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Disease
Phobias
Visual Hallucinations
Cyclothymic
Impulse control disorder
Dissociative
Bulimia Nervosa
Adjustment Disorder
Delusional Disorder
OCRD hoardin!" e#coriation" trichotill$eperation an#iety disorder
Autism
Panic Disorder
$uicide Increases %&
Addicts
'neuresis
'ncoprisis
Disease
(AD
OCRD trichotillomania" hoardin!" e#co
$ocial Phobia&$ocial An#iety Disorders
OCD
Panic Disorder
P)$D
$eperation an#iety disorder
Acute Delerium in elderly
Delerium
Acute *ania
$leep Apnea
$peci+ic Phobia e#, +ear o+ drivin!" spid
Dementia
A$D
)ourette-s
Re+ractory Bulimia
Per+ormance an#iety
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A.athisia
R'* $leep behavior disorder
Narcoleptics %& cataple#y
$omatic $# Disorder
Conversion
Illness an#iety disorder hypochondriasiODD
Conduct Disorder
$elective mutism
Personality Disorders
Dissociative Disorders +u!ue" amnesia"
Anore#ia Nervosa
Adjustment )herapy
Persistent Depressive Disorder
Cyclothymic Disorder
Bin!e eatin! disorder Depersonali/ation Disorder
*DD
Premature 'jaculation
)obacco
Impulse control d&o Pyromania" Intermi
Insomnia
*aintenance +or *ania&Bipolar
Re+ractory or $evere Depression or Pre!
Restless le! syndrome
Diabetic Neuropathy$leep )errors
P)$D Ni!hmares
Dru!
$$RIs
Atypical anti1psychotics
)ypical anti1psychotics
Amo#apine
Ramelteon
'C)
Dru! (roup
Non1ben/odia/epine an#iolytics
Disease
Personality Disorder
Bereavement 12 Persistent Comple# Ber
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Persistent Depressive Disorder
)ourette-s
$elective mutism
'neuresis
'ncopresis
$e#ual abuse$omatic $# Disorder
$e#ual disorders not caused by Dru!s
ADHD
ODD
$eperation An#iety Disorder
$chi/ophrenia
*ania&Bipolar
Hypomania
Delusional Disorder
(AD
Disease
Panic Attac.s
)ourette-s
Autism
P)$D
$chi/ophrenia
Huntin!tons
OCD
Al/heimer Dru!s
3ithium
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Related Disease
An#iety" *ood and $ubstance Abuse
Delerium" Alcohol 4ithdra%al" Dru! Into#ication" 3e%y Body Dementia
Bipolar" Boderline personality disorder" or $ubstance abuse
$ubstance abuse
Psychotherapy
5leptomania
Acute $tress Disorder&P)$D" Bereavement" *DD
$chi/ophrenia" $ubstance abuse" Dementia&delirium" *ania&hypomania&bipolar
OCD and other OCRDs*DD and Panic Disorder as an adult
Rule out dea+ness
An#iety" *ood and $ubstance Abuse
Depression" Bipolar" $chi/ophrenia
*otivAtional )herapy
Rule out 6)I" diabetes" sei/ures
Rule out constipation" hypothyroidism" anal +issures
Dru!s primary7
$$RIs 8 CB)s
CB) 8 $$RIs
$$RI or CB)
CB) more e++ective" but not appropriate +or all70 $$RIs 9st line7 and Clomipramine
9st line treatment $$RIs0 Immediate relie+ Ben/odia/epines
$$RIs 8 CB)s 0 Pra/osin +or ni!htmares
CB) and $$RIs
I* Hi!h1potency Anti1psychotics Ben/os CI in delerium" e#cept D)s7
Anti1psychotics
Atypical Antipsychotics
CPAP
CB) %& e#posure therapy $ystematic desensiti/ation" +loodin!70 :nd Ben/os" and $$RIs
Choliner!ic a!onists, Donepe/il" !alantamine" rivasti!mine 12 $lo%s decline but cannot reverse
Remedial 'ducation and Behavioral )herapy
A: a!onist clonidine" !uan+acine7" Anti1psychotics haloperidol" risperidone7
)opiramate
B1bloc.ers propanolol7" Ben/os
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Propanolol
Clona/epam avoid in Renal Disorders7
$odium O#ybate
;ollo% up %& primary care0 )ests should be limited but not eliminated
'ducation and reassurance s# %ill improve over time
Remove Psycholo!ical $tressor Psychotherapy
Psychotherapy
Psychotherapy" behavior therapy" mana!ement o+ an#iety
Psychotherapy
Psychotherapy
Psychotherapy0 $$RIs don-t %or. b&c nutritional de+icit in )ryptophan
$upportive Psychotherapy
Psychotherapy 1 $$RIs
Psychotherapy
Psychotherapy$ymptomatic t# +or < depression $$RIs7" an#iety $$RIs" ben/os7
$$RIs0 $$RIs0 12 antidepressant" )CA" *AO1I" Antipsychotics
$$RIs
Varenicline" Buproprion" Nicotine
CB)
CB) 1 Ben/os" Non1ben/o (ABA" $edatin! non1(ABA
3ithium" Valproic Acid" 3amotri!ine" Risperidone
'C)
Ropinirole or pramipe#ole dopamine a!onists70 $econdary 1 (abapentin" opiods" ben/os
)CAsDia/epam 1 small doses
Pra/osin = Ima!ery Rehersal )herapy
Diseases
*DD" OCD" Bulimia Nervosa" Panic Disorder" Diabetic Neuropathy" Premenstrual Dysphoric Disorder
87 s# o+ shi/ophrenia
*DD %& psychotic +# inhibits N' reupta.e" Bloc.s dopamine receptors7
$leep aid 1 *)9 and *): a!onist
Re+ractory or Very $evere Depression or i+ Rapid )# needed
Dru!s
9st !en anti1histamines hydro#y/ine" diphenhydramine7" Buspirone" Propanolol" Barbiturates
)imeline
29 year
29: months
87 = 1 s# o+ schi/ophrenia
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2: years
29 year
9 month
:#&%ee. +or > months 1 a+ter a!e ?
