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Give definition, etiopathogenesis or risk factors, clinical features , diagnosis , management and any other important information about following topics - depression, bipolar disorder, Emotional and behavioural disorders in childhood (ADHD, ODD, CD) , Other specific psychiatric disorders in children (SLD, enuresis, sibling rivalry etc), substance use disorders ,Behavioural addictions ,Psychotic disorders , Psychiatric disorders in elderly , Psychiatric emergencies – Suicide, deliberate self-harm, violence/aggression, medication related complications , Obsessive compulsive disorders ,Sleep disorders , Eating disorders , Stress related disorders , Anxiety disorders ,Personality disorders ,Psychosomatic disorders ,Women and mental health - postpartum blues /depression/ psychosis, premenstrual dysphoric disorder - refer standard textbook or icd 11 and dsm 5

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All 18 topics are now covered. Here's a summary of what's in your notes:

What's Covered

All content is aligned with DSM-5, ICD-11, and Kaplan & Sadock's Synopsis of Psychiatry.

#	Topic	Key Exam Points
1	Depression	SIGECAPS, monoamine hypothesis, SSRI first-line, ECT indications, TRD
2	Bipolar Disorder	DIG FAST, Bipolar I vs II, lithium monitoring/toxicity, rapid cycling
3	ADHD	Neurodevelopmental, methylphenidate, multimodal Tx
3	ODD	Angry/irritable/argumentative/vindictive, PMT first-line
3	Conduct Disorder	4 categories, childhood vs adolescent onset, MST
4	SLD/Dyslexia	Phonological processing, IEP, no pharmacotherapy
4	Enuresis	Types, enuresis alarm (best long-term), desmopressin
4	Sibling Rivalry	Regression features, parental psychoeducation
5	Substance Use	DSM-5 11 criteria, alcohol withdrawal timeline, DTs, OAT for opioids
6	Behavioural Addictions	Gambling/Gaming Disorder criteria, CBT + naltrexone
7	Schizophrenia	Dopamine hypothesis, FRS, positive/negative/cognitive symptoms, clozapine, EPS/NMS
7	Other psychoses	Schizoaffective, brief psychotic, schizophreniform, delusional disorder
8	Elderly Psychiatry	Depression vs dementia, late-onset psychosis, BPSD, delirium types
9	Psychiatric Emergencies	SAD PERSONS, Tarasoff, rapid tranquilization protocol, serotonin syndrome vs NMS
10	OCD	OFC-caudate circuit, ERP + SSRI, Y-BOCS, OC spectrum
11	Sleep Disorders	CBT-I, narcolepsy (CHESS), OSA, parasomnias, RBD-Parkinson link, RLS
12	Eating Disorders	AN (highest mortality), BN (fluoxetine 60mg), BED (lisdexamfetamine), refeeding syndrome
13	Stress Disorders	ASD vs PTSD, 4 clusters, TF-CBT + EMDR, avoid BZDs in PTSD
14	Anxiety Disorders	GAD/Panic/Social/Specific phobia, SSRI first-line, CBT
15	Personality Disorders	3 clusters, BPD (DBT), ASPD, OCPD vs OCD
16	Psychosomatic	SSD, Illness Anxiety, Conversion Disorder (Hoover's sign), Factitious/Malingering
17	Women's MH	Blues vs PPD vs PPP (key distinctions!), PMDD luteal-phase SSRIs, brexanolone

Key Exam Tips:

Highest mortality: Anorexia Nervosa
Most effective antipsychotic: Clozapine (requires CBC monitoring)
Gold standard for insomnia: CBT-I
Gold standard for BPD: DBT
PPP = Psychiatric Emergency: admit, antipsychotics + lithium/ECT
Lithium reduces suicide in bipolar; clozapine reduces suicide in schizophrenia
Serotonin syndrome: Clonus + hyperreflexia (vs NMS: lead-pipe rigidity + hyperthermia)

Good luck with your exams! Let me know if you'd like to go deeper on any specific topic or practice MCQs.

