NAME

NAMEOFOF OBSESSIVE-
SPECIFIC BODY
SOCIAL
DYSMORPHIC
ANXIETY PANIC
HOARDING
DISORDER TRICHOTILLOMANIA
AGORAPHOBIA GENERALIZED
EXCORIATION
ANXIETY
DISORDER
DISORDER COMPULSIVE
PHOBIA
BEHAVIOR DISORDER
DISORDER DISORDER DISORDER

ICD CODE 300.29

300.3 300.23
300.7 300.3
300.1 312.39
300.22 300.02
698.4
F42 F40.10
F45.22 F41.0
F42 F63.2
F40.00 L98.1
F41.1
A. Marked fear or anxiety A. Marked fear or anxiety about A. Recurrent unexpected panic A. Marked fear or anxiety about A. Excessive anxiety and worry
about
A. Presence
a specific of obsessions,
object or one
A. Preoccupation
or more social situations
with one or in attacks.
A. Persistent
A panic difficulty
attack is an A.two
Recurrent
or morepulling
of the outfollowing
of one'sfive A.
(apprehensive
Recurrent skin expectation),
picking
situation
compulsions, or both: which
more perceived
the individual defects
is exposed
or flaws abrupt
discardingsurgeorofparting
intensewith fear or hair,situations:
resulting in hair loss. resulting
occurringinmore skin lesion
days than not for
CRITERIA Note:
1. Recurrent
In children, and the
persistent
fear or to
in possible
physical scrutiny
appearance by others
that are intense
possessions,
discomfort
regardless
that reaches
of B.1.Repeated
Using public
attempts
transportation
to decrease B.
at Repeated
least 6 months,
attempts aboutdecrease
a
CRITERIA anxiety may
thoughts, urges,
be expressed
or imagesby that B. notThe
observable
individual or fears
appear that slight
he atheir
peakactual
withinvalue minutes, and or2.stop
Being
hairinpulling.
open spaces stop
number skin of
picking
events or activities
crying,
are experienced,
tantrums, at freezing,
some time
or or
to she
others.
will act in a way or show during
B. Thiswhich
difficulty
timeisfour
due (orto a C.3.TheBeing
hair inpulling
enclosedcauses places
clinically C.
(such
The asskin
workpicking
or school
causes
clinging.the disturbance, as
during anxiety
B. At somesymptomspoint that
during willthe
be more)
perceivedof the need
following
to save the significant
4. Standing distress
in lineororimpairment
being in a in significant
performance). distress impairment in
B. The phobic
intrusive and unwanted,
object or cause negatively
course of the evaluated
disorder, the symptoms
items and occur:to distress social,
crowd. occupational. or other social
B. The andindividual
occupational finds or it other
situationanxiety
marked almostor always
distress. C.
individual
The social hassituations
performedalmost 1.associated
Palpitations,withpounding
discarding important
5. Being areas
outside of offunctioning.
the home important
difficult toareas
control of the
functioning
worry. C.
provokes
2. The individual
immediate attempts
fear orto always
repetitive
provoke
behaviors
fear or suchanxiety.
as heart,
them or accelerated heart D.alone.
The hair pulling or hair loss is not D. TheTheanxiety
skin picking
and worry is notare
anxiety.or suppress them or to
ignore D.
reassurance
The socialseeking
situationsor mental
are rate.
C. The2.difficulty
Sweating. discarding attributable
B. The individual
to another fearsmedical
or avoids attributable
associated with to thethree
physiological
(or more)
C. The phobic
neutralize themobjectwith some
or avoided
acts suchorasendured
comparing withhis intense
or her 3.possessions
Tremblingresults or shaking.
in the condition
these situations
such as because
a dermatological
of effects
of the following
of a substance six symptoms
cocaine
situation
other thought
is actively
or action
avoided or fear
appearance
or anxiety. with that of others in 4.accumulation Sensations of shortness
possessions of condition
thoughts that escape might be another
with at least
medical some condition
symptoms such
endured
1. Repetitive
with intense
behaviors fear
oror E.
response
The fear to or
theanxiety
appearanceis out of breath
that congest
or smothering
and clutter E.difficult
The hair orpulling
help might
is notnot better
be as
having
scabiesbeen present for more
anxiety.acts that the individual proportion
mental concerns to the actual threat 5.active
Feelings
livingofareas
choking.
and explained
available by in the event
symptoms of of E.
days
Thethan
skin not
pickingfor the
is not
past better
6
D. The
feels driven
fearto orperform
anxiety isinout posed
C. Thebypreoccupation
the social situation causesand 6.substantially
Chest paincompromises
or discomfort another
developing
mental panic-like
disorder symptoms
such as or explained
months by symptoms of
NAME OF MAJOR
of proportion
response DEPRESSIVE
to antoobsession
the actualorDISORDER to
clinically significantMANIC
the sociocultural context.
distress or EPISODE7.their
Nausea
intended POSTPARTUM
or abdominal
use. If living BLUES
attempts
other incapacitatingPREMENSTRUAL
to improve aorperceived another
Note:  DYSTHYMIC
mental
Only one itemDISORDER
disorder issuch as
DISORDER
danger posed
according to rules
by thethatspecific
must be F. impairment
The fear, in anxiety,
social,or distress.
areas are uncluttered, it is defect
embarrassing DYSPHORIC
or flaw insymptoms
appearance in psychotic
required in disorder,
children. stereotypic
object orrigidly.
applied situation and to the avoidance
occupational, is persistent,
or other important
typically 8.onlyFeeling
because dizzy,
of the
unsteady, body
C. Thedysmorphic
agoraphobic DISORDER
disordersituations movement
1. Restlessness disorder,or feeling
and keyed
sociocultural
2. The behaviors context.
or mental lasting
areas of forfunctioning.
6 months or more. light-headed,
interventionsoroffaint. third parties almost always provoke fear or nonsuicidal
up or on edge. self-injury
ICD CODE E. The
acts arefear,
aimed anxiety,
at preventing
or or G. D. The
The fear,
appearance
anxiety, or 9.D. Chills
The hoarding
or heat sensations.
causes anxiety. 625.4 2. Being easily fatigued. 300.4
avoidanceanxiety
reducing is persistent,
or distress, or avoidance
preoccupation causes is not
clinically
better 10.
clinically
Paresthesias
significant distress D. The agoraphobic situations N94.3 are 3. Difficulty concentratingF34.1 or
