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Weight related effects © SPMM Course Valproate can cause obesity, hyperandrogenism and PCOD associated with hirsutism. Anticonvulsant hypersensitivity syndrome is seen in 0.1% of patients taking anticonvulsants. Aromatic compounds (lamotrigine, carbamazepine, ...

6. Other agents - adverse effects © SPMM Course 6. Other agents - adverse effects Cholinesterase inhibitors: Donepezil causes nausea, diarrhea, insomnia, vomiting, muscle cramps commonly. Rivastigmine causes similar symptoms albeit at a higher frequency of som...

7. Psychiatric effects of non-psychiatric drugs © SPMM Course High-potency benzodiazepines such as triazolam can cause anterograde amnesia. Paradoxical disinhibition is seen in a few patients especially when preexisting brain damage is present. Triazolam is ba...

8. Prescribing controlled drugs © SPMM Course 8. Prescribing controlled drugs 1971 MISUSE OF DRUGS ACT UK Class A drugs: Ecstasy, LSD, heroin, cocaine, crack, magic mushrooms (whether prepared or fresh), methylamphetamine (crystal meth), other amphetamines if ...

9. ADR Databases © SPMM Course 9. ADR Databases It is vital that adverse drug reactions (ADRs) that are hitherto unreported are detected rapidly and recorded to reduce the hazards of medical prescribing. Such reports will also trigger regulatory action to ensu...

1. Approaches to Classification © SPMM Course Approaches to Classification The two major contemporary classificatory systems are ICD 10 (1992) and DSM IV (1994). American Psychiatric Association produces the DSM system. WHO commissioned ICD 10? DSM-V was rele...

Structure of ICD-10 © SPMM Course both diagnoses in a given patient at a point of time. This hierarchy is generally non-reflexive, i.e. each disorder tends to manifest the symptoms of those lower down but not those of disorders higher up. Despite such a hierarc...

Structure of DSM-IV

Newer Classification Systems

Proposed changes to ICD-11 © SPMM Course o ICD-10: CDDG (clinical descriptions and diagnostic guidelines) - for clinical, educational and service use. It is mainly used by psychiatric practitioners and gives clinical descriptions of each disorder together with...

Summary of major changes to DSM-5 © SPMM Course Summary of major changes to DSM-5 DSM-5 is comprised of three sections: Section 1: An introduction and guidance to use; Section 2: An outline of the diagnostic categories with the newly revised chapters; Section ...

2. Psychoactive substance use disorders © SPMM Course 2. Psychoactive substance use disorders Mental and behavioural disorders due to psychoactive substance use are dealt in Chapters F10 to F19 in ICD-10. Substances discussed here include alcohol, opioids, can...

3. Organic disorders © SPMM Course 3. Organic disorders Chapter F00 in ICD-10 discusses organic disorders such as dementia. Major categories include dementia  of  Alzheimer’s  disease,  vascular  dementia,   dementia in other diseases classified elsewhere (inc...

4. Classification of psychosis

Schizophrenia

Earlier diagnostic criteria © SPMM Course 4. Classification of psychosis Schizophrenia Schizophrenia usually manifests as a severe psychotic illness with onset in early childhood, characterised by bizarre (i.e. Schneiderian) delusions, auditory hallucinations,...

ICD-10 schizophrenia © SPMM Course of onset of psychosis o Onset of illness prior to age 40 ICD-10 schizophrenia ICD 10 description of schizophrenia is largely based on Schneider’s  first-rank symptoms. Kurt Schneider described a number of symptoms which he be...

Contrasting DSM-IV and ICD-10 © SPMM Course florid symptoms such as delusions and hallucinations have been minimal or substantially reduced and absence of organic brain disease or disorder”. Post schizophrenic depression is classed under F20s. Some schizophren...