Make exam ready

Asking for Preferences

No, make it a bit shorter to revise

Here's your rapid revision cheat sheet - all 18 topics condensed to the highest-yield points only:

PSYCHIATRY RAPID REVISION

1. DEPRESSION (MDD)

Dx: ≥5 symptoms ≥2 weeks; must have depressed mood ±anhedonia → SIGECAPS
Subtypes: Melancholic (early AM awakening, diurnal variation), Atypical (mood reactivity + hypersomnia + hyperphagia), Seasonal (SAD), Psychotic
Bio: ↓ 5-HT, NE, DA | ↑ Cortisol | ↓ REM latency on PSG
Tx: Mild = CBT | Mod-Severe = SSRI + CBT | ECT = severe/psychotic/catatonic/pregnant/food refusal
TRD: Fail ≥2 antidepressants → augment (lithium, atypical AP) or ketamine/ECT
Duration: 6-9 months post-remission; lifelong if ≥3 episodes

2. BIPOLAR DISORDER

Mania ≥1 week + impairment: DIG FAST (Distractibility, Impulsivity, Grandiosity, Flight of ideas, Activity↑, Sleep↓, Talkativeness)
Hypomania: Same but ≥4 days, no impairment/psychosis
Bipolar I: ≥1 manic episode | Bipolar II: Hypomania + depression (NO mania)
Rapid cycling: ≥4 episodes/year → hypothyroidism? antidepressant?
Acute mania Tx: Lithium / Valproate / Atypical AP (olanzapine, quetiapine, risperidone)
Bipolar depression Tx: Quetiapine, lurasidone, lamotrigine - AVOID antidepressant monotherapy
Maintenance: Lithium (gold standard; reduces suicide) | Lamotrigine (prevents depression)
Lithium levels: Therapeutic 0.6-1.2 | Toxic >1.5 → coarse tremor, ataxia, confusion, seizures
Lithium SE: Fine tremor, polyuria (NDI), hypothyroidism, weight gain, Ebstein's anomaly
Lithium ↑ by: NSAIDs, thiazides, ACEi

3. ADHD

Onset <12 years; ≥2 settings; ≥6 inattentive or hyperactive-impulsive symptoms (≥5 if ≥17y)
Presentations: Combined (most common), Inattentive, Hyperactive-Impulsive
Tx: Stimulants (methylphenidate/amphetamine) = first-line | Atomoxetine = non-stimulant (tics, anxiety, substance abuse risk)
Behavioral parent training in preschool; CBT in older children

4. ODD

≥4 symptoms ≥6 months: Angry/irritable mood + Argumentative/defiant + Vindictive
Tx: Parent Management Training (PMT) first-line

5. CONDUCT DISORDER

≥3 of 15 criteria in 12 months: Aggression / Destruction / Deceit / Rule violations
Childhood onset (<10y) = worse prognosis | ~40% → ASPD
Tx: Multisystemic Therapy (MST)

6. CHILDHOOD - OTHER

Disorder	Key Feature	Tx
SLD (Dyslexia)	Phonological processing deficit; left hemisphere	Phonics-based instruction (Orton-Gillingham)
Enuresis	≥5y, ≥2x/week, ≥3 months	Alarm (best long-term); Desmopressin (short-term)
Sibling Rivalry	Regression after new sibling	Parental psychoeducation, 1-on-1 time
Separation Anxiety	Fear of separation, somatic complaints	CBT + SSRI
Selective Mutism	No speech in specific situations	CBT, SSRI

7. SUBSTANCE USE DISORDERS

DSM-5: 2-3 criteria = mild; 4-5 = moderate; ≥6 = severe

Alcohol

Withdrawal timeline: Tremors 6-24h → Seizures 24-48h → Delirium Tremens 48-72h (fever, confusion, visual/tactile hallucinations; 5-15% mortality)
Tx withdrawal: Benzodiazepines + Thiamine IV/IM before glucose (prevent Wernicke's)
Relapse prevention: Naltrexone (reduces reward) | Acamprosate (reduces craving) | Disulfiram (aversive)
Wernicke's: Confusion + Ataxia + Ophthalmoplegia | Korsakoff's: Anterograde amnesia + Confabulation (mammillary body)

