Disorder tricks that make the DSM stick

Positive (added): hallucinations, delusions, disorganized speech. Negative (removed): flat affect, alogia (reduced speech), avolition (no motivation), anhedonia. Positive symptoms respond better to antipsychotics.

Cluster A (Odd): Paranoid, Schizoid, Schizotypal. Cluster B (Dramatic): Borderline, Narcissistic, Histrionic, Antisocial. Cluster C (Anxious): Avoidant, Dependent, OCPD.

Panic disorder: recurrent unexpected panic attacks. Agoraphobia: fear of open/escape-difficult situations. Social anxiety: fear of social scrutiny. GAD: excessive worry about multiple things. Specific phobia: fear of a particular object or situation.

Re-experiencing: flashbacks, nightmares. Avoidance: avoid trauma reminders. Hyperarousal: startle response, sleep problems, irritability. Negative cognition/mood: guilt, detachment, loss of interest. Duration: >1 month.

Bipolar I: full manic episodes (at least 7 days, may require hospitalization). Bipolar II: hypomania (less severe) + major depression. Manic episode: elevated or irritable mood, decreased need for sleep, grandiosity, racing thoughts, increased goal-directed activity, poor judgment. Treated with mood stabilizers (lithium).

Obsessions: persistent, unwanted, intrusive thoughts that cause anxiety (contamination, harm, symmetry). Compulsions: repetitive behaviors or mental acts to neutralize the anxiety (handwashing, checking, counting). Ego-dystonic: the person knows the thoughts/behaviors are excessive but can't stop. Treated with CBT (ERP) + SSRIs.

Dissociative amnesia: inability to recall important personal information, usually trauma-related. Depersonalization/derealization: feeling detached from one's mind/body or surroundings. Dissociative Identity Disorder (DID): two or more distinct personality states, associated with severe early trauma.

Anorexia nervosa: severely restricts food intake, intense fear of weight gain, distorted body image. Often normal or low BMI. Bulimia nervosa: recurrent binge eating followed by purging (vomiting, laxatives, excessive exercise). Maintains normal weight. Binge eating disorder: recurrent binges without compensatory behaviors.

Somatic symptom disorder: one or more physical symptoms plus excessive concern about health. NOT faking — distress is genuine. Illness anxiety disorder (formerly hypochondria): high health anxiety with mild/no symptoms. Conversion disorder: neurological symptoms (paralysis, blindness) without neurological cause.

ASD: persistent deficits in social communication and interaction, plus restricted/repetitive behaviors, interests, or activities. Presents in early development. Wide spectrum: some nonverbal with significant support needs; others high-functioning. Sensory sensitivities common. No single cause — complex genetic and environmental factors.

Inattentive type: fails to attend to details, easily distracted, forgetful, loses things, doesn't follow through. Hyperactive-impulsive: fidgets, can't stay seated, talks excessively, interrupts, difficulty waiting. Combined: meets criteria for both. Symptoms present before age 12 in multiple settings.

GAD (Generalized Anxiety): chronic uncontrollable worry about multiple areas — key symptom is difficulty controlling worry. Social Anxiety: fear of social scrutiny and embarrassment. Panic Disorder: recurrent unexpected panic attacks + fear of future attacks + agoraphobia. Specific Phobia: marked fear of specific object/situation. OCD (now separate): obsessions + compulsions. PTSD: trauma exposure + intrusion + avoidance + hyperarousal + negative cognitions. Best treatments: CBT + exposure therapy. Medications: SSRIs/SNRIs.

Major Depression: 5+ SIGECAPS symptoms for 2+ weeks, must include depressed mood OR loss of interest. Bipolar I: at least one manic episode (elevated/irritable mood, grandiosity, decreased need for sleep, racing thoughts, risky behavior — 7+ days). Bipolar II: hypomanic + major depressive episodes. Dysthymia (Persistent Depressive Disorder): chronic low-grade depression 2+ years. Bipolar treatments: mood stabilizers (lithium), atypical antipsychotics.

Cluster A (Odd/Eccentric): Paranoid (distrust), Schizoid (social detachment), Schizotypal (odd beliefs and perceptions). Cluster B (Dramatic/Emotional): Antisocial (disregard for others), Borderline (instability in relationships, identity, mood), Histrionic (attention-seeking), Narcissistic (grandiosity, lack of empathy). Cluster C (Anxious/Fearful): Avoidant (social inhibition, feelings of inadequacy), Dependent (submissive, needs reassurance), Obsessive-Compulsive (perfectionism, control).

Positive symptoms (excesses): delusions (fixed false beliefs), hallucinations (most often auditory — "hearing voices"), disorganized speech and behavior. Negative symptoms (deficits): flat affect, alogia (poverty of speech), avolition (lack of motivation), anhedonia, asociality. Diagnosis requires 2+ symptoms for 6+ months with significant dysfunction. Dopamine hypothesis: excess dopamine in mesolimbic pathway → positive symptoms. Antipsychotics block D2 receptors.