Compile this pdf and make it easier format simplify manner for applying on question and clearly understand concept easily with help of mnemonics visual diagrams examples characters flowchart mindmaps etc for Neet pg like competitive exams but the stuff must cover all topic
cd /tmp/workspace && python3 -c " import pdfplumber import json pdf_path = '/tmp/workspace/attachments/e1d35427-d8f1-47a1-b115-e00050a4f604/Psychiatry Revision Edition 8 - No watermark.pdf' with pdfplumber.open(pdf_path) as pdf: print(f'Total pages: {len(pdf.pages)}') # Extract first 10 pages to see structure for i, page in enumerate(pdf.pages[:10]): text = page.extract_text() print(f'--- PAGE {i+1} ---') print(text[:800] if text else '[No text]') print() "
python3 -c " import pdfplumber pdf_path = '/tmp/workspace/attachments/e1d35427-d8f1-47a1-b115-e00050a4f604/Psychiatry Revision Edition 8 - No watermark.pdf' all_text = [] with pdfplumber.open(pdf_path) as pdf: for i, page in enumerate(pdf.pages): text = page.extract_text() all_text.append(f'=== PAGE {i+1} ===\n{text if text else \"[No text]\"}') full = '\n\n'.join(all_text) with open('/tmp/workspace/psych_raw.txt', 'w') as f: f.write(full) print(f'Done. Total chars: {len(full)}') "
mkdir -p /tmp/workspace/psych-neetpg && cat > /tmp/workspace/psych-neetpg/psychiatry_neetpg.html << 'HTMLEOF' <!DOCTYPE html> <html lang="en"> <head> <meta charset="UTF-8"/> <meta name="viewport" content="width=device-width, initial-scale=1.0"/> <title>Psychiatry NEET PG Master Guide</title> <style> :root { --blue:#1a73e8; --green:#27ae60; --red:#e74c3c; --yellow:#f39c12; --purple:#8e44ad; --teal:#16a085; --orange:#e67e22; --dark:#2c3e50; --lightblue:#ebf5fb; --lightgreen:#eafaf1; --lightyellow:#fef9e7; --lightred:#fdedec; --lightpurple:#f5eef8; --lightteal:#e8f8f5; } * { box-sizing:border-box; margin:0; padding:0; } body { font-family:'Segoe UI',Arial,sans-serif; background:#f0f4f8; color:#2c3e50; font-size:15px; } .cover { background:linear-gradient(135deg,#1a73e8,#8e44ad); color:white; text-align:center; padding:60px 20px; } .cover h1 { font-size:2.8em; font-weight:900; letter-spacing:2px; } .cover h2 { font-size:1.4em; margin-top:10px; opacity:0.9; } .cover .badge { display:inline-block; 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border:1px solid #ccc; border-radius:6px; padding:4px 10px; font-size:0.82em; color:#555; } .keyword { background:var(--blue); color:white; border-radius:4px; padding:2px 7px; font-weight:700; font-size:0.9em; } .important { background:var(--red); color:white; border-radius:4px; padding:2px 7px; font-weight:700; font-size:0.85em; } .tip { background:var(--green); color:white; border-radius:4px; padding:2px 7px; font-weight:700; font-size:0.85em; } ul { padding-left:20px; margin:8px 0; } li { margin:4px 0; line-height:1.6; } p { margin:8px 0; line-height:1.7; } .two-col { display:grid; grid-template-columns:1fr 1fr; gap:16px; margin:14px 0; } .three-col { display:grid; grid-template-columns:1fr 1fr 1fr; gap:12px; margin:14px 0; } .card { background:#f8f9fa; border-radius:10px; padding:14px; border-top:4px solid var(--blue); } .card.green { border-top-color:var(--green); } .card.red { border-top-color:var(--red); } .card.purple { border-top-color:var(--purple); } .card.yellow { border-top-color:var(--yellow); } .card.teal { border-top-color:var(--teal); } .card h4 { margin-top:0; } .emoji { font-size:1.2em; } .example { background:#e8f4f8; border-radius:8px; padding:12px 16px; margin:10px 0; border-left:4px solid var(--teal); } .example .label { font-weight:900; color:var(--teal); margin-bottom:4px; } .qbox { background:#fff3cd; border:2px solid var(--yellow); border-radius:8px; padding:12px; margin:10px 0; } .qbox .qlabel { color:var(--orange); font-weight:900; font-size:0.95em; } .divider { border:none; border-top:2px dashed #dee2e6; margin:20px 0; } @media print { body { background:white; } .chapter { box-shadow:none; border:1px solid #ddd; } } </style> </head> <body> <!