typically
preventing lasting
some for
dreaded
6 months
A. Five or more of the following symptoms have significant
explained by
distress
concernsor with
A. A distinct period ofbody 11.
or impairment in social,
A. Sometimes occurs in new actively avoided, require the mind going
A. In most menstrual cycles This disorder represents a blank.
or more.
event
been present orduring
situation the same 2-week period impairment
fat orand
weightinin social,
an individual
abnormally Derealization/depersonalization
occupational,
and persistently or other
mothers and occasionallypresence of a companion,
during the past year,or areat 4. consolidation
Irritability. of DSM-IV-defined
F. The
B.
represent The fear,
obsessions
a change anxiety,
from or or
previous occupational,
whose at
functioning; symptoms or other
meetimportant
elevated, expansive, or12. important
Fear ofareas
irritable losing
fathers ofcontrol
and it isorknownendured
to with
leastintense
5 of the fearfollowing
or 5. chronic
Muscle tension.
major depressive
CRITERIA avoidance
compulsions causes
are time-
least one of the symptoms is either clinically areas
diagnostic
of functioning.
criteria for an eating
mood and abnormally and going
functioning
crazy have adverse effects on child anxiety. symptoms from sections B disorder 6. Sleep disturbance
and dysthymic disorder.
significant
consuming
(1) depressed mood distress
1hr/dayoror cause H.
disorder.
The fear, anxiety,
persistentlyor increased 13. E. The
goal- Fearhoarding
of dying. is not
outcomes E. The fear andor Canxiety
were ispresent
out of in the D. A. TheDepressed
anxiety, worry, moodorfor most of
(2) lossclinically
impairment
of interestsignificant
in
orsocial, distress or
pleasure. avoidance is not attributable
directed activitytoor energy,
B.attributable
At least one to brain
of the injury,
attacks
B. Symptoms include proportion to
final the
week actual
beforedanger
menses, physical
the symptoms
day, for more cause
days than not,
Note: impairment
occupational,
Do not include inorsocial,
other
symptoms that arethe physiological
clearly effects
lasting of a 1 week has
at least cerebrovascular
and been followed disease,
changeableby 1 month and crying
mood, and to theimproved
sociocultural withincontext
a few days clinically significant
as indicated distress
by either or
subjective
important
occupational, areas or of
other
attributable to another medical condition. substance or another medical (or
Prader—Willi
more) of
present most of the day, nearly easily, sadness, andonesyndrome
or both of the F. The fear, anxiety, or
of menses onset, and avoidance impairment in social,
account or observation by others,
functioning.
important
1. Depressed areasmost
mood of functioning. condition.
of the day, nearly every every day or any duration following:
F. The
if hoarding is not better
irritability, is persistent,
often liberally typically
became lastinginforthe
minimal 6 occupational,
for at leastor other important
2 years. Note: In
day, asC.
G.indicated
The obsessive-compulsive
disturbance
by either issubjective
not I. The
report or fear, anxiety, or
hospitalization 1.explained
is necessary Persistent byintermixed
concern
the symptoms orwith
worry
happy months or more.
week after menses. areas of functioning.
children and adolescents, mood
better made
symptoms
observation explained
arebynot byattributable
othersthe avoidance is not B. better
Duringexplained
the period of about
ofmood
other
additional
mental panic
disorders
feelings, attacks
that G. causesB.
occur in women clinically
At leastsignificant
1 of the E. can
The bedisturbance
irritable and is not
duration
Note: to
symptoms
In the physiological
children of
andanother effects
mental
adolescents, ofcan
a bebyirritable
the symptoms of another
disturbance orsuch
and increased theirasconsequences
OCD, MDD,10schizo
within 2. A
days distress orfollowing
impairment in social,such attributable
symptoms must be at toleast
the physiological
1 year.
mood disorder,
substance including
(or another medical mental disorder including BDD,
energy or activity, three (or significant
and another maladaptive
psychotic change
C. Sometimes accompanied occupational, or other important
as affective lability such as effects
B. Presence, whileordepressed,
of a substance another of
agoraphobia,
condition
2. Markedly diminishedOCD, interest
PTSD, SAD, PD, ASD
or pleasure in all, more) of the followingindisorder, behaviormajor related to the
by psychotic features but areas of functioning.
mood swings; irritability medical
two condition
(or more) such
of the as
following:
SAD
D.
or almost GAD, BDD, HOARDING
all, activities most of theD, day, nearly
J. If another medicalsymptoms condition attacks
neurocognitive
(four if the mood is disorder,
greater ASD of H. inflammatory
likelihood bowel disease,
anger; depressed mood, hyperthyroidism
1.Poor appetite or overeating
TRICHOTILLOMANIA,
every day parkinson’s disease, obesity, C.
only irritable) are present to a The disturbance is not
developing major depression parkinson’s hopelessness, or self-the
disease is present, F. PD, SAD, OCD,
2.Insomnia or SAD, PTSD,
hypersomnia
EXCORIATION, SMD, EATING
3. Significant weight loss when not dieting or D, disfigurement from burns or
significant degree and attributable to the physiological
after the postpartum blues fear, anxiety, or avoidance
deprecating thoughts; is BDD, SSD, Illness anxiety
3.Low energy or fatigue
weightIAD,gainPARAPHILIC
or decreaseD,orMDD, ASD,in appetite
increase injury is present, the fear,
represent a noticeableeffects
changeof a substance
especially if they are severe clearly excessive
anxiety, tension or being disorder, 4. Lowanorexia,
self-esteem. schizo or
nearlySSOPD,
every day.SRAD, DISRUPTIVE, anxiety, or avoidancefrom usual is clearly
behavior: hyperthyroidism, I. SP, SAD, keyed
SAD, OCD,up PTSD, BDD delusional
5. Poor disorder
concentration or difficulty
Note: IMPULSE
In children, CONTROL,
considerCONDUCT
failure to make unrelated or is1.excessiveInflated self-esteemcardiopulmonary
