Ego Defenses

throwing tantrums

acting out

immature

Ego Defenses

Changing one's character or personal identity to avoid emotional distress

Dissociation

immature

Ego Defenses

Not acknowledging apiece of bad news, as though it was never said

Denial

Immature

Ego Defenses

Using one's aggression to succeed in business ventures

Sublimation

Mature

Ego Defenses

A thought that is avoided is replaced by an unconscious emphasis on the opposite

Reaction formation

Immature

Ego Defenses

An abused child becomes an abusive parent

identification

immature

Ego Defenses

Belief that people are either all good or all bad

Splitting

immature

Ego Defenses

A veteran that can describe horrific war details without any emotion

Isolation

Immature

Ego Defenses

This defense mechanism underlies all other defense mechanisms

Repression

Immature

Ego Defenses

A man who is cheating accuses his wife of sleeping with his friend

Projection

Immature

Ego Defenses

Arsonist donates money to the fire department

Altruism

Mature

Ego Defenses

Joking about something that makes you nervous

Humor

Mature

Ego Defenses

Offering an explanation for unacceptable attitudes, beliefs, or behaviors

Rationalization

Immature

Ego Defenses

Man yelling at his family after a bad day at work

Ego Defenses

Voluntary suppression of a painful event

Suppression

Mature

Ego Defenses

Teenager sleeping in his parent's room after his friend dies in a motor vehicle accident

Ego Defenses

Inovluntary forgetting of a traumatic event

Neurotransmitter Changes

Anxiety

Increased norepinephrine

Decreased GABA

Decreased serotonin

Decreased norepinephrine

Decreased serotonin

Decreased dopamine

Increased norepinephrine

Increased serotonin

Increased dopamine

Decreased GABA

Decreased Ach

Decreased dopamine

Increased serotonin

Increased acetylcholine

Duration of symptoms for diagnosis

Schizophrenia

Duration of symptoms for diagnosis

Brief Psychotic Disorder/Psychotic Break

Duration of symptoms for diagnosis

Schizophreniform Disorder

Duration of symptoms for diagnosis

Manic Episode

Duration of symptoms for diagnosis

Cyclothymic disorder

Duration of symptoms for diagnosis

Major Depressive Disorder

Duration of symptoms for diagnosis

Dysthymia

Duration of symptoms for diagnosis

PTSD

Duration of symptoms for diagnosis

Acute Stress Disorder

Duration of symptoms for diagnosis

Generalized Anxiety Disorder

Duration of symptoms for diagnosis

Adjustment Disorder

< 6 months (previous stressor)

> 6 months (chronic stressor)

Duration of symptoms for diagnosis

Substace Dependence

Duration of symptoms for diagnosis

Pathologic Grief

Decreased slow wave sleep

Decreased time to REM

Increased REM 

Multiple awakenings

Early morning awakening

Decreased slow wave sleep

Increased latency to REM

Decreased REM

Multiple awakenings

Duration of symptoms for diagnosis

Delusional disorder

Personality Disorder and Cluster

pervasive distrust, suspicious, projection is common

Paranoid PD

Cluster A

Personality Disorder and Cluster

social withdrawal, limited emotional expression

Schizoid

Cluster A

Personality Disorder and Cluster

Odd beliefs, magical thinking, eccentric, awkward

Schizotypal

Cluster A

Personality Disorder and Cluster

Violates others rights, criminality

Personality Disorder and Cluster

Unstable mood and relationships, impulsive, self-mutilating, boredom, emptiness, splitting

Borderline PD

Cluster B

Personality Disorder and Cluster

Emotionality, excitability, attention seeking, sexually provacative, concerned with appearance

Histrionic PD

Cluster B

Personality Disorder and Cluster

Grandiosity, sense of entitlement, lacks empathy, enraged at criticism

Narcissistic PD

Cluster B

Personality Disorder and Cluster

Hypersensitive to rejection, socially inhibited, inadequacy, desires relationships with others

Avoidant PD

Cluster C

Personality Disorder and Cluster

perfectionistic, preoccupation with order, control, ego syntonic

Obsessive Compulsive PD

Cluster C

Personality Disorder and Cluster

Submissive, clinging, needs to be taken care of, low self confidence

Dependent PD

Cluster C

Haloperidol

Potency and Class

Side Effects

High potency antipsychotic

Extrapyramidal symptoms

Trifluoperazine

Potency and Class

Side Effects

High- medium potency antipsychotic

Extrapyramidal symptoms

Fluphenazine

Potency and Class

Side Effects

high potency antipsychotic

extrapyramidal symptoms

Thioridazine

Potency and Class

Side Effects

Low potency antipsychotic

Anticholinergic side effects

Retinal deposits

Chlorpromazine

Potency and Class

Side Effects

Low potency typical antipsychotic

Anticholinergic symptoms

Corneal deposits

Neuropleptic Malignant Syndrome

Symptoms

Treatment

rigidity

myoglobinuria

autonomic instability

hyperpyrexia

Tx. dantrolene or bromocriptine

Tardive Dyskinesia

Symptoms

Cause

Sterotypic oral facial movements from > 4 months of antipsychotics

Irreversible.

4 h Dystonia

4 d Akinesia

4 wk Akathisia

4 mo Tardive Dyskinesia

Typical Antipsychotics

Mechanism

Indications

Side Effects

Block D2 dopamine receptors (increase cAMP)

Schizophrenic positive symptoms, psychosis, mania, Toourette's

EPS, anticholinergic, neuroleptic malignant syndrome, tardive dyskinesia, endrocrinopathies (diabetes, galactorrhea)

Atypical Antipsychotics

Mechanism

Indications

Side effects

Block 5 HT, DA, Alpha, Histamine 1 receptors

Schizophrenia positive and negative symptoms

OCD, anxiety, depression, mania, Tourettes (olanzapine)

Fewer EPS and anticholinergic side effects

Endocrinopathies- diabetes, galactorrhea

Lithium

Indication

Side Effects

bipolar disorder, SIADH

Tremor, polyuria, heart block, hypothyroidism, Ebstein Anomaly (fetal heart defects)

Buspirione

mechanism

indication

Serotonin agonist

Generalized anxiety disorder

TCAs

mechanism

indication

side effects

toxicity

names

block NE and 5 HT reuptake and muscarinic receptors

MDD, bedwetting, OCD, fibromyalgia

Sedation, anticholinergic effects, seizures

Convulsions, Coma, Cardiotoxic (arrhythmia)

imimpramine, amitriptyline, desipramine, nortiptyline, clomipramine, doxepin, amoxapine

SSRIs

Indications

Toxicity

Contraindicated medications

Depression, OCD< bulimia, social phobia, anxiety

Serotonin syndome- hyperthermia, muscle rigidity, CV collapse, flushing diarrhea, seizures

SNRI, MAOI, St. John's Wort, Sibutramine, Tryptophan, cocaine, amphetamine

MAOIs

Indications

Toxicity

Names

Atypical depression, anxiety, hypochondriasis

Hypertensive crisis- tyramine ingestion, SSRI/demerol- serotonin syndrome

Selegeline, phenelzine, tranylcypromine, isocarboxazid

Buproprion

Increases norepinephrine and dopamine (NDRI)

Depression, smoking cessation, good with SSRIs

Seizures, headache

Mirtazapine

mechanism

indication

side effects

blocks alpha 2 to increase NE and serotonin

Elderly patients with anorexia and insomnia

Anti-histamine side effects 

Trazodone

mechanism

Indication

Toxicity

inhibits serotonin reuptake (Tetra cyclic)

insomnia, depression

Priapism, sedation, hypotension