psychotic features
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major depressive disorder (MDD). 1- SIG: E CAPS ≥ 5 diagnostic \ 2- lasting ≥ 2 weeks / 3-No history of mania or hypomania
4- Not due to substances or another medical condition
with psychotic features
Differentiating MDD with psychotic features from MDD without psychotic features is important as treatment differs.
severe subtype of unipolar major depression
combined treatment with an antidepressant and antipsychotic or electroconvulsive therapy
Delusional 👤
experience delusions
but NO other psychotic symptoms
≥1 delusions for at least a month. 🤦🏻♀️
schizoaffective disorder : experience both mood and psychotic symptoms.
differentiated from MDD+psychotic features ≥2 weeks in the absence of MDD mood symptomatology.
Schizophreniform
experience psychotic symptoms ALONE in the absence of an identifiable mood disorder.
Schizophreniform ALONE
Adjustment disorder [ Symptoms do not meet criteria for another psychiatric illness.]
occur within 3 months of an identifiable psychosocial stressor (eg, divorce, illness
Lasting < 6 months
Treatment: CBT is first line; antidepressants and anxiolytics may be considered.
Persistent depressive disorder (dysthymia)
Chronic depressed mood lasted ≥2 years. (1 year in children/adolescents)
Schizophrenia experience psychotic symptoms ALONE in the absence of an identifiable mood disorder. 🚩
Diagnosis /
- Delusions
positive symptoms
- Hallucinations, often Auditory🦻🏼
positive symptoms
3. Disorganized speech🤧
positive symptoms
- Disorganized or catatonic behavior
positive symptoms
- Negative symptoms (eg, apathy, flat affect)poverty of speech, social withdrawal)
-VE
Symptom onset ≥ 6 months prior to diagnosis; including at least 1 month of ≥2 of the following active symptoms (with at least 1 from the first 3):
Uwold // Flat affect (ie, reduced emotional expressiveness), decreased attention to personal hygiene, وصخخخخ وصخخخخخخ and thought blocking (ie, sudden inability to finish a thought) are findings typical of schizophrenia.
Normal stress response ⚠
Not excessive or out of proportion to severity of stressor
No significant functional impairment :
overall behavior in patients with delusional disorder is not obviously bizarre or odd, and general functioning is not significantly impaired (eg, this patient has a stable relationship and employment).
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Differential diagnosis
Schizophrenia: other psychotic symptoms present (eg, hallucinations, disorganization, negative symptoms); greater functional impairment
Personality disorders: pervasive pattern of suspiciousness (paranoid), grandiosity (narcissistic), or odd beliefs (schizotypal), but no clear delusions
Personality disorders involve persistent patterns of behavior usually arising in early adulthood. They are pervasive across a broad range of situations (eg, interpersonal, vocational) but do not involve specific delusions (eg, persistent false, fixed beliefs).
symptoms last ≥1 month but <6 months [1-6]
The diagnosis cannot be made when psychotic symptoms occur [only] in the context of a manic episode, t.
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Delusions
False, fixed, beliefs
Disorganized thought
Speech may be incoherent (“word salad”
Hallucinations
Educational objective: Depressed adolescents may display irritable rather than depressed mood, declining academic performance, and withdrawal from social activities. Initial evaluation of all children and adolescents with suspected depression should include a careful suicide risk assessment.
Schizoid personallity prefers to be a loner, detached, unemotional
Specifiers
With pure dysthymic syndrome: criteria for major depressive episode never met
With intermittent major depressive episodes
With persistent major depressive episodes: criteria for major depressive episode met throughout previous 2 years
<6 M
A normal stress response is differentiated from an adjustment disorder by: milder symptoms, lack of marked distress, and lack of social or occupational impairment.
مو اله ضبط 3M اهمشي مو اكثر يعني شهرين عادي
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treatment
Antipsychotic medication Dopamin antagonist 🤦🏻♀️
Adjunctive psychosocial interventions (eg, social skills training,
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brief psychotic disorder characterized by acute onset of psychotic symptoms (delusions, hallucinations) lasting ≥1 day and ≤1 month.
[1Day -1 Month] 🤧