or private research centers. publics ou privés. Review of the literature Racing and crowded thoughts in mood disorders: A data-oriented theoretical reappraisal Tachypsychie dans les troubles de l’humeur : une réévaluation théorique basée sur les données de la littérature a,b,c, a,b b a,d,e G. Bertschy ∗ , S. Weibel , A. Giersch , L. Weiner a Pôle de psychiatrie, santé mentale & addictologie des hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France b Inserm U1114, 67000 Strasbourg, France c Fédération de médecine translationnelle de Strasbourg, université de Strasbourg, 67000 Strasbourg, France d Laboratoire de psychologie des cognitions, 67000 Strasbourg, France e Faculté de psychologie, université de Strasbourg, 67000 Strasbourg, France a r t i c l e i n f o a b s t r a c t Article history: Objectives.