or disorders C. At least 1 of the making decisions
D
expected weight gain grandiosity. D. SP, SAD, SAD, OCD, PTSD following symptoms such 6. Feelings of hopelessness.
4. Insomnia or hypersomnia nearly every day 2. Decreased need for sleep; as diminished interest in C. During the 2-year period (1
CHILDHOODagitation or retardationEARLY/MIDDLE
CHILDHOOD/EARLY
5. Psychomotor ADOLESENCE
nearly ADOLESENCE
feels rested after only 3 ADOLESENCE/
CHILDHOOD
hours LATE TEENAGE CHILDHOODusual OR LATER
activities, difficulty OLDER yearADULTS
for children or adolescents)
ONSET - animal phobia, blood-
ADOLESENCE - when people start to become YEARS
every day (observable by others; not merely of sleep concentrating, lack of of the disturbance, the individual
subjective feelings of restlessness or being slowed 3. More talkative than usual or energy; changes in has never been without the
down. pressure to keep talking. appetite, overeating, or symptoms in Criteria A and B for
6. Fatigue or loss of energy nearly every day 4. Flight of ideas or subjective food craving; sleeping too more than 2 months at a time.
7. Feelings of worthlessness or excessive or experience that thoughts are much or too little; D. Criteria for a major
inappropriate guilt (which may be delusional) racing. subjective sense of being depressive disorder may be
nearly every day 5. Distractibility such as overwhelmed or out of continuously present for 2 years.
8. Diminished ability to think or concentrate, or attention too easily drawn to control; physical symptoms E. There has never been a manic
indecisiveness, nearly every day unimportant or irrelevant such as breast tenderness episode or a hypomanic episode,
9. Recurrent thoughts of death (not just fear of external stimuli, as reported or or swelling, joint/muscle and criteria have never been met
dying), recurrent suicidal ideation without a observed. pain, bloating, or weight for cyclothymic disorder
specific plan, or a suicide attempt or a specific plan 6. Increase in goal-directed gain F. The disturbance is not better
for committing suicide activity either socially, at work • Symptoms lead to explained by a persistent
B. The symptoms cause clinically significant or school, or sexually or significant distress or schizoaffective disorder,
distress or impairment in social, occupational, or psychomotor agitation functional impairment schizophrenia, delusional
other important areas of functioning. purposeless non-goal-directed • Symptoms are not an disorder, or other specified or
C. The episode is not attributable to the activity exacerbation of another unspecified schizophrenia
physiological effects of a substance or another 7. Excessive involvement in mood or anxiety disorder or spectrum and other psychotic
medical condition. activities that have a high personality disorder disorder.
Note: Criteria A–C constitute a major depressive potential for painful • Symptoms are G. The symptoms are not
episode. Major depressive episodes are common consequences such as engaging confirmed with prospective attributable to the physiological
in bipolar I disorder but are not required for the in unrestrained buying sprees, daily ratings over two effects of a substance (e.g., a
diagnosis of bipolar I disorder. sexual indiscretions, or foolish cycles drug of abuse, a medication) or
Note: Responses to a significant loss may include business investment. • Symptoms are present another medical condition such
the feelings of intense sadness, rumination about C. The mood disturbance is when oral contraceptives as hypothyroidism
the loss, insomnia, poor appetite, and weight loss sufficiently severe to cause are not being taken H. The symptoms cause clinically
noted in Criterion A, which may resemble a marked impairment in social or significant distress or impairment
depressive episode. Although such symptoms may occupational functioning or to in social, occupational, or other
be understandable or considered appropriate to necessitate hospitalization to important areas of functioning.
the loss, the presence of a major depressive prevent harm to self or others, Note: Because the criteria for a
episode in addition to the normal response to a or there are psychotic features. major depressive episode include
significant loss should also be carefully considered. D. The episode is not four symptoms that are absent
This decision inevitably requires the exercise of attributable to the physiological from the symptom list for
clinical judgment based on the individual’s history effects of a or to another persistent depressive disorder
and the cultural norms for the expression of medical condition. Note: A full (dysthymia), a very limited
distress in the context of loss. manic episode that emerges number of individuals will have
D. The occurrence of the major depressive during antidepressant depressive symptoms that have
episode is not better explained by schizoaffective treatment such as medication, persisted longer than 2 years but
disorder, schizophrenia, schizophreniform electroconvulsive therapy but will not meet criteria for
disorder, delusional disorder, or other specified persists at a fully syndromal persistent depressive disorder. If
and unspecified schizophrenia spectrum and other level beyond the physiological full criteria for a major depressive
psychotic disorders. effect of that treatment is episode have been met at some
E. There has never been a manic episode or a sufficient evidence for a manic point during the current episode
hypomanic episode. episode and, therefore, bipolar of illness, they should be given a
Note: This exclusion does not apply if all of the 1 disorder diagnosis of major depressive
manic-like or hypomanic-like episodes are Note: Criteria A–D constitute a disorder. Otherwise, a diagnosis
substance-induced or are attributable to the manic episode. At least one of other specified depressive
physiological effects of another medical condition. lifetime manic episode is disorder or unspecified
required for the diagnosis of depressive disorder is warranted
bipolar I disorder

