to diagnose schizophrenia 2 or more of the followings should be present for at least 6

months:
The Phrase is HD N CD and it means "HD= High Definition ,N=& ,CD=Cd"
H: hallucinations
D: delusions
N: Negative symptoms (flat affect, social withdrawal, poverty of speech)
C: catatonic or grossly disorganized behavior
D: Disorganized speech

Mnemonics in a mnutshell: 32 aids to psychiatric

diagnosis
Clever, irreverent, or amusing, a mnemonic you remember is a
lifelong learning tool
Vol. 7, No. 10 / October 2008

Jason P. Caplan, MD
Assistant clinical professor of psychiatry, Creighton University School of
Medicine, Omaha, NE, Chief of psychiatry, St. Josephs Hospital and Medical
Center Phoenix, AZ
Theodore A. Stern, MD
Professor of psychiatry, Harvard Medical School Chief, psychiatric
consultation service, Massachusetts General Hospital, Boston, MA

This week's quiz:

Sleep regulation & function

More
From SIG: E CAPS to CAGE and WWHHHHIMPS, mnemonics help
practitioners and trainees recall important lists (such as criteria for
depression, screening questions for alcoholism, or life-threatening

causes of delirium, respectively). Mnemonics efficacy rests on the

principle that grouped information is easier to remember than
individual points of data.
Not everyone loves mnemonics, but recollecting diagnostic criteria is
useful in clinical practice and research, on board examinations, and
for insurance reimbursement. Thus, tools that assist in recalling
diagnostic criteria have a role in psychiatric practice and teaching.

In this article, we present 32 mnemonics to help clinicians diagnose:

affective disorders (Box 1)1 2
anxiety disorders (Box 2)3 6
medication adverse effects (Box 3)7 8
personality disorders (Box 4)9 11
addiction disorders (Box 5)12 13
causes of delirium (Box 6).14
,

We also discuss how mnemonics improve ones memory, based on

the principles of learning theory.
How mnemonics work
A mnemonicfrom the Greek word mnemonikos (of memory)
links new data with previously learned information. Mnemonics assist
in learning by reducing the amount of information (cognitive load)
that needs to be stored for long-term processing and retrieval. 15
Memory, defined as the persistence of learning in a state that can be
revealed at a later time,16 can be divided into 2 types:

declarative (a conscious recollection of facts, such as

remembering a relatives birthday)

procedural (skills-based learning, such as riding a bicycle).

Declarative memory has a conscious component and may be

mediated by the medial temporal lobe and cortical association
structures. Procedural memory has less of a conscious component; it
may involve the basal ganglia, cerebellum, and a variety of cortical
sensory-perceptive regions.17
BOX 1.
MNEMONICS FOR DIAGNOSING AFFECTIVE DISORDERS
Depression
SIG: E CAPS*
Suicidal thoughts
Interests decreased
Guilt
Energy decreased
Concentration decreased
Appetite disturbance
(increased or decreased)
Psychomotor changes
(agitation or retardation)
Sleep disturbance
(increased or decreased)
* Created by Carey Gross,
MD
Depression
C GASP DIE1
Concentration decreased
Guilt
Appetite
Sleep disturbance
Psychomotor agitation or
retardation
Death or suicide (thoughts
or acts of)
Interests decreased
Energy decreased

Dysthymia
HES 2 SAD2
Hopelessness
Energy loss or fatigue
Self-esteem is low
2 years minimum of depressed mood most
of the day, for more days than not
Sleep is increased or decreased
Appetite is increased or decreased
Decision-making or concentration is
impaired

Mania
DIG FAST
Distractibility
Indiscretion
Grandiosity
Flight of ideas
Activity increase
Sleep deficit
Talkativeness

Hypomania
TAD HIGH
Talkative
Attention deficit
Decreased need for sleep
High self-esteem/grandiosity
Ideas that race
Goal-directed activity increased
High-risk activity

Mania
DeTeR the HIGH*
Distractibility
Talkativeness
Reckless behavior
Hyposomnia
Ideas that race
Grandiosity
Hypersexuality
* Created by Carey
Gross, MD

Declarative memory can be subdivided into working memory and

long-term memory.
With working memory, new items of information are held briefly so
that encoding and eventual storage can take place.