9#&month +or > months 1 a+ter a!e @
2 months o+ duration2 months o+ duration
2 months o+ duration
2 months o+ duration
2 months o+ duration
2 months o+ duration
2 months o+ duration
29 %ee.
2@ days
29 month
2 months o+ duration
Brain
3ocus Ceruleus and Decreased Amy!dala
Caudal Nucleus Atrophy" Decreased +rontal lobe mass
Increased cortical thic.ness" inc0 total brain volume
Decreased Hippocampal Volume
'nlar!ed Ventricles
Caudate Nucleus 8 Putamen
Orbito+rontal corte# abnormalities = $triatum and Caudal Nucleus
Di++use cortical atrophyAvoid
)hia/ides" N$AIDs" Ace1I
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)#,
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111227
$ummary
1> months over in
Adjustment Disorder
$ocial Phobia&An#iety
Acute $tress Disorder
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9 month
$elective mutism
Delusional Disorder
$chi/ophrni+orm
P)$D
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Dysthymic Disorder 1 Venla+a#ine or Buproprion
$$RI = CB) 1 All an#iety disorders e#cept Per+ormance Phobia
(AD
$ocial Phobia&$ocial An#iety Disorders 1 B1bloc.er or Ben/os +or Per+orm&$pea.in!
OCDRD Hoardin!" '#coriation" )richo" Body Dysmorphic7OCD 1 Clomipramine :nd line
Panic Disorder 1 Ben/os immediate relie+
P)$D 1 Pra/osin +or ni!htmares" Clonidine and B1bloc.ers also e++ective +or an!er" ra!e p
$eparation An#iety Disorder
Anti1psychotics not used in psychosis
Delerium 1 'lderly Patients avoid ben/os7
Delerium 1 A'IO6 )IP$
Acute *ania 1 Atypical Antipsychotics
CPAP
$leep Apnea
'#ceptions
Dementia 12 Anti1choliner!ics donepe/il" !alantamine" rivasti!mine7
$peci+ic Phobia 12 CB)" '#posure 12 Ben/os 8 $$RIs
A$D 12 Remedial 'ducation and behavioral therapy
)ourettes 12 a: a!onist clonidine" !uan+acine7 12 antipsychotics halo" resper7
Re+ractory Bulimia Nervosa 12 )opiramate
Per+ormance An#iety 12 B1bloc.ers or Ben/os Propanolol7
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A.athisia 12 Propanolol
R'* $leep behavior disorder 12 Clona/epam avoid in Renal Disorder7
Narcoleptics %& cataple#y 12 $odium O#ybate
$omatic $# disorder 1pain 12 ;ollo% up %& PCP re!ularly
Conversion 12 Reassurance
Illness An#iety Disorder 12 Remove psycholo!ical $tressor Psychotherapy
ODD
Conduct Disorder
$elective *utism 1 %& behavior therapy" an#iety mana!ement
Personality Disorders
Disociative Disorders +u!ue" amnesia" identity disorder7
Anore#ia Nervosa 1 Olan/apine may help
Bin!e1eatin! Disorder
Adjustment Disorder
Persistent Depressive Disorder Cyclothymic Disorder
$$RIs
Depersonali/ation Disorder 1$$RI +or depression" ben/os or $$RIs +or an#iety too
Bulimia Nervosa 1 )opiramate in re+ractory cases
*DD 1 also %& )CA" *AO1I and Antipsychotics
Premature 'jaculation
Varenicline" Buproprion" Nicotine
)obacco
CB)
Impulsive Control Disorders 1 Intermittent '#plosive Disorder" Pyromania" 5leptomaniaInsomnia 1 Ben/os" Non1ben/o (ABA" $edatin! non1(ABA
*ood $tabili/ers, 3ithium" Valproic Acid" 3amotri!ine" RisperidoneCarbama/epine
*aintenance o+ mania&bipolar
'C)
Re+ractory" Pre!nant or $evere *DD
Ropinirole or pramipe#ole dopamine a!onists70 $econdary 1 (abapentin" opiods" ben/os
Restless le! syndrome
)CA
Diabetic Neuropathy
Dia/epam
$leep )errors
2 @ days
Hypomania
1 mo7
ntil 9 mo7
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months
$e#ual Disorder not complicated %& dru!s
ADHD
$chi/ophrenia
$e#ual Abuse
$AD 1 Adults$omatic $# Disorder or illness an#iety or conversion
ODD
(AD
Conduct Disorder
Prevalance
$chi/ophrenia, P 9E" *F ?E" $ 9E
Bipolar, P 9E" $ G1E
OCD % )ourettes, ?E1GE
Delirium R;, Old A!e
Delirium ''(, Bac.!round slo%in!
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nic hyperarousal7
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Pra/osin = Ima!ery Rehersal )herapy
P)$D
9 %ee. 2: %ee.s
*ania&Bipolar ># *DD ?# %& either Anhedonia or Depression
Brie+ Psychotic Disorder $AD 1 Children 2@ %ee.s
$chi/oa++ective
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9 year : year
Persistent Comple# Bereavement Disorder Persistent depressive disorder 1 Adult
)ourettes-s Cyclothymic Disorder
Personality Disorder
Persistent Depressive Disorder 1 Child
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;riday
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4ednesday )hursday ;riday
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