MID 20S
WITHIN 10 DAYS TEENAGE YEARS
 ONSET LATE ADOLESENCE – MIDDLE ADULTHOOD - of the birth of the mother of - before age of 21
- long-term effects in adolescence can last at least their child
through young adulthood

EARLY CHILDHOO – OLD AGE

- reactions may begin

GENDER MALE > FEMALE FEMALE > MALE FEMALE FEMALE > MALE
DIFF

1. BIOLOGICAL CAUSAL FACTORS 1. HORMONAL 1. HORMONES

- family and twin studies, serotonin-transporter READJUSTMENTS - hormone changes can
CAUSAL gene, ss, - dramatic drop in estrogen cause a serotonin
FACTORS 2. NEUROCHEMICAL FACTORS  and progesterone after you deficiency
DEPRESSION give birth may play a role
- monoamine theory of depression - other hormones produced
(norepinephrine and serotonin), dopamine by thyroid gland
dysfunction 2.ALTERATIONS IN
3. ABNORMALITIES OF HORMONAL SEROTONERGIC &
REGULATORY AND IMMUNE SYSTEMS NORADRENERGIC
- hypothalamic-pituitary-adrenal/HPA axis FUNCTIONING
(failure of feedback loop) - low serotonin or
- elevated cortisol activity, dexamethasone, norepinephrine levels in the
hypothalamic-pituitary-thyroid axis (low thyroid brain that are aggravated by
hormones), proinflammatory cytokines nutritional deficiencies
4. NEUROPHYSIOLOGICAL AND 3. PSYCHOLOGICAL
NEUROANATOMICAL INFLUENCES  COMPONENT
- anterior prefrontal cortex (lower activity on the - lack of social support or has
left side of the prefrontal cortex), orbital difficulty in adjusting to her
prefrontal cortex, dorsolateral prefrontal cortex, new identity & responsibility
hippocampus, anterior cingulate cortex, amygdala - if the woman has a personal
5. SLEEP AND OTHER BIOLOGICAL RHYTHMS or family history of
- non-rem sleep and rem sleep, circadian rhythms depression that leads to
6. STRESSFUL LIFE EVENTS AS CAUSAL FACTORS heightened sensitivity to the
- independent and dependent life events stress of childbirth; PMDD
7. VULNERABILITY AND RESPONSES TO 4. SELF-IMAGE & ANXIETY
STRESSORS 
- sensitivity, genotype–environment interaction
8. PERSONALITY AND COGNITIVE DIATHESES
- neuroticism, low positive affectivity
A. ELECTROCONVULSIVE THERAPY/ECT A. VALIDATION A. Daily Record of Severity A. ELECTROCONVULSIVE
- very effective when client is drug resistant and B. EDUCATION of Problems /DRSP THERAPY/ECT
TREATMENTS suicidal C. REASSURANCE - prospective daily B. TRANSCRANIAL MAGNETIC
B. TRANSCRANIAL MAGNETIC D. PSYCHOSOCIAL SUPPORT monitoring of symptoms STIMULATION/TMS
STIMULATION/TMS E. INTERPERSONAL for two consecutive C. COGNITIVE BEHAVIORAL
C. COGNITIVE BEHAVIORAL THERAPY PSYCHOTHERAPY menstrual cycles is a clinical THERAPY
D. ENSURE SAFETY - discuss interpersonal requirement to meet D. BEHAVIORAL ACTIVATION
E. BEHAVIORAL ACTIVATION TREATMENT problems, exploring negative criteria TREATMENT
F. INTERPERSONAL THERAPY  feelings and encouraging B. COGNITIVE THERAPY E. INTERPERSONAL THERAPY
their expression, improving - may help women get a
communication, problem handle on how hormonal
solving, suggesting new changes throughout the
modes of behavior menstrual cycle affect their
 thinking and mood
A. ANTIDEPRESSANT MEDICATIONS A. BREXANOLONE A. ANTIDEPRESSANT A. ANTIDEPRESSANT
- SSRIs, MOIs, TCA - zulresso MEDICATIONS MEDICATIONS
MEDICATION - should not take on mothers - particularly SSRIs - particularly tricyclics
S that are giving breastfeed B. ORAL CONTRACEPTIVE
- an antidepressant - combination of ethinyl
estradiol & drospirenone
- can help since it is
associated with estrogen
and progesterone
> DEPRESSIVE DISORDER > DEPRESSIVE DIAGNOSIS > PSYCHOTIC FEATURES
> ANXIETY DISORDERS > SUICIDAL IDEATION/ > MDD
COMORBIDIT
Y