Working memory guides decision-making and future planning and is

intricately related to attention.18 21Functional MRI and positron emission
tomography as well as neurocognitive testing have shown that
working memory tasks activate the prefrontal cortex and brain regions
specific to language and visuospatial memory.
The hippocampus is thought to rapidly absorb new information, and
this data is consolidated and permanently stored via the prefrontal
cortex.22 26 Given the hippocampus limited storage capacity, new
information (such as what you ate for breakfast 3 weeks ago) will
disappear if it is not repeated regularly.17
Long-term memory, on the other hand, is encoded knowledge that is
linked to facts learned in the past; it is consolidated in the brain and
can be readily retrieved. Neuroimaging studies have demonstrated
opposing patterns of activation in the hippocampus and prefrontal
cortex, depending on whether the memory being recalled is:

new (high hippocampal activity, low prefrontal cortex activity)

old (low hippocampal activity, high prefrontal cortex activity). 27

Mnemonics are thought to affect working memory by reducing the
introduced cognitive load and increasing the efficiency of memory
acquisition and encoding. They reduce cognitive load by grouping
objects into a single verbal or visual cue that can be introduced into
working memory. Learning is optimized when the load on working
memory is minimized, enabling long-term memory to be facilitated. 28
BOX 2.
MNEMONICS FOR DIAGNOSING ANXIETY DISORDERS
-

Generalized
anxiety
disorder
Worry
WARTS3
Wound up
Worn-out
Absentminded
Restless
Touchy
Sleepless

Generalized
anxiety
disorder
WATCHERS4
Worry
Anxiety
Tension in
muscles
Concentration
difficulty
Hyperarousal
(or irritability)
Energy loss
Restlessness
Sleep
disturbance

Posttraumatic
stress
disorder
TRAUMA5
Traumatic
event
Re-experience
Avoidance
Unable to
function
Month or
more of
symptoms
Arousal
increased

Anxiety disorder due to a general medical condition

Physical Diseases That Have CommonlyAppeared Anxious:
Pheochromocytoma
Diabetes mellitus
Temporal lobe epilepsy
Hyperthyroidism
Carcinoid
Alcohol withdrawal
Arrhythmias

Posttraumatic
stress
disorder
DREAMS6
Disinterest in
usual
activities
Re-experience
Event
preceding
symptoms
Avoidance
Month or
more of
symptoms
Sympathetic
arousal

BOX 3.
MNEMONICS FOR DIAGNOSING MEDICATION ADVERSE
EFFECTS

Antidepressant discontinuation
syndrome
FINISH7
Flu-like symptoms
Insomnia
Nausea
Imbalance
Sensory disturbances
Hyperarousal (anxiety/agitation)

Neuroleptic malignant
syndrome
FEVER8
Fever
Encephalopathy
Vital sign instability
Elevated WBC/CPK
Rigidity
WBC: white blood cell count
CPK: creatine phosphokinase

Serotonin
syndrome
HARMED
Hyperthermia
Autonomic
instability
Rigidity
Myoclonus
Encephalopathy
Diaphoresis

Mnemonics may use rhyme, music, or visual cues to enhance

memory. Most mnemonics used in medical practice and education are
word-based, including:

Acronymswords, each letter of which stands for a particular

piece of information to be recalled (such as RICE for treatment of a
sprained joint: rest, ice, compression, elevation).

Acrosticssentences with the first letter of each word

prompting the desired recollection (such as To Zanzibar by motor car
for the branches of the facial nerve: temporal, zygomatic, buccal,
mandibular, cervical).

Alphabetical sequences (such as ABCDE of trauma

assessment: airway, breathing, circulation, disability, exposure).29
An appropriate teaching tool?
Dozens of mnemonics addressing psychiatric diagnosis and treatment
have been published, but relatively few are widely used. Psychiatric
educators may resist teaching with mnemonics, believing they might
erode a humanistic approach to patients by reducing psychopathology
to a laundry list of symptoms and the art of psychiatric diagnosis to a
check-box endeavor. Mnemonics that use humor may be rejected as
irreverent or unprofessional.30 Publishing a novel mnemonic may be
viewed with disdain by some as an easy way of padding a curriculum
vitae.

