Psychotic D/O:

 Psychotic disorder due to another medical condition

 Substance/medication-induced psychotic disorder
 Delirium/Dementia
 Bipolar disorder, manic/mixed episode
 Major depression with psychotic features
 Schizophrenia (>6)
 Schizophreniform (1-6)
 Schizoaffective
 Brief Psychotic disorder (<1)
 Delusional Disorder
 Paranoid personality disorder
 Schizotypal personality disorder
 Schizoid personality disorder

Mood D/O:

 Mood disorder due to another medical condition

 Substance/medication-induced depressive disorder
 Substance/medication-induced bipolar disorder
 Major depressive disorder
 Normal Bereavement
 Bipolar 1 disorder (manic)
 Bipolar 2 disorder (MDD + hypomanic)
 Dysthymia
 Cyclothymic disorder
 Premenstrual dysphoric disorder
 Antisocial personality disorder
 Borderline personality disorder
 Histrionic personality disorder
 Narcissistic personality disorder
 Hypothyroidism

Anxiety/OCD/Trauma/Stressor-related D/O:

 Panic Disorder
 Agoraphobia
 Social Phobia (Social Anxiety disorder)
 Specific Phobia
 Generalized anxiety disorder
  Obsessive-compulsive disorder
 Body dysmorphic disorder
 Hoarding disorder
 Trichotillomania
 Excoriation disorder

 Posttraumatic stress disorder (>1 after life-threatening stressor)

 Acute stress disorder (<1 + trauma recent)
 Adjustment disorder (<6 after non-life threatening stressor)
 Avoidant PD
 Dependent PD
 Obsessive-compulsive PD

Substance-related and Addictive D/O:

 Substance Use Disorder

Dissociate D/O:

 Dissociative Amnesia
 Depersonalization/Derealization disorder
 Dissociate identity disorder (Multiple Personality Disorder)

Somatic Symptom and Factitious Disorders

 Somatic Symptom Disorder

 Conversion disorder
 Illness Anxiety disorder
 Factitious disorder
 Malingering

Impulse Control D/O:

 Intermittent Explosive Disorder

 Kleptomania
 Pyromania

Eating D/O:

 Anorexia Nervosa
 Bulimia Nervosa
 Binge-eating disorder

Sleep-Wake D/O:
  Insomnia
 Hypersomnolence disorder
 Obstructive sleep apnea
 Central sleep apnea
 Narcolepsy
 Circadian Rhythm Sleep-Wake disorder
 Sleepwalking
 Sleep terrors
 Nightmare disorder
 REM sleep behavior disorder
 Restless leg syndrome

Neurocognitive D/O:

 Alzhiemer’s disease
 Vascular dementia
 Lewy body dementia
 Frontotemporal dementia
 Huntington’s disease
 Parkinson’s disease
 Normal pressure hydrocephalus
 Prion disease
 HIV infection

S – Sleep D – distractibility

I – Interests I – insomnia/irritability

G – guilt G – Grandiosity

E – energy F – Flight of Ideas

C – concentration A – Agitation

A – appetite S – Speedy thoughts/speech

P – psychomotor agitiation/retardation T - thoughtlessness

S – SI/HI (hopelessness, helplessness,

worthlessness)
CC: “…..”

HPI:

 Onset/Precipitating factors
 Mood
 Depression: SIG E CAPS
 Anxiety: panic attacks, obsessions-compulsions, PTSD
 Manic: elevated mood, DIG FAST
 Psychotic:
o AH/VH
o Paranoia

Past Psych Hx:

 Other Dx
 Prior hospitalizations
 Suicide attempts
 Outpatient treatments
 Med trials

PMH:

Past Neurologic History: neurologic deficits, seizures, etc.

Meds:

Allergies:

PSH:

FH (psych):

SH:

 Tobacco, Etoh, Drugs

 Occupation
 Live with
 History of abuse/psychological trauma
 Legal issues

PE:
Vitals:

MSE:

 Appearance
 Behavior/Psychomotor
 Cooperation
 Speech
 Thought process
 Though content
 Affect
 Mood
 Perceptual disturbances
 LOC/Orientation
 Insight/Judgment
 Cognition (concentration/memory)
 Knowledge base
 Endings (SI/HI)
 Reliability

Plan:

 CBC, CMP, LFTs, TSH/fT4, UA, urine toxicology, Glucose, Lipid panel
 Consider starting pharmacotherapy, psychotherapy (CBT), and group therapy

 State diagnosis and counsel pt on…

o Commonly used psychopharmacologic agents
o Side effects
o Indications
Appearance = appropriate dress, normal grooming and hygiene/disheveled/poor hygiene
Behavior = No unusual movements or psychomotor changes
Cooperation = cooperative/uncooperative
Speech = normal rate/tone/volume/without pressure
Though process = Linear and logical/disorganized/circumstantial/tangential
Though content = SI/HI, delusions, paranoia, phobias, obsessions/compulsions
Affect = congruent with normal range/blunted/flat/tearful/labile
Mood = “…” – euthymic, irritable, anxious, depressed, elevated
Perceptual disturbances: AH/VH
Level of Consciousness = AOx3

1. Who, When, Where?

Insight/judgement = good/fair/poor

 Understands need for help

 “What would you do if you found a stamped envelope lying on the sidewalk?”

Cognition = Good/poor concentration and memory

 Remember “Pen, Bed, Light”

 Spell “world” backwards
 Recall 3 objects
 “Where did you live when you were growing up?”

Knowledge base = current/past intact

 “Who is the president of the US?”

 “What is the state’s capital?”

Endings (Suicidality) = denies SI and HI/passive/contemplating/intent with plan

Reliability = good/poor