NAME OF CYCLOTHYMIC DISORDER HYPOMANIC EPISODE BIPOLAR I DISORDER BIPOLAR II DISORDER RAPID CYCLING
DISORDER

ICD CODE 301.13 / F34.0 296.7 / F31.9 296.89 / F31.81

A. For at least 2 years (at least 1 year in children and A. Milder forms of manic A. The most important A. People with bipolar II A. People with bipolar
adolescents) there have been numerous periods with episode; similar kinds of aspect of bipolar I disorder experience periods disorder experience atleast 4
hypomanic symptoms that do not meet criteria for a symptoms of manic can lead disorder is the presence of hypomania but their episodes a year with either
CRITERIA hypomanic episode and numerous periods with to diagnosis for atleast 4 days of mania. symptoms are below the manic or depressive
depressive symptoms that do not meet criteria for a B. similar with manic B. People with bipolar I threshold for full-blown mania. B. People tend to experience
major depressive episode. episode/mania, a person disorder experience B. The person diagnosed more manic and hypomanic
B. During the above 2-year period (1 year in children should experience 3 or more episodes of mania and with bipolar II disorder also episodes than depression
and adolescents), the hypomanic and depressive symptoms but in lesser periods of depression. Even experiences periods of D. Make more suicide
periods have been present for at least half the time degree in MIDF if the periods of depression depressed mood that meet the attempts
and the individual has not been without the C. less impairment in social do not reach the threshold criteria for major depression C. A temporary phenomenon
symptoms for more than 2 months at a time. and occupational for a major depressive and disappears within 2 years
C. Criteria for a major depressive, manic, or episode, the diagnosis of
hypomanic episode have never been met. bipolar I disorder is still
D. The symptoms in Criterion A are not better given.
explained by schizoaffective disorder, schizophrenia,
schizophreniform disorder, delusional disorder, or
other specified or unspecified schizophrenia spectrum
and other psychotic disorder.
E. The symptoms are not attributable to the
physiological effects of a substance (e.g., a drug of
abuse, a medication) or another medical condition
(e.g., hyperthyroidism).
F. The symptoms cause clinically significant distress
or impairment in social, occupational, or other
important areas of functioning
 ADOLESCENCE/YOUNG ADOLESCENCE/YOUNG EARLIER AVERAGE ONSET
ONSET ADULTHOOD ADULTHOOD