BOX 4.
MNEMONICS FOR DIAGNOSING PERSONALITY DISORDERS
Schizotypal
personality
disorder
ME
PECULIAR9
Magical
thinking
Experiences
unusual
perceptions
Spousal
Paranoid
infidelity
ideation
suspected
Eccentric
Unforgivin behavior or
g (bears
appearance
grudges)
Constricted
Suspicious or
Perceives
inappropriate
attacks (and affect
reacts
Unusual
quickly)
thinking or
Enemy or speech
friend?
Lacks close
(suspects
friends
associates Ideas of
and
reference
friends)
Anxiety in
Confiding social
in others is situations
feared
Rule out
Threats
psychotic or
perceived
pervasive
in benign
development
events
al disorders

Impulsive
Moodiness
Paranoia or
dissociation
under stress
Unstable selfimage
Labile intense
relationships
Suicidal
gestures
Inappropriate
anger
Vulnerability
to
abandonment
Emptiness
(feelings of)

Histrionic
personality
disorder
PRAISE ME9
Provocative or
seductive
behavior
Relationships
considered
more intimate
than they are
Attention
(need to be the
center of)
Influenced
easily
Style of speech
(impressionisti
c, lacking
detail)
Emotions
(rapidly
shifting,
shallow)
Make up
(physical
appearance
used to draw
attention to
self)
Emotions
exaggerated

Dependent
personality
disorder
RELIANCE9
Reassurance
required
Expressing
disagreement
difficult
Life
responsibilitie
Narcissistic
s assumed by
personality
others
disorder
Initiating
GRANDIOSE1 projects
1
difficult
Grandiose
Alone (feels
Requires
helpless and
attention
uncomfortable
Arrogant
when alone)
Need to be
Nurturance
special
(goes to
Dreams of
excessive
success and
lengths to
power
obtain)
Interpersonally Companionshi
exploitative
p sought
Others (unable urgently when
to recognize
a relationship
feelings/needs ends
of)
Exaggerated
Sense of
fears of being
entitlement
left to care for
Envious
self

Borderline
personality
disorder
DESPAIRER
*
Disturbance of
identity
Emotionally

Histrionic
personality
disorder
ACTRESSS*
Appearance
focused
Center of
attention

Avoidant
personality
disorder
CRINGES9
Criticism or
rejection
preoccupies
thoughts in

Paranoid
personality
disorder
SUSPECT9

Schizoid
personality
disorder
DISTANT9

Antisocial
personality
disorder
CORRUPT9
Cannot
Detached
conform to
or flattened law
affect
Obligations

Borderline
personality
disorder
IMPULSIVE1
0

Obsessivecompulsive
personality
disorder
SCRIMPER*
Stubborn
Cannot

Schizotypal
personality
disorder
ME
PECULIAR9
Magical
thinking
Experiences
unusual
perceptions
Spousal
Paranoid
infidelity
ideation
suspected
Eccentric
Unforgivin behavior or
g (bears
appearance
grudges)
Constricted
Suspicious or
Perceives
inappropriate
attacks (and affect
reacts
Unusual
quickly)
thinking or
Enemy or speech
friend?
Lacks close
(suspects
friends
associates Ideas of
and
reference
friends)
Anxiety in
Confiding social
in others is situations
feared
Rule out
Threats
psychotic or
perceived
pervasive
in benign
development
events
al disorders

Impulsive
Moodiness
Paranoia or
dissociation
under stress
Unstable selfimage
Labile intense
relationships
Suicidal
gestures
Inappropriate
anger
Vulnerability
to
abandonment
Emptiness
(feelings of)

Histrionic
personality
disorder
PRAISE ME9
Provocative or
seductive
behavior
Relationships
considered
more intimate
than they are
Attention
(need to be the
center of)
Influenced
easily
Style of speech
(impressionisti
c, lacking
detail)
Emotions
(rapidly
shifting,
shallow)
Make up
(physical
appearance
used to draw
attention to
self)
Emotions
exaggerated

