NEET PG

OCD-Management & prognosis

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 OCD-Management & prognosis Management: Pharmacotherapy: First Line – SSRIs and Clomipramine [adverse side effect profile] If first line fails then antipsychotics [Haloperidol, quetiapine, risperidone, olanzapine] Other Drugs [Venlafaxine, Lithium, valproate and carbamazepine] Psychotherapy: Cognitive Behavior therapy [Exposure & Response prevention] Desensitization, thought stopping, flooding and aversive conditioning Other T/T modalities – ECT, Psychosurgery [Cingulotomy, …

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Panic Disorder-Management

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 Panic Disorder-Management Establishing a Differential Diagnosis: MI / Angina / Other Cardiac Conditions Asthma / Other Pulmonary conditions Hypothyroidism, Hypoglycemia, Carcinoid Syndrome, Pheochromocytoma. After ruling out all the above-mentioned conditions, the management of panic disorder involves: BDZ and SSRIs Psychotherapy – Cognitive Behavioral therapy Relaxation techniques

Schizophrenia-Epidemiology

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Schizophrenia-Epidemiology Prevalence of schizophrenia Incidence Rate 0.15-0.25 Per 1000 General population 1% Non twin sibling of schizophrenic patient 8% Dizygotic twin of schizophrenic patient 12% Monozygotic twin of schizophrenic patient 47% Child with 1 schizophrenic parent 12% Child with both parents’ schizophrenic 40% Usual Age of onset in Adolescence & Young Adulthood [If age > …

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Etiopathogenesis of schizophrenia-Genetic factors

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 Etiopathogenesis of schizophrenia-Genetic factors The etiopathogenesis of schizophrenia consists of following factors: Genetic Biochemical Neuropathological Genetic Factors: Nine Linkage sites identified – 1q, 5q, 6p, 8p, 10p, 13q, 15q, 22q α- 7 nicotinic receptor DISC 1 [Disrupted in Schizophrenia] COMT [Catechol-o-methyl transferase] NRG 1 [Neuregulin 1] GRM 3 [Glutamate receptor metabotropic] RGS 4 [Regulator …

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Schizophrenia-Disorganization symptoms

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 Schizophrenia-Disorganization symptoms The symptoms of schizophrenia are divided into: Positive Negative Disorganization Motor Disorganization symptoms: Formal Thought disorder – Loss of organization of thought Disorganized behavior – inappropriate behavior which breaks social norms Inappropriate affect – Affect which is not in sync with the social situation

Other antipsychotics

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 Other antipsychotics Long Acting Injectable [Depot] Antipsychotics used in patients with poor compliance Available for Fluphenthixol Fluphenazine Haloperidol Pipotiazine Risperidone Zuclopenthixol Olanzapine Paliperidone Aripiprazole Thioridazine can cause irreversible retinal pigmentation, QT Prolongation but Less EPM side effect Chlorpromazine with corneal and lenticular deposits Penfluridol is the longest acting antipsychotic Ziprasidone can cause QT Prolongation …

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Delusional disorder

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 Delusional disorder Delusional disorder: Development of a single or a set of related delusion which are persistent Hallucination, disorganization and negative symptoms are absent Persecutory Type, Jealous Type, Erotomania Type, Grandiose Type Somatic Type – Delusional parasitosis, Delusional dysmorphophobia, Delusion of Halitosis Capgras Syndrome – Familiar person has been replaced by an imposter Fregoli …

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