Neuro Psychiatric Illnesses

(A) Schizophrenia and other psychotic disorders


Characterized by changes in affect (ambivalent, constricted, and inappropriate responsiveness, loss of empathy with others), behavior (withdrawn, aggressive, bizarre), and thinking (distortion of reality, somethings with delusions and hallucinations). Schizophrenia includes five types:
1. Disorganized (hebephrenic)type
2. Catatonic type
3. Paranoid type
4. Undifferentiated type
5. Residual type

Delusional (paranoid) disorder

Psychotic disorder in which there are presistent delusions, e.g., erotomanic, grandiose, jealous, persecutory, somatic, unspecified. Paranoia is a rare condition characterized by the gradual development of an elaborate delusional system with grandiose ideas; it has a chronic course; the rest of the personality remains intact.

Brief psychotic disorder

Psychotic disorder of less than 4 weeks duration brought on by an external stressor.

Schizophreniform disorder

Similar to Schizophrenia with delusions, hallucinations, and incoherence but that lasts less than 6 months.

Schizoaffective disorder

Characterized by a mixture of schizophrenic symptoms and pronounced elation (bipolar type) or depression (depressive type).

Shared psychotic disorder.

Same delusion occurs in two persons, one of whom is less intelligent or more dependent on the other (also known as shared paranoid disorder, folie a deux).

Psychotic disorder

Psychotic disorder due to a general medical condition. Hallucinations or delusions that result from medical illness, e.g., temporal lobe epilepsy, avitaminosis, meningitis.

Substance-induced psychotic disorder.

Symptoms of psychosis caused by psychoactive or other substances, e.g., hallucinogens, cocaine.

Psychotic disorder NOS.

(Also known as atypical psychosis.)
Psychotic features that are related to
1. a specfic culture(koro- found in South and East Asia, fear of Shrinking penis),
2. a certain time or event (postpartum psychosis-48 to 72hours after childbirth), or
3. a unique set of symptoms (Capgras's syndrome-patients think they have a double).

(B) Mood disorders

1. Bipolar disorders :- Marked by severe mood swings between depression and elation and by remission and recurrence.
Bipolar I - full manic or mixed episode, usually with major depressive episode.
BipolarII - major depressive episode and hypomanic episode (less intense than mania) without manic or mixed episode.
Cyclothymic disorder - less severe type of bipolar disorder.

2. Depressive disorders:- Major depressive disorder - severely depressed mood, mental and motor retardation, apprehension, uneasiness, perplexity, agitation, guilty feelings, suicidal ideation, usually recurrent. Dysthymic disorder - less severe form of depression usually caused by identifiable event or loss (also called depressive neurosis).
Postpartum depression occurs within 1 month after childbirth.
Seasonal pattern depression (also called seasonal affective disorder SAD) occurs most during winter months.

(C) Anxiety disorders

Characterized by massive and persistent anxiety (generalized anxiety disorder), often to the point of panic (panic disorder) and fears of going outside the home (agoraphobia); fear of specific situations or objects (specific phobia) or of performance and public speaking (social phobia); involuntary and persistent intrusions of thought, desires,urges, or actions (obsessive-compulsive disorder). Includes posttraumatic stress disorder (PTSD)- follows extraordinary life stress (war, catasrrophe) and characterized by anxiety, nightmares, agitation and sometimes depression; Acute stress disorder is similar to PTSD but lasts for 4 weeks or less. May also be due to

(1) a medical condition, e.g., hyperthyroidism, or
(2) a substance, e.g., cocaine.

(D) Somatoform disorders

Marked by preoccupation with the body and fears of disease. Classified into somatization disorder - multiple somatic complaints without organic pathology.
Conversion disorder (hysteria, Briquet's syndrome)
Hypochondriasis (Hypochondriacal neurosis)
Pain disorder
Body dysmorphic disorder

(E) Eating disorders

Characterized by marked disturbance in eating behavior. Includes anorexia nervosa (loss of body weight, refusal to eat) and bulimia nervosa (binge eating with or without vomiting).

(F) Impulse-control disorders (not elsewhere classified)

Covers disorders in which persons cannot control impulses and act out. Subtypes include intermitted explosive disorder (aggression), Kleptomania (stealing), pyromania (fire setting), trichotillomania (hair pulling), and pathological gamblin