Dependent
personality
disorder
RELIANCE9
Reassurance
required
Expressing
disagreement
difficult
Life
responsibilitie
Narcissistic
s assumed by
personality
others
disorder
Initiating
GRANDIOSE1 projects
1
difficult
Grandiose
Alone (feels
Requires
helpless and
attention
uncomfortable
Arrogant
when alone)
Need to be
Nurturance
special
(goes to
Dreams of
excessive
success and
lengths to
power
obtain)
Interpersonally Companionshi
exploitative
p sought
Others (unable urgently when
to recognize
a relationship
feelings/needs ends
of)
Exaggerated
Sense of
fears of being
entitlement
left to care for
Envious
self

labile
Suicidal
behavior
Paranoia or
dissociation
Abandonment
(fear of)
Impulsive
Relationships
unstable
Emptiness

Theatrical
Relationships
(believed to be
more intimate
than they are)
Easily
influenced
Seductive
behavior
Shallow
emotions

social situations
Restraint in
relationships
due to fear of
shame
Inhibited in
new
relationships
Needs to be
sure of being
liked before

Paranoid
personality
disorder
SUSPECT9

Indifferent
to criticism
or praise
Sexual
experiences
of little
interest
Tasks done
solitarily
Absence of
close

ignored
Reckless
disregard for
safety
Remorseless
Underhanded
(deceitful)
Planning
insufficient
(impulsive)
Temper

Borderline
personality
disorder
IMPULSIVE1
0

discard
worthless
objects
Rule obsessed
Inflexible
Miserly
Perfectionistic
Excludes
leisure due to
devotion to

Schizotypal
personality
disorder
ME
PECULIAR9
Magical
thinking
Experiences
unusual
perceptions
Spousal
Paranoid
infidelity
ideation
suspected
Eccentric
Unforgivin behavior or
g (bears
appearance
grudges)
Constricted
Suspicious or
Perceives
inappropriate
attacks (and affect
reacts
Unusual
quickly)
thinking or
Enemy or speech
friend?
Lacks close
(suspects
friends
associates Ideas of
and
reference
friends)
Anxiety in
Confiding social
in others is situations
feared
Rule out
Threats
psychotic or
perceived
pervasive
in benign
development
events
al disorders

Impulsive
Moodiness
Paranoia or
dissociation
under stress
Unstable selfimage
Labile intense
relationships
Suicidal
gestures
Inappropriate
anger
Vulnerability
to
abandonment
Emptiness
(feelings of)

Histrionic
personality
disorder
PRAISE ME9
Provocative or
seductive
behavior
Relationships
considered
more intimate
than they are
Attention
(need to be the
center of)
Influenced
easily
Style of speech
(impressionisti
c, lacking
detail)
Emotions
(rapidly
shifting,
shallow)
Make up
(physical
appearance
used to draw
attention to
self)
Emotions
exaggerated

(feelings of)
Rage
(inappropriate)
* Created by
Jason P.
Caplan, MD

Speech
(impressionisti
c and vague)
* Created by
Jason P.
Caplan, MD

Paranoid
personality
disorder
SUSPECT9

friends
(irritable and
Neither
aggressive)
desires nor
enjoys
close
relationship
s
Takes
pleasure in
few
activities

Borderline
personality
disorder
IMPULSIVE1
0

Dependent
personality
disorder
RELIANCE9
Reassurance
required
Expressing
disagreement
difficult
Life
responsibilitie
Narcissistic
s assumed by
personality
others
disorder
Initiating
GRANDIOSE1 projects
1
difficult
Grandiose
Alone (feels
Requires
helpless and
attention
uncomfortable
Arrogant
when alone)
Need to be
Nurturance
special
(goes to
Dreams of
excessive
success and
lengths to
power
obtain)
Interpersonally Companionshi
exploitative
p sought
Others (unable urgently when
to recognize
a relationship
feelings/needs ends
of)
Exaggerated
Sense of
fears of being
entitlement
left to care for
Envious
self
engaging
socially
Gets around
occupational
activities with
need for
interpersonal
contact
Embarrassment
prevents new
activity or

work
Reluctant to
delegate to
others
* Created by
Jason P.
Caplan, MD

Schizotypal
personality
disorder
ME
PECULIAR9
Paranoid
personality
disorder
SUSPECT9