Opioids

OD triad: Miosis + Respiratory depression + Coma → Naloxone
Withdrawal: Opposite signs - mydriasis, rhinorrhea, piloerection, diarrhea; not life-threatening
OAT: Buprenorphine (partial agonist) + Methadone (full agonist)

Cocaine/Stimulants

Intoxication: Euphoria, mydriasis, tachycardia, hypertension; severe → psychosis, MI, stroke
Withdrawal: Crash - dysphoria, fatigue, hypersomnia; no medical emergency
Tx: CBT + Contingency Management (no approved pharmacotherapy)

Cannabis

Intoxication: Euphoria, tachycardia, conjunctival injection, ↑ appetite
Cannabis psychosis: High-potency THC; risk factor for schizophrenia
Cannabis Hyperemesis: Cyclical vomiting; relieved by hot showers

8. BEHAVIOURAL ADDICTIONS

ICD-11 recognized: Gambling Disorder, Gaming Disorder
DSM-5 recognized: Gambling Disorder only
Gambling Dx: ≥4 of 9 criteria in 12 months (tolerance-like, withdrawal-like, chasing losses, lies, bailouts)
Tx: CBT + Gamblers Anonymous + Naltrexone (best pharmacotherapy)

9. SCHIZOPHRENIA

Dopamine: Mesolimbic ↑ DA = positive sx | Mesocortical ↓ DA = negative sx + cognitive
Genetics: MZ twins ~50%; 1st degree ~10%
Schneider's First Rank Symptoms: Thought echo/insertion/withdrawal/broadcasting, passivity, delusional perception, 3rd person hallucinations
Negative sx (5 A's): Affective flattening, Alogia, Avolition, Anhedonia, Asociality
Dx DSM-5: ≥2 symptoms ≥1 month (must include ≥1 of delusions/hallucinations/disorganized speech) + 6 months total

Antipsychotics

Drug	Key Point
Clozapine	TRS (≥2 AP failures); agranulocytosis - weekly CBC; no EPS/TD
Olanzapine	Most metabolic SE; weight gain, DM
Aripiprazole	Dopamine partial agonist; least metabolic
Risperidone	High EPS at high doses; most prolactin elevation
Quetiapine	Sedating; bipolar depression

EPS

EPS	Timing	Tx
Acute dystonia	Hours-days	Benztropine / diphenhydramine IM
Akathisia	Days-weeks	Propranolol / BZD / ↓ dose
Parkinsonism	Weeks-months	Anticholinergics
Tardive Dyskinesia	Months-years	VMAT2 inhibitors (valbenazine)

NMS (Emergency)

Fever + Lead-pipe rigidity + Autonomic instability + Altered consciousness
↑ CK, leukocytosis
Tx: Stop AP, dantrolene, bromocriptine, ECT

10. PSYCHOTIC DISORDERS - COMPARISON

Disorder	Duration	Key Feature
Brief Psychotic	1 day - 1 month	Full recovery; often stress-triggered
Schizophreniform	1-6 months	Same as schizophrenia criteria
Schizophrenia	≥6 months	Functional decline
Schizoaffective	≥6 months	Psychosis ≥2 weeks without mood episode
Delusional Disorder	≥1 month	Non-bizarre delusions; functioning intact

11. ELDERLY PSYCHIATRY

Depression vs Pseudodementia

	Depression	Dementia
Onset	Rapid	Insidious
Cognitive complaint	Patient emphasizes	Patient minimizes
Memory	STM = LTM	STM >> LTM
Response to Tx	Improves	Progressive

Elderly men = highest completed suicide rate
Tx: Sertraline/escitalopram (fewest interactions); avoid TCAs; ECT very effective

Delirium

Acute onset, fluctuating, inattention + cognitive disturbance
Hypoactive = most common, most missed, worst prognosis
Tx: Treat underlying cause; haloperidol low dose; non-pharm measures first