AVERAGE AGE: 18-22 Y/O AVERAGE AGE: 5 YEARS LATER

THAN BIPOLAR I

GENDER FEMALE = MALE FEMALE = MALE FEMALE > MALE

DIFF (depressive ep. are more (depressive ep. are more
common in women) common in women)
1. BIOLOGICAL CAUSAL FACTORS
- genetics such as polygenic trait (more than 1
CAUSAL
gene), monozygotic
FACTORS
2. NEUROCHEMICAL FACTORS
- INCREASED DOPAMINERGIC ACTIVITY
3. ABNORMALITIES OF HORMONAL REGULATORY
SYSTEMS
- HPA axis, high cortisol, HPT axis
4. NEUROPHYSIOLOGIC AND NEUROANATOMIC
INFLUENCES
- blood flow to the left prefrontal cortex is reduced
during depression, deficits in activity in the prefrontal
cortex
5. SLEEP AND OTHER BIOLOGICAL RHYTHMS
- manic = sleep very little
depression = hypersomnia
6. STRESSFUL LIFE EVENTS
7. OTHER PSYCHOLOGICAL FACTORS IN BIPOLAR
DISORDER
- low social support, neuroticism and cognitive
variables
A. ELECTROCONVULSIVE THERAPY/ECT A. COGNITIVE BEHAVIORAL A. COGNITIVE BEHAVIORAL
- treatment of manic episodes, about 6 to 12 THERAPY THERAPY
TREATMENTS treatments about every day, better in 2 to 4 weeks, B. INTERPERSONAL AND B. INTERPERSONAL AND
effects: confusion/amnesia SOCIAL RHYTHM THERAPY SOCIAL RHYTHM THERAPY
B. TRANSCRANIAL MAGNETIC STIMULATION/TMS
- treatment usually occurs 5 days a week for 2 to 6
weeks/10-30 days
C. DEEP BRAIN STIMULATION
D. BRIGHT LIGHT THERAPY
E. COGNITIVE-BEHAVIORAL THERAPY
F. MINDFULNESS BASED COGNITIVE THERAPY
- change the way in which these people relate to their
thoughts, feelings, and bodily sensations
G. BEHAVIORAL ACTIVATION TREATMENT
H. INTERPERSONAL AND SOCIAL RHYTHM THERAPY
I. FAMILY AND MARITAL THERAPY

A. ANTIDEPRESSANT MEDICATIONS A. ANTIDEPRESSANT

- monoamine oxidase inhibitors, tricyclic particularly MEDICATIONS
MEDICATION imipramine, SSRIs
S - new atypical antidepressants: bupropion,
 venlafaxine
B. ANTIPSYCHOTIC MEDICATIONS
NAME OF SOMATIC SYMPTOM ILLNESS ANXIETY DISORDER CONVERSION DISORDER FACTITIOUS DISORDER
DISORDER C. MOOD STABILIZERS
- lithium DISORDER
D. ANTICONVULSANTS
ICD CODE - alone or combination
300.82with lithium
/ F45.1 300.7 / F45.21 300.11
> BORDERLINE PERSONALITY DISORDER
> DRUG A. AND
One ALCOHOL ABUSEsymptoms
or more somatic A. Preoccupation with having or acquiring a A. One or more symptoms of altered A. Falsification of physical or
COMORBIDIT that are distressing or result in serious illness. voluntary motor or sensory function. psychological signs or symptoms, or
Y significant disruption of daily life. B. Somatic symptoms are not present or, if B. Clinical findings provide evidence of induction of injury or disease, associated
CRITERIA B. Excessive thoughts, feelings, or present, are only mild in intensity. If another incompatibility between the symptom and with identified deception/deceiving
behaviors related to the somatic medical condition is present or there is a high risk recognized neurological or medical B. The individual presents himself or
symptoms or associated health for developing a medical condition (strong family conditions. herself to others as ill, impaired, or
concerns as manifested by at least history is present), the preoccupation is clearly C. The symptom or deficit is not better injured.
one of the following: excessive or disproportionate. explained by another medical or mental C. The deceptive behavior is evident
1. Disproportionate and persistent C. There is a high level of anxiety about health, disorder. even in the absence of obvious external
thoughts about the seriousness of and the individual is easily alarmed about D. The symptom or deficit causes clinically rewards.
one’s symptoms. personal health status. significant distress or impairment in social, D. The behavior is not better explained
2. Persistently high level of anxiety D. The individual performs excessive health- occupational, or other important areas of by another mental disorder, such as
about health or symptoms. 3. related behaviors (repeatedly checks his or her functioning or warrants medical delusional disorder or another psychotic
Excessive time and energy devoted to body for signs of illness) or exhibits maladaptive evaluation. disorder.
these symptoms or health concerns. avoidance (avoids doctor appointments and
C. Although any one somatic hospitals).