Magical
thinking
Experiences
unusual
perceptions
Spousal
Paranoid
infidelity
ideation
suspected
Eccentric
Unforgivin behavior or
g (bears
appearance
grudges)
Constricted
Suspicious or
Perceives
inappropriate
attacks (and affect
reacts
Unusual
quickly)
thinking or
Enemy or speech
friend?
Lacks close
(suspects
friends
associates Ideas of
and
reference
friends)
Anxiety in
Confiding social
in others is situations
feared
Rule out
Threats
psychotic or
perceived
pervasive
in benign
development
events
al disorders

Borderline
personality
disorder
IMPULSIVE1
0

Impulsive
Moodiness
Paranoia or
dissociation
under stress
Unstable selfimage
Labile intense
relationships
Suicidal
gestures
Inappropriate
anger
Vulnerability
to
abandonment
Emptiness
(feelings of)

Histrionic
personality
disorder
PRAISE ME9
Provocative or
seductive
behavior
Relationships
considered
more intimate
than they are
Attention
(need to be the
center of)
Influenced
easily
Style of speech
(impressionisti
c, lacking
detail)
Emotions
(rapidly
shifting,
shallow)
Make up
(physical
appearance
used to draw
attention to
self)
Emotions
exaggerated

Dependent
personality
disorder
RELIANCE9
Reassurance
required
Expressing
disagreement
difficult
Life
responsibilitie
Narcissistic
s assumed by
personality
others
disorder
Initiating
GRANDIOSE1 projects
1
difficult
Grandiose
Alone (feels
Requires
helpless and
attention
uncomfortable
Arrogant
when alone)
Need to be
Nurturance
special
(goes to
Dreams of
excessive
success and
lengths to
power
obtain)
Interpersonally Companionshi
exploitative
p sought
Others (unable urgently when
to recognize
a relationship
feelings/needs ends
of)
Exaggerated
Sense of
fears of being
entitlement
left to care for
Envious
self
taking risks
Self viewed as
unappealing or
inferior

Entire Web sites exist to share mnemonics for medical education

(see Related Resources). Thus it is likely that trainees are using them
with or without their teachers supervision. Psychiatric educators need
to be aware of the mnemonics their trainees are using and to:

screen these tools for factual errors (such as incomplete

diagnostic criteria)

remind trainees that although mnemonics are useful,

psychiatrists should approach patients as individuals without the
prejudice of a potentially pejorative label.
Our methodology

In preparing this article, we gathered numerous mnemonics (some

published and some novel) designed to capture the learners attention
and impart information pertinent to psychiatric diagnosis and
treatment. Whenever possible, we credited each mnemonic to its
creator, butgiven the difficulty in confirming authorship of (what in
many cases has become) oral historyweve listed some mnemonics
without citation.

Continued...
1 2 Next Page
Back To: Current & Past Issues

Psychiatry Mnemonics
Psychiatry Mnemonics

Male erectile dysfunction (MED): biological causes MED:

Medicines(propranalol, methyldopa, SSRI, etc.)
Ethanol
Diabetes mellitus

Middle adolescence (14-17 years): characteristics HERO:

Heterosexual crushes/ Homosexual Experience
Education regarding short term benefits
Risk taking
Omnipotence
And there is interest in being a Hero (popular).

Autistic disorder: features AUTISTICS:

Again and again (repetitive behavior)
Unusual Abilities
Talking (language) delay
IQ subnormal
Social development poor
Three years onset
Inherited component [35% concordance]
Cognitive impairment
Self injury

Male Erectile Dysfunction (MED): drugs causing it "STOP

erection":
SSRI (fluoxtine)
Thioridazone
methyldOpa
Propranalol

Premature ejaculation: treatment 2 S's:

SSRIs [eg: fluoxitime]
Squeezing technique [glans pressure before climax]
More detail with 2 more S's:
Sensate-focus excercises [relieves anxiety]

Stop and start method [5-6 rehearsals of stopping stimulation before

climax]

Narcolepsy: symptoms, epidemiology CHAP:

Cataplexy
Hallucinations
Attacks of sleep
Paralysis on waking
Usual presentation is a young male, hence "chap".

Reinforcement schedules: variable ratio SLOT machines

show SLOwesTextinction.

Depression: major episode DSM-IV criteria First, of course

depressed mood is one. Then:
SIG E CAPS:
Sleep disturbance
Interest loss
Guilt (or intense worthlessness)
Energy loss
Concentration loss
Appetite changes
Psychomotor agitation or retardation
Suicidal tendency

HM: this classic patient's lesion HM had Hippocampus

Missing.
Hippocampus and surrounding areas were removed surgically: prevented formation
of new memories.

