Why don't providers usually diagnose personality disorders in patients under the age of 18? -
answer✔Appreciating development and the necessary developmental phases and struggles in
"becoming self".
Cluster A - answer✔Odd or eccentric- Paranoid, Schizoid and Schizotypal
Cluster B - answer✔Dramatic and erratic- Histrionic, Narcissistic, Borderline, Antisocial
Cluster C - answer✔Fearful and Anxious- Obsessive Compulsive PD, Aviodant, Dependent
How would describe the general diagnostic differences between Schizoid and Schizotypal
Personality Disorder? - answer✔People with Schizoid PD prefer to work alone and do not desire
the company of others. Those with Schizotypal PD might talk about strange, magical or mystical
phenomenon and might appear suspicious of others. In Schizotypal PD, care must be taken to
not pathologize cultural norms (ie talking to the dead or communicating with natural spirits)
How would describe the key differences between Avoidant Personality disorder and Social
Phobia? - answer✔In Avoidant PD, the concern is about criticism and rejection from others. In
social phobia, concerns are more specific about doing something that the person thinks is
embarrassing out of the proportion than what others think (i.e. Someone will never eat at
parties because they are so worried about getting something stuck in their teeth).
How might cultural aspects impact of making or not making the diagnosis of Dependent
Personality Disorder? - answer✔The cultural roles in decision making and information sharing
could be misinterpreted as a Dependent Personality Disorder.
Describe 3 key aspects of interacting with a patient in an outpatient setting who demonstrates
manipulative behavior? - answer✔a. Establishing specific parameters about frequency of non-
appointment communication
b. Define and enforce professional boundaries
c. Clear and detailed communication in the EHR for covering/call staff
How are OCD and OCP the same? How are they different? - answer✔Other than the names,
OCD and OCP share obsessional thinking but themes are different:
OCPD- Rigid, unyielding, obsessed with perfection, process, demands others follow their strict
and rigid guidelines
OCD- Defined Obsessions and compulsions that are internalized, more significant anxiety, if
rigidity is present, it is more internalized than projected on others.
Review the different psychotic disorders, what are some key differential diagnoses? Why? -
answer✔Delusional Disorder, Brief Psychotic Disorder, Schizophreniform Disorder,
Schizoaffective Disorder, Substance/Medication Induced Psychotic Disorder, Psychotic Disorder
Possible differentials: Bipolar Disorder- The disorganization of thought in mania can resemble
psychosis, Major Depression, Substance Use Disorder- Possible detox, Obsessive-
Compulsive Disorder- Extreme obsessions can present like psychosis
What are some non-pharmacologic interventions for psychotic disorders? - answer✔Social skills
training, CBT, art therapy
What are important lab values to monitor for people taking SGAs? - answer✔Blood glucose,
triglycerides, lipid panel, CBC
Review the dopamine pathways and how they relate to symptoms. - answer✔Mesocortical
pathway- projects to dorsolateral prefrontal cortex- Negative symptoms, cognitive symptoms
Mesolimbic- Positive symptoms
Nigrostriatal- regulates movements (is thought to be "normal" in schizophrenia but during
treatment with dopamine medications, can result in DA excess can result in movements
Tuberoinfundibular Pathway- Projects from hypothalamus to anterior pituitary. Thought to be
normal in schizophrenia but when stimulated with treatment of DA medications and can cause
hyperprolactinemia.
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