symptom may not be continuously E. Illness preoccupation has been present for at
present, the state of being least 6 months, but the specific illness that is
symptomatic is persistent typically feared may change over that period of time.
NAME OF moreDEREALIZATION/
than 6 months F. The illness-related preoccupation
DISSOCIATIVE IDENTITY is not better
DISORDER DEPERSONALIZATION DISORDER explained by another mental disorder, such as
DISORDER
somatic symptom disorder, panic disorder,
generalized anxiety disorder, body dysmorphic
ICD CODE 301.13 / F34.0 296.7 / F31.9 296.89 / F31.81
disorder, obsessive-compulsive disorder, or
delusional disorder, somatic type
A. The presence of persistent or A. Disruption of identity characterized by A. The most A. People with bipolar II A. People with bipolar
recurrent experiences
NONWHITE, ANDofLESS EDUCATED two or more distinct personality states, important aspect of
COMMON IN MILITARY LIFE disorder experience periods disorder experience atleast 4
depersonalization, derealization, or both: which may be described in some cultures as bipolar I disorder is of hypomania
- most common in soldier especially but their episodes a year with either
CRITERIA
ONSET 1. Depersonalization: Experiences of an experience of possession. The disruption the presence of
in highly stressful symptoms are below the
combat manic or depressive
unreality, detachment, or being an outside in identity involves marked discontinuity in mania. threshold for full-blown mania. B. People tend to experience
observer with respect to one’s thoughts, sense of self and sense of agency, B. People with B.
LOWER SOCIOECONOMIC CIRCLESThe person diagnosed more manic and hypomanic
feelings, sensations, body, or actions (e.g., accompanied by related alterations in affect, bipolar I disorder with bipolar II disorder also episodes than depression
perceptual alterations, distorted sense of behavior, consciousness, memory, experience episodes
EARLY ADOLESCENCE experiences
AND EARLY periods of D. Make more suicide
time, unreal or absent self, emotional perception, cognition, and/or sensory-motor of mania and
ADULTHOOD periods depressed mood that meet the attempts
and/or physical numbing). functioning. These signs and symptoms may of depression. Even if criteria for major depression C. A temporary phenomenon
GENDER 2. Derealization:
FEMALE > MALE
Experiences of unreality be observed by others or reported by the the periods of
FEMALE > MALE
and disappears within 2 years
DIFF or detachment with respect to individual. depression do not
surroundings (e.g., individuals or objects B. Recurrent gaps in the recall of everyday reach the threshold for
are experienced
NO CONCORDANCEas unreal,AMONG
dreamlike,
TWINS events, important personal information, and/ a major NOdepressive
CONCORDANCE AMONG TWINS
foggy,- do
lifeless, or visually
not appear to bedistorted).
heritable or traumatic events that are inconsistent episode,
- dothe
notdiagnosis
appear to be heritable
CAUSAL B. During the depersonalization or with ordinary forgetting. of bipolar I disorder is
FACTORS derealization experiences, reality testing C. The symptoms cause clinically significant still given.
remains intact. distress or impairment in social,
DSM-5 occupational, or other important areas of
C. The symptoms cause clinically functioning.
significant distress or impairment in social, DSM-5
 occupational, or other important areas of
functioning.
D. The disturbance is not attributable to
the physiological effects of a substance
(e.g., a drug of abuse, medication) or
another medical condition (e.g., seizures).
E. The disturbance is not better explained
by another mental disorder, such as
schizophrenia, panic disorder, major
depressive disorder, acute stress disorder,
posttraumatic stress disorder, or another
dissociative disorder.
D. The disturbance is not a normal part of a
broadly accepted cultural or religious
practice.
Note: In children, the symptoms are not
better explained by imaginary playmates or
other fantasy play.
E. The symptoms are not attributable to the
physiological effects of a substance (e.g.,
blackouts or chaotic behavior during alcohol
intoxication) or another medical condition
(e.g., complex partial seizures).