Cluster personality disorders Cluster A Disorder =

Atypical. Unusual and eccentric.
Cluster B Disorder = Beast. Uncontrolled wildness.
Cluster C Disorder = Coward [avoidant type], Compulsive
[obsessive-compulsive type], or Clingy [dependent type].

Gain: primary vs. secondary vs. tertiary Primary:

Patient's Psyche improved.
Secondary: Symptom Sympathy for patient.
Tertiary: Therapist's gain.

Depression: major episode characteristics SPACE DIGS:

Sleep disruption
Psychomotor retardation
Appetite change
Concentration loss
Energy loss
Depressed mood
Interest wanes
Guilt
Suicidal tendencies

Impotence causes PLANE:

Psychogenic: performance anxiety
Libido: decreased with androgen deficiency, drugs
Autonomic neuropathy: impede blood flow redirection
Nitric oxide deficiency: impaired synthesis, decreased blood pressure
Erectile reserve: can't maintain an erection

Sleep stages: features DElta waves during DEepest

sleep (stages 3 & 4, slow-wave).
dREaM during REMsleep.

AIDS Dementia Complex (ADC): features AIDS:

Atrophy of cortex
Infection/ Inflammation
Demyelination
Six months death

Kubler-Ross dying process: stages "Death Always

Brings Great Acceptance":
Denial
Anger
Bargaining
Grieving
Acceptance

REM: features REM:

Rapid pulse/ Respiratory rate
Erection
Mental activity increase/ Muscle paralysis

Depression: symptoms BAD CRISES:

Behavioural change (slowing down or agitation)
Appetite change (weight loss or weight gain in the young)
Depressed look (looking down)
Concentration decrease (does not do serial 7s well)
Ruminations (constant negative thoughts, hopelessness good indicator of
suicidality)
Interest (reduced interest in what is normally pleasurable)

Sleep change (insomnia or hypersomnia, sleeping early, waking up at

night, waking up feeling tired)
Energy change (fatigue)
Suicide

Yalom's therapeutic factors ICU CAGES:

I still hope (installation of hope)
I'm part of information (imparting information)
Imitate behavior
Interpersonal learning
Corrective recapitulation of primary
Universality
Catharsis
Altruism
Group cohesiveness (glue)
Existential factors
Socializing techniques development

Borderline personality: traits PRAISE:

Paranoid ideas
Relationship instability
Affective instability/ Abandonment fears/ Angry outbursts
Impulsiveness/ Identity disturbance
Suicidal behaviour/ Self-harming behaviour
Emptiness

Substance dependence: features (DSM IV) "WITHDraw

IT":
3 of 7 within 12 month period:
Withdrawal
Interest or Important activities given up or reduced
Tolerance
Harm to physical and psychosocial known but continue to use
Desire to cut down, control

Intended time, amount exceeded

Time spent too much

Dementia: main causes VITAMIN D VEST:

Vitamin deficiency (B12, folate, thiamine)
Intracranial tumour
Trauma (head injury)
Anoxia
Metabolic (diabetes)
Infection (postencephalitis, HIV)
Normal pressure hydrocephalus
Degenerative (Alzheimer's, Huntington's, CJD, etc)
Vascular (multi infarct dementia)
Endocrine (hypothyroid)
Space occupying lesion (chronic subdural haematoma)
Toxic (alcohol)

Mania: cardinal symptoms DIG FAST:

Distractibility
Indiscretion (DSM-IV's "excessive involvement in pleasurable activities")
Grandiosity
Flight of ideas
Activity increase
Sleep deficit (decreased need for sleep)
Talkativeness (pressured speech)

Depression criteria/symptoms A SAD FACES:

Appetite, weight changes
Sleep changes
Anhedonia
Dysphoria (low mood)
Fatigue
Agitation (psychomotor)
Concentration

Esteem
Suicide

Mania: diagnostic criteria Must have 3 of MANIAC:

Mouth (pressure of speech)/ Moodl
Activity increased
Naughty (disinhibition)
Insomnia
Attention (distractability)
Confidence (grandiose ideas)

Neuroleptic side effects onset The rule of 4's:

Dystonia: 4 hours-4 days
Akathesia: 4 days-40 days
Extrapyramidal symptoms: 4 days-4 weeks
Tardive dyskinesia: 4 months (greater than)
Note that tardive is obviously the latest one to happen (tardive=tardy/late).
Note that the first letters of these four classic symptoms spell "DATE", and
this mnemonic is the dates when they occur.

