Medical Blog

Munchausen Syndrome

Introduction
Background

The medical case literature provides compelling documentation of patients who have intentionally exaggerated, feigned, simulated, aggravated, or self-induced an illness or injury for the primary purpose of assuming the sick role. These occurrences were documented in the modern medical literature as early as the mid-19th century, and were identified as a distinct psychiatric disorder in 1951 by Asher, who coined the term Munchausen syndrome. Read more…

Dissociative Disorders

Etiology and Introduction

Since the 1980s, the concept of dissociative disorders has taken on a new significance. They now receive a large amount of theoretical and clinical attention from persons in the fields of psychiatry and psychology. Dissociative disorders are a group of psychiatric syndromes characterized by disruptions of aspects of consciousness, identity, memory, motor behavior, or environmental awareness. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) includes 4 dissociative disorders and one category for atypical dissociative disorders. These include dissociative amnesia (DA), dissociative identity disorder (DID), dissociative fugue, depersonalization disorder, and dissociative disorder not otherwise specified (DDNOS).
Read more…

Neuroleptic Malignant Syndrome

Introduction
Background

Neuroleptic malignant syndrome (NMS) refers to the combination of hyperthermia, rigidity, and autonomic dysregulation that can occur as a serious complication of the use of antipsychotic drugs. Delay first used the term in 1960, after observing patients treated with high-potency antipsychotics.

Even the newer atypical antipsychotics, which are not classified accurately as neuroleptics, can cause NMS. Over the past 30 years, the syndrome has been associated with a variety of drugs that lead to decreased dopamine receptor activation. Read more…

Brief Psychotic Disorder

Introduction
Background

In 1913, Karl Jaspers described specific criteria for the diagnosis of reactive psychosis, including the presence of an identifiable and extremely traumatic stressor, a close relation between the stressor and the development of psychosis, and a generally benign course for the psychotic episode.

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) describes brief psychotic disorder based primarily on duration of symptoms. DSM-IV defines brief psychotic disorder as an illness lasting from 1 day to 1 month, with an eventual return to the premorbid level of functioning. Read more…

Adjustment Disorders

Background

Adjustment disorder (AD) is a stress-related, short-term, nonpsychotic disturbance. Persons with AD are often viewed as disproportionately overwhelmed or overly intense in their responses to given stimuli. These responses manifest as emotional or behavioral reactions to an identifiable stressful event or change in the person’s life; for instance, in the pediatric population, these events could be parental separation or divorce, a new birth in the family, or loss of an attachment figure or object (eg, pets). The disorder is time-limited, usually beginning within 3 months of the stressful event, and symptoms lessen within 6 months upon removal of the stressor or when new adaptation occurs. Read more…

Tourette Syndrome

Introduction
Background

Tourette syndrome (TS) is a childhood neuropsychiatric disorder characterized by motor and phonic (vocal) tics. It is often associated with behavior disorders, particularly obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD). These behavior disorders often accompany the tics and may dominate the clinical picture in some patients. TS is a genetic condition that runs in families. However, the precise genetic abnormality responsible for the phenotype has not yet been elucidated. Read more…

Autistic Spectrum Disorders

Introduction
Background

The autistic spectrum disorders are a neurobiologically diverse group of conditions whose precise relationship to each other is unclear, yet they present with a consistent, diffuse pattern of abnormality across several areas of behavior. Individuals with these disorders do not present merely with slow or limited development, but rather with development that is atypical in the pervasive but diffuse areas of functions affected.

Three main clusters of behaviors define autism, as follows: (1) social abnormalities, especially a lack of social reciprocity; (2) language abnormalities, with deviant communication features and limited development of language; and (3) rigid, stereotyped, repetitive patterns of unusual behavior.

Case reports consistent with autism exist from the 1890s, but Kanner first defined the syndrome in 1943, as did Asperger a year later.
Read more…

Attention Deficit Hyperactivity Disorder

Introduction
Background

Attention deficit hyperactivity disorder (ADHD) is a developmental condition of inattention and distractibility, with or without accompanying hyperactivity. In the past, various terms were used to describe this condition, including hyperactive syndrome and, from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III), “minimal brain dysfunction.” In the revised DSM-III, this condition was renamed ADHD. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR), adults or children must have had an onset of symptoms before age 7 years that caused significant social or academic impairment. More recently, attention has focused on adult forms of ADHD, which probably have been underdiagnosed.
Pathophysiology Read more…

Sexual and Gender Identity Disorders

Introduction

History

The study of sexual deviancy began just before the turn of the 20th century as the taboo of discussing sexuality was beginning to lift. Early pioneers included Richard von Kraff-Ebing, Albert Moll, August Forel, Iwan Bloch, Magnus Hirschfield, Havelock Ellis, and Sigmund Freud. Their work was not well accepted, and they were regarded with disdain.
Read more…

Schizophreniform Disorder

Definition and Diagnostic Features

Definition

Schizophreniform disorder is characterized by the presence of the criterion A symptoms of schizophrenia, including delusions, hallucinations, disorganized speech, disorganized or catatonic behavior, and negative symptoms. The disorder, including its prodromal, active, and residual phases, lasts longer than 1 month but less than 6 months.

Diagnostic features Read more…