Tick Tock
Major depressive disorder is characterized by discrete episodes lasting at least _____.
What is: 2 weeks
A patient develops emotional and behavioral symptoms causing significant impairment within 2 months of an identifiable stressor. The presentation does not meet criteria for another mental disorder.
adjustment disorder
What lifetime mood episode distinguishes bipolar I from bipolar II disorder?
a manic episode
(Bipolar II requires that there has never been a manic episode)
A perception-like experience occurring without an external stimulus, experienced with the force and impact of normal perception and not under voluntary control.
hallucination
A patient has excessive anxiety and worry about multiple areas of life more days than not for 8 months, associated with restlessness, fatigue, muscle tension, and insomnia. What important GAD criterion has not yet been established?
difficultly controlling the worry
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased activity or energy must ordinarily last at least this long to meet the duration criterion for mania.
1 week
Note: ANY duration qualifies as mania if hospitalization is necessary.
A patient has psychotic symptoms lasting 3 weeks, followed by full return to the premorbid level of functioning.
brief psychotic disorder
(Duration is ≥1 day but <1 month)
What feature, if present during an otherwise hypomanic syndrome, makes the episode manic by definition?
psychotic features
This type of hallucination is the most common one experienced by patients with schizophrenia
auditory
A patient has a documented hypomanic episode and has never experienced mania. What additional type of episode is required for a bipolar II disorder diagnosis?
A major depressive episode
In adults, depressed mood for most of the day, more days than not, must be present for at least this long for persistent depressive disorder.
2 years
A patient has a major depressive episode and a past hypomanic episode but has never experienced a manic episode.
bipolar II disorder
What key characteristic distinguishes mania from hypomania?
mania -> marked impairment in social/occupational functioning, necessitates hospitalization
hypomania -> does not cause marked impairment in social/occupational functioning, does not necessitate hospitalization
This type of delusion—belief that one is being harmed, harassed, or targeted—is described as the most common in schizophrenia.
persecutory delusion
A 25-year-old has a longstanding pattern of deceitfulness, impulsivity, repeated unlawful behavior, aggressiveness, and lack of remorse beginning at age 16. What required historical feature is missing for Antisocial Personality Disorder?
evidence of conduct disorder with onset before age 15
A patient has delusions, hallucinations, and disorganized speech for 4 months. What is the most likely diagnosis?
schizophreniform disorder
For 7 months, a patient has excessive anxiety and worry about finances, work performance, health, and family. They find the worry difficult to control and also have restlessness, fatigue, muscle tension, and sleep disturbance.
generalized anxiety disorder
What duration of symptoms separates schizophreniform disorder from schizophrenia?
6 months
Schizophreniform lasts ≥1 but <6 months; schizophrenia requires continuous symptoms for ≥6 months
Which two negative symptoms does DSM-5-TR describe as particularly prominent in schizophrenia?
diminished emotional expression and avolition
A patient is experiencing insomnia, fatigue, guilt, poor concentration, appetite loss, and psychomotor slowing. What symptoms also need to be present in order for this to be diagnosed as MDD?
depressed mood or anhedonia
For a diagnosis of schizoaffective disorder, delusions or hallucinations must occur for at least this long in the absence of a major mood episode.
2 weeks
A patient has chronic psychosis plus recurrent major mood episodes that occupy the majority of the total illness. There has also been a 3-week period of hallucinations and delusions without a major mood episode.
schizoaffective disorder
What features help distinguish substance-induced psychotic disorder from an independent psychotic disorder?
an independent disorder is suggested if psychosis precedes substance use, persists for a substantial period after intoxication/withdrawal, or has occurred recurrently independent of substances
What are the five major symptom domains used to define schizophrenia-spectrum and other psychotic disorders?
delusions, hallucinations, disorganized thinking/speech, grossly disorganized or abnormal motor behavior, and negative symptoms
A patient has persistently elevated mood, increased energy, decreased need for sleep, pressured speech, grandiosity, and increased goal-directed activity for 3 days. There is no marked impairment, hospitalization, or psychosis. What is missing for this to qualify as a hypomanic episode?
one more day — hypomania requires at least 4 consecutive days