12. PSYCHIATRIC EMERGENCIES

Suicide Risk - SAD PERSONS

Sex (M), Age, Depression, Previous attempt (strongest predictor), Ethanol, Rational thinking loss, Social support lacking, Organized plan, No spouse, Sickness

Hopelessness = strongest psychological predictor (Beck)
Lithium reduces suicide in bipolar | Clozapine reduces suicide in schizophrenia
DBT = best evidence for suicidal behavior/BPD

Serotonin Syndrome vs NMS

	Serotonin Syndrome	NMS
Cause	Serotonergic excess (SSRI+MAOI)	Dopamine blockade (antipsychotics)
Onset	Rapid (hours)	Slower (days)
Tone	Clonus, hyperreflexia, myoclonus	Lead-pipe rigidity
Temp	Elevated	Very high
Tx	Cyproheptadine, stop drug	Dantrolene, bromocriptine, stop AP

Rapid Tranquilization

De-escalation → Oral medication → IM medication
IM haloperidol + lorazepam (standard)
DO NOT combine IM olanzapine + benzodiazepine (respiratory depression)

Lithium Toxicity

Levels >1.5 → coarse tremor, ataxia, confusion
2.0 → seizures, arrhythmias, renal failure
Tx: Stop, saline hydration, hemodialysis if >4 mmol/L or severe

13. OCD

Circuit: OFC - Caudate - Thalamus (hyperactive loop)
Obsessions = ego-dystonic | Compulsions to reduce anxiety
Y-BOCS: >16 = moderate; >24 = severe
Tx: ERP (gold standard psychotherapy) + SSRI (high dose, 8-12 weeks for response)
SSRI hierarchy: Fluvoxamine, fluoxetine, sertraline, paroxetine (all FDA-approved)
Clomipramine: Most potent; 2nd line (SE: cardiac, seizures, anticholinergic)
Augmentation: Add risperidone/aripiprazole for partial response

OC Spectrum

BDD: Perceived appearance defect; mirror checking; high suicide risk
Hoarding Disorder, Trichotillomania, Excoriation

14. SLEEP DISORDERS

Sleep cycle: N1 → N2 (spindles, K-complexes) → N3 (delta, deep) → REM | ~90 min
Depression → ↓ REM latency, ↑ REM density

Disorder	Key Feature	Tx
Insomnia	CBT-I = GOLD STANDARD	Zolpidem short-term; suvorexant (orexin antagonist)
Narcolepsy Type 1	Cataplexy + ↓ CSF hypocretin; HLA-DQB1*06:02	Modafinil (EDS); Sodium oxybate (cataplexy)
OSA	AHI ≥5 + sx; snoring, EDS, witnessed apneas	CPAP = gold standard
Sleepwalking/Terrors	NREM (N3), first half night, amnesia	Reassurance; clonazepam if frequent
RBD	REM without atonia; acts out dreams	Clonazepam; associated with Parkinson's/DLB
RLS	Urge to move legs; worse at rest/night	Check ferritin; dopamine agonists

15. EATING DISORDERS

	Anorexia (AN)	Bulimia (BN)	BED
Weight	Significantly low	Normal/overweight	Overweight
Compensatory	Restriction/exercise	Purging (vomiting, laxatives)	None
Body image	Distorted	Distorted	Less prominent
Highest mortality	✅ (any psychiatric disorder)	-	-
Physical signs	Lanugo, amenorrhea, bradycardia, osteoporosis	Russell's sign, dental erosion, parotid enlargement	-
Electrolytes	Hypokalemia, hypophosphatemia	Hypokalemia, metabolic alkalosis	-
Tx	FBT (adolescents), CBT-E	CBT-E + Fluoxetine 60mg	CBT-E + Lisdexamfetamine

Refeeding syndrome: Hypophosphatemia → cardiac failure → supplement phosphate
AN hospitalization: BMI <15, rapid weight loss, cardiac arrhythmia, electrolyte crisis