-- COVER --> <div class="cover"> <h1>π§ PSYCHIATRY</h1> <h2>NEET PG / USMLE / Medical PG Master Revision Guide</h2> <div class="badge">π Marrow Revision Edition 8 | Simplified with Mnemonics, Flowcharts & Mindmaps</div> <div style="margin-top:16px; opacity:0.8; font-size:0.95em;">All topics covered | Apply-ready format | Visual learning</div> </div> <!-- TABLE OF CONTENTS --> <div class="toc"> <h2>π Table of Contents</h2> <ol> <li><a href="#ch1">Psychosis, Delusions & Hallucinations</a></li> <li><a href="#ch2">Schizophrenia</a></li> <li><a href="#ch3">Antipsychotics & Catatonia</a></li> <li><a href="#ch4">Mood Disorders - Depression</a></li> <li><a href="#ch5">Antidepressants</a></li> <li><a href="#ch6">Mania & Bipolar Disorder</a></li> <li><a href="#ch7">Stress-Related Disorders (PTSD, Adjustment)</a></li> <li><a href="#ch8">Anxiety Disorders</a></li> <li><a href="#ch9">OCD & Related Disorders</a></li> <li><a href="#ch10">Somatic Symptom Disorders</a></li> <li><a href="#ch11">Dissociative Disorders</a></li> <li><a href="#ch12">Eating & Feeding Disorders</a></li> <li><a href="#ch13">Sleep Disorders</a></li> <li><a href="#ch14">Sexual Disorders & Gender Identity</a></li> <li><a href="#ch15">Personality Disorders</a></li> <li><a href="#ch16">Neurodevelopmental Disorders (ADHD, ASD, ID)</a></li> <li><a href="#ch17">Substance Use Disorders</a></li> <li><a href="#ch18">Neurocognitive Disorders (Dementia)</a></li> <li><a href="#ch19">ECT & Other Biological Therapies</a></li> <li><a href="#ch20">Psychotherapy & Defense Mechanisms</a></li> </ol> </div> <!-- CHAPTER 1: PSYCHOSIS --> <div class="chapter" id="ch1"> <div class="chapter-header"> <h2>π Chapter 1: Psychosis, Delusions & Hallucinations</h2> <div class="subtitle">Foundation of Psychiatry | High Yield for NEET PG</div> </div> <h3>Neurotic vs. Psychotic - The Core Distinction</h3> <table class="comparison"> <tr><th>Feature</th><th>π’ Neurotic Illness</th><th>π΄ Psychotic Illness</th></tr> <tr><td>Insight</td><td>Present (+)</td><td>Absent (-)</td></tr> <tr><td>Judgement</td><td>Intact</td><td>Impaired</td></tr> <tr><td>Reality contact</td><td>Maintained</td><td>Lost</td></tr> <tr><td>Personality changes</td><td>Minimal</td><td>Significant</td></tr> </table> <div class="box box-blue"> <b>π‘ Quick Rule:</b> In psychosis, the patient does NOT know they are ill (lack of insight). In neurosis, they are aware something is wrong. </div> <h3>π΄ Delusions</h3> <div class="box box-red"> <b>Definition:</b> False, FIXED belief - not consistent with culture, despite evidence to the contrary.<br/> <b>Contrast:</b> Idea = False FLUCTUATING belief (not a delusion) </div> <h4>Types of Delusions by Content</h4> <div class="three-col"> <div class="card red"><h4>Persecution/Paranoid</h4><p>Most common (M/c). "Someone is following me."</p></div> <div class="card yellow"><h4>Grandiosity</h4><p>Seen in MANIA. "I am the king of the world."</p></div> <div class="card"><h4>Poverty</h4><p>Seen in DEPRESSION. "I have nothing left."</p></div> <div class="card purple"><h4>Reference</h4><p>"That news anchor is talking about me."</p></div> <div class="card teal"><h4>Control</h4><p>Believes being controlled by external agency (Somatic passivity).