AVERAGE AGE OF ONSET OF 23 ADOLESCENCE/YOUNG ADOLESCENCE/YOUNG EARLIER AVERAGE ONSET

ONSET ADULTHOOD ADULTHOOD

AVERAGE AGE: 18-22 AVERAGE AGE: 5 YEARS LATER

Y/O THAN BIPOLAR I

GENDER FEMALE > MALE FEMALE = MALE FEMALE = MALE FEMALE > MALE
DIFF - females tend to have a larger number of (depressive ep. are (depressive ep. are more
alters than do males more common in common in women)
women)
1.

CAUSAL
FACTORS

A. PROFESSIONAL ASSISTANCE A. COGNITIVE A. COGNITIVE BEHAVIORAL

- dealing with the precipitating stressors BEHAVIORAL THERAPY THERAPY
TREATMENTS and in reducing anxiety may be helpful B. INTERPERSONAL B. INTERPERSONAL AND
- there are no clearly effective treatments AND SOCIAL RHYTHM SOCIAL RHYTHM THERAPY
either through medication or THERAPY
psychotherapy
A. ANTIDEPRESSANT
THERE ARE NO CLEARLY EFFECTIVE MEDICATIONS
MEDICATION MEDICATION
S
>> ANXIETY DISORDERS >> DEPRESSIVE DISORDERS
>> MOOD DISORDERS >> PTSD
COMORBIDIT >> AVOIDANT PERSONALITY DISORDERS - most common
Y >> BORDERLINE PERSONALITY DISORDERS >> SUBSTANCE USE DISORDERS
>> OBSESSIVE-COMPULSIVE PERSONALITY >> BORDERLINE PERSONALITY DISORDER
DISORDERS
NAME OF DEREALIZATION/
DISORDER DEPERSONALIZATION
DISORDER
ICD CODE 301.13 / F34.0
A. The presence of persistent
or recurrent experiences of
depersonalization,
CRITERIA derealization, or both:
1. Depersonalization:
Experiences of unreality,
detachment, or being an
outside observer with respect
to one’s thoughts, feelings,
sensations, body, or actions
(e.g., perceptual alterations,
distorted sense of time, unreal
or absent self, emotional
and/or physical numbing).
2. Derealization: Experiences
of unreality or detachment
with respect to surroundings
(e.g., individuals or objects are
experienced as unreal,
DISSOCIATIVE IDENTITY
DISORDER
A. Disruption of identity
characterized by two or more
distinct personality states, which
may be described in some
cultures as an experience of
possession. The disruption in
identity involves marked
discontinuity in sense of self and
sense of agency, accompanied by
related alterations in affect,
behavior, consciousness,
memory, perception, cognition,
and/or sensory-motor
functioning. These signs and
symptoms may be observed by
others or reported by the
individual.
B. Recurrent gaps in the recall of
everyday events, important
296.7 / F31.9
A. The most important
aspect of bipolar I
disorder is the presence
of mania.
B. People with bipolar I
disorder experience
episodes of mania and
periods of depression. Even if
the periods of depression do
not reach the threshold for a
major depressive episode,
the diagnosis of bipolar I
disorder is still given.
SEPARATION ANXIETY DISORDER 
A. Developmentally inappropriate and A. People with bipolar disorder
excessive fear or anxiety concerning separation experience atleast 4 episodes a
from those to whom the individual is attached, year with either manic or
as evidenced by at least three of the ff: depressive
1. Recurrent excessive distress when B. People tend to experience
anticipating or experiencing separation from more manic and hypomanic
home or from major attachment figures. episodes than depression
2. Persistent and excessive worry about losing D. Make more suicide attempts
major attachment figures or about possible C. A temporary phenomenon
harm to them, such as illness, injury, disasters, and disappears within 2 years
or death.
3. Persistent and excessive worry about
experiencing an untoward event (e.g., getting
lost, being kidnapped, having an accident,
becoming ill) that causes separation from a
major attachment figure.
4. Persistent reluctance or refusal to go out,
away from home, to school, to work, or
elsewhere because of fear of separation.
 dreamlike, foggy, lifeless, or
visually distorted).
B. During the
depersonalization or
derealization experiences,
reality testing remains intact.
DSM-5
C. The symptoms cause
clinically significant distress or
impairment in social,
occupational, or other
important areas of functioning.
D. The disturbance is not
attributable to the
physiological effects of a
substance (e.g., a drug of
abuse, medication) or another
medical condition (e.g.,
seizures).
E. The disturbance is not
better explained by another
mental disorder, such as
schizophrenia, panic disorder,
major depressive disorder,
acute stress disorder,
posttraumatic stress disorder,
or another dissociative
disorder.
AVERAGE AGE OF ONSET OF
ONSET 23
GENDER
DIFF
personal information, and/ or
traumatic events that are
inconsistent with ordinary
forgetting.
C. The symptoms cause clinically
significant distress or impairment
in social, occupational, or other
important areas of functioning.
DSM-5
D. The disturbance is not a
normal part of a broadly
accepted cultural or religious
practice.
Note: In children, the symptoms
are not better explained by
imaginary playmates or other
fantasy play.
E. The symptoms are not
attributable to the physiological
effects of a substance (e.g.,
blackouts or chaotic behavior
during alcohol intoxication) or
another medical condition (e.g.,
complex partial seizures).
FEMALE > MALE
- females tend to have a larger
number of alters than do males
5. Persistent and excessive fear of or
reluctance about being alone or without major
attachment figures at home or in other
settings.
6. Persistent reluctance or refusal to sleep
away from home or to go to sleep without
being near a major attachment figure.
DSM-5
7. Repeated nightmares involving the theme
of separation.
8. Repeated complaints of physical symptoms
(e.g., headaches, stomachaches, nausea,
vomiting) when separation from major
attachment figures occurs or is anticipated.
B. The fear, anxiety, or avoidance is
persistent, lasting at least 4 weeks in children
and adolescents and typically 6 months or
more in adults.
C. The disturbance causes clinically significant
distress or impairment in social, academic,
occupational, or other important areas of
functioning.
D. The disturbance is not better explained by
another mental disorder, such as refusing to
leave home because of excessive resistance to
change in autism spectrum disorder; delusions
or hallucinations concerning separation in
psychotic disorders; refusal to go outside
without a trusted companion in agoraphobia;
worries about ill health or other harm befalling
significant others in generalized anxiety
disorder; or concerns about having an illness in
illness anxiety disorder.
ADOLESCENCE/YOUNG EARLIER AVERAGE ONSET
ADULTHOOD
AVERAGE AGE: 18-22 Y/O
FEMALE = MALE FEMALE = MALE FEMALE > MALE
(depressive ep. are more (depressive ep. are more common in women)
common in women)
 1.

CAUSAL
FACTORS

A. PROFESSIONAL A. COGNITIVE BEHAVIORAL A. COGNITIVE BEHAVIORAL THERAPY

ASSISTANCE THERAPY B. INTERPERSONAL AND SOCIAL RHYTHM
TREATMENTS - dealing with the precipitating B. INTERPERSONAL AND THERAPY
stressors and in reducing SOCIAL RHYTHM THERAPY
anxiety may be helpful
- there are no clearly effective
treatments either through
medication or psychotherapy
A. ANTIDEPRESSANT
THERE ARE NO CLEARLY MEDICATIONS
MEDICATION EFFECTIVE MEDICATION
S
>> ANXIETY DISORDERS >> DEPRESSIVE DISORDERS
>> MOOD DISORDERS >> PTSD
COMORBIDIT >> AVOIDANT PERSONALITY - most common
Y DISORDERS >> SUBSTANCE USE DISORDERS
>> BORDERLINE PERSONALITY >> BORDERLINE PERSONALITY
DISORDERS DISORDER
>> OBSESSIVE-COMPULSIVE
PERSONALITY DISORDERS