16. STRESS DISORDERS

	ASD	PTSD	Adjustment
Duration	3 days - 1 month	>1 month	<6 months after stressor
ICD-11	Not a mental disorder	Mental disorder	Mental disorder
Tx	Psychological first aid, TF-CBT	TF-CBT + EMDR	Supportive/CBT

PTSD 4 clusters: Intrusion + Avoidance + Negative cognitions + Hyperarousal
Prazosin: PTSD nightmares | SSRIs: Sertraline, paroxetine (FDA-approved)
Avoid BZDs in PTSD | Avoid debriefing (CISD) (may worsen)
Complex PTSD (ICD-11): PTSD + affect dysregulation + negative self-concept + interpersonal difficulties

17. ANXIETY DISORDERS

Disorder	Core Feature	Tx
GAD	Uncontrollable worry ≥6m; ≥3 sx (WATCHERS)	CBT; SSRI/SNRI; Buspirone
Panic Disorder	Recurrent unexpected attacks + 1m worry	CBT; SSRI (start low)
Social Anxiety	Fear of scrutiny/embarrassment ≥6m	CBT; SSRI; Beta-blockers (performance)
Specific Phobia	Specific object/situation; vasovagal (BII type)	In vivo exposure (single session)
Agoraphobia	Fear in ≥2 public situations	CBT + SSRI

GAD mnemonic WATCHERS: Worry, Anxiety, Tension, Can't concentrate, Hypervigilance, Energy↓, Restlessness, Sleep↓

18. PERSONALITY DISORDERS

Clusters

Cluster	"Think of"	Disorders
A - Odd/Eccentric	Psychosis spectrum	Paranoid, Schizoid, Schizotypal
B - Dramatic/Erratic	Mood/impulse	ASPD, BPD, Histrionic, Narcissistic
C - Anxious/Fearful	Anxiety spectrum	Avoidant, Dependent, OCPD

High-Yield Distinctions

Disorder	Key Differentiator	Tx
BPD	Splitting, fear of abandonment, self-harm, identity	DBT
ASPD	Conduct Disorder before 15; no remorse	Therapeutic communities
Schizotypal	Magical thinking, ideas of reference; schizophrenia spectrum	Low-dose AP
Avoidant	Wants relationships but fears rejection	CBT, SSRI
Schizoid	Doesn't want relationships; not distressed	-
OCPD	Ego-syntonic perfectionism (vs OCD ego-dystonic)	CBT

19. PSYCHOSOMATIC / SOMATIC DISORDERS

Disorder	Key Feature	Tx
Somatic Symptom Disorder	Excessive thoughts/anxiety about ≥1 somatic symptom	CBT + scheduled appointments
Illness Anxiety	Fear of serious illness; minimal symptoms	CBT; SSRIs
Conversion Disorder	Neurological sx incompatible with neurology; Hoover's sign	Psychoeducation, PT/OT, CBT
Factitious Disorder	Falsifies sx for sick role (no external gain)	Supportive confrontation
Malingering	Falsifies sx for external gain (compensation, avoid jail)	Not a psychiatric disorder

La belle indifférence: Apparent lack of concern in conversion disorder (not pathognomonic)

20. WOMEN'S MENTAL HEALTH

The 3 Postpartum Conditions - KEY DISTINCTIONS

	Baby Blues	PPD	PPP
Onset	Days 3-5	Days to months (up to 12m)	Days 3-14
Prevalence	30-80%	10-15%	1-2/1000
Severity	Mild, self-limiting	Moderate-severe	Psychiatric emergency
Duration	<2 weeks	Weeks-months	Variable
Psychosis	No	No	Yes (infanticide risk!)
Tx	Reassurance + support	SSRI (sertraline) + CBT	Antipsychotic + Lithium + ECT
Breastfeeding	Continue	SSRI safe	Stop if lithium used

Biggest risk for PPP: Bipolar disorder (risk 20-30%)
Brexanolone (IV) + Zuranolone (oral) = FDA-approved specifically for PPD (GABA modulators)
EPDS ≥13 = positive screen for PPD