</p></div> <div class="card green"><h4>Nihilistic</h4><p>Seen in severe depression. "I don't exist." (Cotard)</p></div> </div> <h4>π Named Delusion Syndromes - Memory Characters</h4> <div class="mnemonic"> <span class="label">π§ MEMORY TABLE - Named Delusions</span> <table> <tr><td>π</td><td><b>Othello Syndrome</b> - Jealousy/infidelity delusion. Common in <b>chronic alcoholism</b>. (Othello = jealous husband)</td></tr> <tr><td>π</td><td><b>Magnan Syndrome</b> - Cocaine bugs / formication + delusion of persecution + tactile hallucination</td></tr> <tr><td>π</td><td><b>De Clerambault (Erotomania)</b> - Delusion of love - believes someone famous loves them</td></tr> <tr><td>π</td><td><b>Cotard Syndrome</b> - Severe depression + Nihilistic delusion ("I am dead / my organs don't exist")</td></tr> <tr><td>π¦</td><td><b>Ekbom Syndrome</b> - Delusional parasitosis = Match box sign (+). Also a type of restless leg syndrome.</td></tr> <tr><td>π₯</td><td><b>Capgras Syndrome</b> - Known person is a STRANGER (Negative misidentification)</td></tr> <tr><td>ποΈ</td><td><b>Fregoli Syndrome</b> - Stranger is believed to be a known PERSECUTOR (Positive misidentification)</td></tr> </table> </div> <div class="example"> <div class="label">π NEET PG Question Pattern:</div> Q: A patient believes his wife has been replaced by an impostor β <b>Capgras Syndrome</b><br/> Q: A patient believes a stranger following him is his old enemy in disguise β <b>Fregoli Syndrome</b> </div> <h3>π Hallucinations</h3> <div class="box box-purple"> <b>Definition:</b> Perception WITHOUT a stimulus (vs. Illusion = misinterpretation of an existing stimulus) </div> <table class="comparison"> <tr><th>Type</th><th>Most Common In</th></tr> <tr><td>Auditory Hallucination</td><td>Schizophrenia (M/c overall)</td></tr> <tr><td>Visual Hallucination</td><td>Organic mental illness / Neurocognitive disorders</td></tr> <tr><td>Tactile/Haptic</td><td>Cocaine use (Cocaine bugs)</td></tr> <tr><td>Olfactory</td><td>Temporal lobe epilepsy, depression</td></tr> </table> <h4>Special Types</h4> <table class="comparison"> <tr><th>Type</th><th>Definition</th><th>Example</th></tr> <tr><td>True Hallucination</td><td>Originates from outer objective space</td><td>Hearing voice from outside</td></tr> <tr><td>Pseudohallucination</td><td>Originates from inner subjective space</td><td>Voice inside the head</td></tr> <tr><td>Extracampine</td><td>Experience beyond sensory field</td><td>Seeing someone behind a wall</td></tr> <tr><td>Functional Hallucination</td><td>Stimulus & hallucination = SAME modality</td><td>Hearing another voice when someone speaks</td></tr> <tr><td>Reflex Hallucination</td><td>Stimulus & hallucination = DIFFERENT modality (Synesthesia)</td><td>Hearing a voice when light is turned on</td></tr> </table> </div> <!-- CHAPTER 2: SCHIZOPHRENIA --> <div class="chapter" id="ch2"> <div class="chapter-header" style="background:linear-gradient(90deg,#8e44ad,#c0392b);"> <h2>𧩠Chapter 2: Schizophrenia</h2> <div class="subtitle">Most tested psychiatric disorder | Know all the criteria and symptoms</div> </div> <h3>π¨βπ¬ Famous Contributors</h3> <div class="two-col"> <div class="box box-purple"> <b>Eugene Bleuler</b> - Coined "Schizophrenia"<br/> Described the 4 A's: <div class="mnemonic" style="margin-top:8px;"> <span class="label">π§ 4 A's of Bleuler (AAAA)</span> <span class="word">A-A-A-A</span> <table> <tr><td>A</td><td><b>Autism</b> (social withdrawal)</td></tr> <tr><td>A</td><td><b>Ambivalence</b> (contradictory feelings)</td></tr> <tr><td>A</td><td><b>Affect</b> (blunting/flattening)</td></tr> <tr><td>A</td><td><b>Associations</b> (loosened)</td></tr> </table> <p style="margin-top:6px;font-size:0.85em;color:#666;">β οΈ Auditory hallucination is NOT part of 4 A's of Bleuler</p> </div> </div> <div class="box box-blue"> <b>Emil