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Flashcards in Eating And Personality Disorders Deck (11)
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0
Q

Cluster B dramatic emotional or erratic

A

Antisocial PD
Narcissistic PD
Histrionic PD
Borderline PD

1
Q

Cluster A eccentric or odd

A

Paranoid personality d/o
Schizoid personality d/o
Schizotypal personality d/o

2
Q

Cluster C anxious or fearful

A

Avoidant PD
Dependent PD
Obsessive compulsive PD

3
Q

Diagnostic criteria for PD

A

Enduring pattern of experience and behavior in 2 or more areas where pt differs from cultural expectations

  • cognition (perceiving self and others)
  • affectivity (range, intensity, lability, appropriateness of emotional response)
  • interpersonal functioning
  • impulse control
  • belief that there is problem with outside world, not with self
4
Q

Schizotypal vs schizoid

A

Schizoid -

  • inability to form close interpersonal relationships
  • chooses solitary activities
  • indifferent to praise or criticism
  • cold detached and denies strong emotions

Schizotypal

- deficits in social and interpersonal functioning 
- no close relationships beyond family 
- marked paranoid social anxiety that doesn't decrease with familiarity
- distortion of cognition
 - odd speech restricted affect bizarre appearance and behaviors
5
Q

Borderline PD features

A

Instability of affect impulse control , interpersonal relationships, identity

  • fear of abandonment (intense)
  • intense and unstable relationships
  • impulsive w sex food drugs
  • chronic feeling of emptiness
  • stress induced paranoia or brief psychotic episodes
  • dissociations or disruption of usually integrated functions of consciousness memory identity or perception of environment
6
Q

Treatment of personality disorders

A

Psychotherapy first line in all cases

Cluster A (paranoid schizoid schizotypal)
- cognitive therapy , social skill building
Cluster B (antisocial narcissistic, histrionic, borderline)
- cognitive for narc and hist
- dialectic behavioral (DBT) - firstline for Borderline mindfulness and acceptance
Cluster C- avoidant dependent OCD
- CBT - focus on changing maladaptive thinking patterns

7
Q

Pharmacotherapy for personality disorders

A

Therapy is first line
- pharmacotherapy for symptoms (depression anxiety etc)
- A and C - no established pharm tx
- B - antisocial personality d/o
- lithium (1200mg/day - level 0.6-1.5 meq/L)
- phenytoin 300 mg/day
- divalproex 750mg/day
- CBZ 450 mg/day
- stimulants for inattentive impulsivity
-SSRI for hostility impulsivity aggression
sertraline 150-200mg;
fluoxetine 60-80mg

Cluster B - Borderline PD
- avoid BZD if possible, don’t use bupropion if eating d/I, TCA avoided with suicidality
IPT plus fluoxetine first line
Consider antipsychotics and mood stabilizers if ineffective
Others
Naltrexone , clonidine for hyperaeousla , fatty acids

8
Q

Medication for bulimia nervosa

A

Fluoxetine start at 10-20mg with goal of 60mg qday

9
Q

Binge eating pharmacotherapy

A

Topiramate sibutramine (removed from US market) and zonisamide effective in binge suppression and weight loss
SSRI - cital escital fluox sert decrease binge frequency
NOT lamotrigine

10
Q

Cluster b personality disorders

A
Only ones respknsive to pharmacotherapy 
Antisocial
Narcissistic 
Histrionic
Borderline