Dissociation - defense mechanism that protects a person from overwhelming anxiety by emotionally separating
Depersonalization - unreality or detachment
... [Show More] from one's body, thoughts, feeling and actions
Derealization: - unreality or detachment from one's surroundings
Body dysmorphic disorder - Preoccupation with one or more perceived defects or flaws in physical appearance
Spends significant time trying to correct perceived flaw with makeup, dermatological procedures or plastic surgery
Txt: SSRI and or CBT
Hoarding disorder - Persistent difficulty discarding possessions regardless of actual value
Results in accumulation of possessions that compromise living space or inability to function
Patients who remain resistant to psychosocial interventions, or who lack access to them, can be provided a trial of a serotonin-reuptake inhibitor, particularly if they have a comorbid affective or anxiety disorder;
Trichotillomania - Recurrent pulling out one's hair despite repeated attempts to stop.
Txt: SSRI, Clomipramine; atypical antipsychotics, lithium
Excoriation Disorder - Recurrent skin picking that results in lesions despite attempts to stop.
Cognitive-behavioral therapies may be beneficial for patients accepting psychiatric referral
Txt: SSRIS, antipsychotics, anxiolytics
Posttraumatic Stress Disorder (PTSD) - Re-experiencing of an extremely traumatic event accompanied by symptoms of increased arousal and avoidance of stimuli associate with the trauma.
PTSD treatment - 1st line: SSRIS (Zoloft, Celexa) or SNRIS (Venlafaxine)
FDA approved meds: Sertraline (Zoloft) and Paroxetine (Paxil)
Alpha-1 agonist (Prazosin)= targets flashbacks; nightmares and hypervigilance
Psychotherapy (CBC- exposure therapy etc.)
• PTSD - is a potentially debilitating disorder that can occurs after a traumatic event.
Commonly described in war veterans •
Can also present in those experiencing non- war events
PTSD - • Clinical syndrome is characterized by 4 clusters of symptoms:
Re-experiencing the trauma (with intrusive thoughts, nightmares, or flashbacks) •
Emotional numbing •
Avoidance behaviors •
Persistent hyperarousal and mood symptoms (depression, irritability, anger)
Difference between Acute Stress Disorder and PTSD: - When an individual experiences a traumatic event and displays anxiety symptoms that lasts for only a short duration, the condition is opposed to PTSD.
For the diagnosed as ASD as condition to be diagnosed as ASD, symptoms must occur within one month of trauma and last for not more than one month. The symptoms of ASD, however, are similar to those observed in PTSD.
Comorbidity Assessment: PTSD - It is important to look for:
Substance use disorders (avoid benzodiazepines)
Depression
Bipolar disorder
Psychosis
Nonpharmacologic Treatment in PTSD: - СВТ
Supportive Group Therapy Relaxation therapies [Show Less]