Anxiety disorders: physical illnesses mimicking them "Physical

Health Hazards That Appear Panciky":
Phaeochromocytoma
Hyperthyroidism
Hypoglycaemia
Temporal lobe epilepsy
Alcohol
Paroxysmal arrhythmias

Ganser syndrome: key diagnostic feature The word "Ganser"

is close to but not quite the word "Answer".

Ganser's syndrome is when patient gives an answer that is close to, but not
quite. For example 2+2=5.

Conversion disorder: etiology Conversion disorder:

convert a conflict to a symptom.

Hallucinations: hypnogogic vs. hypnopompic definition "Hypnogogic

= go to sleep":
Hypnogogic hallucinations arise when go to sleep, hypnopompic arise when awaken.

Depression: major depression criteria DEAD SWAMP:

Depressed mood most of the day
Energy loss or fatigue
Anhedonia
Death thoughts (recurrent), suicidal ideation or attempts
Sleep disturbances (insomnia, hypersomnia)
Worthlessness or excessive guilt
Appetite or weight change
Mentation decreased (ability to think or concentrate, indecisiveness)
Psychomotor agitation or retardation

Schizophrenia: negative features 4 A's:

Ambivalence
Affective incongruence
Associative loosening
Autism

Erikson's developmental stages "The sad tale of Erikson

Motors":
The stages in order by age group:
Mr. Trust and MsTrust had an auto they were ashamed
of. She took the initiative to find the guilty party. She found
the industry was inferior. They were making cars with dents
[identity] and rolling fuses [role confusion]. Mr. N.T. Macy
[intimacy] isolated the problem, General TVT absorbed the
cost. In the end, they found the tires were just gritty and the should
have used de- spare!

Conduct disorder vs. Antisocial personality disorder Conduct

disorder is seen in Children.
Antisocial personality disorder is seen in Adults.

Parasomnias: time of onset SLeep terrors and SLeepwalking

occur during SLow-wave sleep (stages 3 & 4).
NightmaRE occurs during REM sleep (and is REMembered).

Depression: symptoms and signs (DSM-IV criteria) AWESOME:

Affect flat
Weight change (loss or gain)
Energy, loss of
Sad feelings/ Suicide thoughts or plans or attempts/ Sexual
inhibition/ Sleep change (loss or excess)/ Social withdrawal
Others (guilt, loss of pleasure, hopeless)
Memory loss
Emotional blunting

Biological symptoms in psychiatry SCALED:

Sleep disturbance

Concentration
Appetite
Libido
Energy
Diurnal mood variation

Psychiatric review of symptoms "Depressed Patients

Seem Anxious, So Claim Psychiatrists":
Depression and other mood disorders (major depression, bipolar disorder,
dysthymia)
Personality disorders (primarily borderline personality disorder)
Substance abuse disorders
Anxiety disorders (panic disorder with agoraphobia, obssessive-compulsive
disorder)
Somatization disorder, eating disorders (these two disorders are combined
because both involve disorders of bodily perception)
Cognitive disorders (dementia, delirium)
Psychotic disorders (schizophrenia, delusional disorder and psychosis
accompanying depression, substance abuse or dementia)

Depression UNHAPPINESS:
Understandable (such as bereavement, major stresses)
Neurotic (high anxiety personalities, negative parental upbringing
Hypochondriasis
Agitation (usually organic causes such as dementia
Pseudodementia
Pain
Importuniing (whingeing, complaining)
Nihilistic
Endogenous
Secondary (ie cancer at the head of the pancreas, bronchogenic cancer)
Syndromal

Depression: melancholic features (DSM IV) MELANcholic:

Morning worsening of symptoms/ psychoMotor agitation, retardation/

early Morning wakening

Excessive guilt
Loss of emotional reactivity
ANorexia/ ANhedonia