PMDD

Luteal phase (days 14-28) symptoms; resolve after menses
Tx: Luteal-phase SSRIs (first-line) | Drospirenone OCP | GnRH agonist (refractory)

Teratogenic Drugs

Drug	Risk
Valproate	Neural tube defects (spina bifida) - AVOID in women of childbearing age
Lithium	Ebstein's anomaly (cardiac)
Carbamazepine	Neural tube defects
Paroxetine	Cardiac defects
SSRIs (late pregnancy)	Persistent pulmonary hypertension of newborn

QUICK MNEMONICS BANK

Mnemonic	What it stands for
SIGECAPS	Depression symptoms (Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidal)
DIG FAST	Mania symptoms
WATCHERS	GAD symptoms
SAD PERSONS	Suicide risk factors
CHESS	Narcolepsy (Cataplexy, Hallucinations, EDS, Sleep paralysis, Sleep disrupted)
5 A's	Schizophrenia negative symptoms (Affective flat, Alogia, Avolition, Anhedonia, Asociality)
3 P's	Insomnia model (Predisposing, Precipitating, Perpetuating)

Exam day reminders:

Always ask about suicidal ideation in any mood/psychotic disorder question

Previous attempt = strongest predictor of future suicide

ECT works faster than medications - use for emergencies

Clozapine = most effective antipsychotic, but CBC monitoring mandatory

Lithium requires: Levels + TFTs + RFTs + ECG

Valproate = avoid in women of childbearing potential

DBT = BPD + suicidal behavior | ERP = OCD | CBT-I = Insomnia | TF-CBT/EMDR = PTSD | FBT = Adolescent AN

Good luck! 🩺

All 18 topics are now structured under your exact headings:

Definition
Etiopathogenesis / Risk Factors
Clinical Features (detailed, with sub-points)
Diagnosis
Management
Important Information

What's covered:

Depression, Bipolar Disorder
ADHD, ODD, Conduct Disorder
SLD, Enuresis, Sibling Rivalry + others
Substance Use Disorders (alcohol, opioids, stimulants, cannabis)
Behavioural Addictions (Gambling, Gaming)
Schizophrenia + other psychotic disorders
Elderly Psychiatry (depression, late-onset psychosis, delirium, BPSD)
Psychiatric Emergencies (Suicide, DSH/NSSI, Violence, Serotonin syndrome, NMS, Anticholinergic toxidrome, Lithium toxicity)
OCD + OC spectrum
Sleep disorders (Insomnia, Narcolepsy, OSA, Parasomnias, RLS)
Eating disorders (AN, BN, BED)
Stress disorders (ASD, PTSD, Adjustment disorder)
Anxiety disorders (GAD, Panic, Social anxiety, Specific phobia)
Personality disorders (all 10 with features)
Psychosomatic disorders (SSD, Illness anxiety, Conversion, Factitious, Malingering)
Women's MH (PMDD, Baby Blues, PPD, PPP - detailed comparison table included)

Let me know if you want to go deeper on any specific topic, need MCQ practice, or need any topic expanded!

Thank you so much

You're welcome! Best of luck with your psychiatry exams! 🩺

You've got solid notes to revise from. A few last tips:

Focus on the comparison tables - examiners love asking Blues vs PPD vs PPP, NMS vs Serotonin Syndrome, Depression vs Dementia
Know your mnemonics cold - SIGECAPS, DIG FAST, SAD PERSONS, CHESS, WATCHERS
First-line treatments are high yield - CBT-I for insomnia, DBT for BPD, FBT for adolescent AN, ERP for OCD, TF-CBT/EMDR for PTSD
Duration criteria trip many students up - keep that table handy

Feel free to come back anytime for MCQ practice, deeper dives on specific topics, or any other subjects. You've got this! 💪

Generate a PDF summary sheet of all 18 topics for quick reference

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Generate a PDF summary sheet of all 18 topics for quick reference

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