Kraepelin</b> - Called it "Dementia Praecox"<br/> Described 3 types: Hebephrenic, Catatonic, Paranoid<br/><br/> <b>Kurt Schneider</b> - First Rank Symptoms (FRS)<br/> <i>Most specific for schizophrenia</i> </div> </div> <h3>β Kurt Schneider's First Rank Symptoms</h3> <div class="box box-yellow"> <b>Remember: 3+3+3 Rule</b> <div class="three-col" style="margin-top:10px;"> <div class="card yellow"><h4>3 Auditory Hallucinations</h4> <ul><li>1st person (own thoughts aloud)</li><li>2nd person (commanding & commentary)</li><li>3rd person (discussing patient)</li></ul> </div> <div class="card yellow"><h4>3 Made Phenomena</h4> <ul><li>Made impulse</li><li>Made volition</li><li>Made affect</li></ul> </div> <div class="card yellow"><h4>3 Thought Phenomena</h4> <ul><li>Thought insertion</li><li>Thought broadcast</li><li>Thought withdrawal</li></ul> </div> </div> <p style="margin-top:10px;">Also: <b>Somatic passivity</b> + <b>Primary delusional experience</b></p> </div> <h3>π Diagnostic Criteria</h3> <div class="two-col"> <div class="box box-red"> <h4>π΄ Positive Symptoms (Mesolimbic pathway βDA)</h4> <ul> <li>Delusions</li> <li>Hallucinations</li> <li>Disorganized thinking</li> <li>Disorganized behaviour</li> </ul> <p style="margin-top:8px;font-size:0.9em;"><b>β οΈ At least 1 of these 3 (Hallucination/Delusion/Disorganized thinking) must be present</b></p> </div> <div class="box box-blue"> <h4>π΅ Negative Symptoms (Mesocortical pathway βDA)</h4> <div class="mnemonic" style="margin:6px 0;"> <span class="label">Mnemonic: 5 A's</span> <table> <tr><td>A</td><td><b>Apathy</b></td></tr> <tr><td>A</td><td><b>Avolition</b></td></tr> <tr><td>A</td><td><b>Attention deficit</b></td></tr> <tr><td>A</td><td><b>Anhedonia</b></td></tr> <tr><td>A</td><td><b>Alogia</b> (poverty of speech)</td></tr> </table> </div> </div> </div> <div class="flowchart"> <b>π Duration Criteria Flowchart</b> <div style="margin-top:12px;"> <div class="flow-step"> <div class="flow-box">Symptoms present</div> <div class="flow-arrow">β</div> <div class="flow-box yellow">ICD: β₯1 month</div> <div class="flow-arrow">/</div> <div class="flow-box green">DSM: β₯6 months</div> </div> </div> </div> <h3>π Prognostic Factors</h3> <div class="mnemonic"> <span class="label">π§ Mnemonic for BETTER PROGNOSIS: "LAGO-MFC"</span> <table> <tr><td>L</td><td><b>Late onset</b></td></tr> <tr><td>A</td><td><b>Acute onset</b></td></tr> <tr><td>G</td><td><b>Girl (Female)</b></td></tr> <tr><td>O</td><td><b>Obvious stressor present</b></td></tr> <tr><td>M</td><td><b>Mood symptoms present</b></td></tr> <tr><td>F</td><td><b>Family support +</b></td></tr> <tr><td>C</td><td><b>Compliant with medications</b></td></tr> </table> <p style="margin-top:8px;font-size:0.9em;">Opposite of all above = WORSE prognosis. More negative symptoms = worse prognosis.</p> </div> </div> <!-- CHAPTER 3: ANTIPSYCHOTICS --> <div class="chapter" id="ch3"> <div class="chapter-header" style="background:linear-gradient(90deg,#16a085,#1a73e8);"> <h2>π Chapter 3: Antipsychotics & Catatonia</h2> <div class="subtitle">Drug pharmacology | Side effects | EPS</div> </div> <h3>Antipsychotic Generations</h3> <table class="comparison"> <tr><th>Feature</th><th>1st Gen (Typical)</th><th>2nd Gen (Atypical)</th><th>3rd Gen</th></tr> <tr><td>MOA</td><td>Block ALL D receptors</td><td>Block 80% D receptors + 5HT2A block</td><td>5HT1A partial agonist</td></tr> <tr><td>EPS</td><td>High</td><td>Low</td><td>Minimal</td></tr> <tr><td>Metabolic SE</td><td>Low</td><td>High (weight gain, DM)</td><td>Low</td></tr> <tr><td>Examples</td><td>Haloperidol, Chlorpromazine, Fluphenazine</td><td>Olanzapine, Risperidone, Quetiapine, Clozapine</td><td>Aripiprazole, Brexpiprazole, Cariprazine</td></tr> </table> <div class="box box-red"> <h4>β CLOZAPINE - Most Important Drug in Psychiatry</h4> <ul> <li><b>Most effective antipsychotic</b></li> <li><b>DOC:</b> Treatment-resistant schizophrenia (failed β₯2 antipsychotics)</li> </ul> <h4 style="margin-top:10px;">π Side Effects of Clozapine:</h4> <div class="mnemonic"> <span class="label">Mnemonic: CLOZAPINE = "Causes Lots Of Zeal And Problems IN Everyone"</span> <table> <tr><td>C</td><td><b>Cardiomyopathy/Myocarditis</b></td></tr> <tr><td>L</td><td><b>Lowered seizure threshold</b> (dose-dependent)</td></tr> <tr><td>O</td><td><b>Obesity/metabolic syndrome</b> (weight gain, dyslipidemia, hyperglycemia)</td></tr> <tr><td>Z</td><td><b>Zero white cells = Agranulocytosis</b> β οΈ Monitor WBC!</td></tr> <tr><td>A</td><td><b>Aches/sedation</b></td></tr> <tr><td>P</td><td><b>Profuse salivation</b> (sialorrhea)</td></tr> </table> </div> </div> <h3>β‘ Extrapyramidal Side Effects (EPS)</h3> <div class="flowchart"> <b>Timeline of EPS:</b> <div style="margin-top:10px;"> <div class="flow-step"> <div class="flow-box red">Hours-Days: Acute Dystonia</div> <div class="flow-arrow">β</div> <div class="flow-box orange">Days-Weeks: Akathisia</div> <div class="flow-arrow">β</div> <div class="flow-box yellow">Weeks-Months: Parkinsonism</div> <div class="flow-arrow">β</div> <div class="flow-box purple">Months-Years: Tardive Dyskinesia</div> </div> </div> </div> <div class="two-col"> <div class="box box-red"> <h4>Acute Dystonia</h4> <ul> <li>Oculogyric crisis</li> <li>Orolingual dystonia</li> <li>Laryngeal dystonia</li> <li>Limb dystonia</li> </ul> <b>Rx:</b> Anticholinergics / Antihistamines </div> <div class="box box-orange"> <h4>Akathisia</h4> <ul> <li>Inner restlessness</li> <li>Motor movements (βlower limb)</li> <li>β οΈ βRisk of suicide</li> </ul> <b>Rx:</b> Ξ²-blockers (Propranolol M/c), Benzodiazepines </div> </div> <div class="box box-purple"> <h4>Tardive Dyskinesia (TD)</h4> <ul> <li>Involuntary repetitive movements (orofacial M/c)</li> <li>Occurs after months-years of antipsychotic use</li> <li><b>DOC:</b> Valbenazine / Deutetrabenazine (VMAT2 inhibitors)</li> <li>Stop causative drug</li> </ul> </div> <div class="box box-red"> <h4>π‘οΈ Neuroleptic Malignant Syndrome (NMS)</h4> <div class="mnemonic"> <span class="label">Mnemonic: FALTER</span> <table> <tr><td>F</td><td><b>Fever</b> (hyperthermia)</td></tr> <tr><td>A</td><td><b>Autonomic instability</b></td></tr> <tr><td>L</td><td><b>Lead-pipe rigidity</b> (βCK)</td></tr> <tr><td>T</td><td><b>Tremor</b></td></tr> <tr><td>E</td><td><b>Encephalopathy</b> (altered consciousness)</td></tr> <tr><td>R</td><td><b>Rhabdomyolysis</b> (βCK, myoglobinuria)</td></tr> </table> <p style="margin-top:8px;"><b>Rx:</b> Stop antipsychotic + Dantrolene + Bromocriptine + ICU care</p> </div> </div> <h3>π§ Catatonia</h3> <div class="box box-teal"> <b>Etiology:</b> Frontal lobe dysfunction due to mood disorders, schizophrenia, or organic illness<br/> <b>Key Features:</b> <ul> <li>Catalepsy - maintains postures</li> <li>Waxy flexibility</li> <li>Psychological pillow (neck remains elevated without pillow)</li> <li>Automatic obedience, Mutism, Withdrawal</li> </ul> </div> <div class="flowchart"> <b>π Catatonia Management Flowchart:</b> <div style="margin-top:10px;"> <div class="flow-step"> <div class="flow-box teal">Catatonia Suspected</div> <div class="flow-arrow">β</div> <div class="flow-box">Lorazepam Trial</div> <div class="flow-arrow">β</div> <div class="flow-box green">Improves in 48-72h β Continue</div> </div> <div class="flow-step" style="margin-top:8px;"> <div style="width:140px;"></div> <div class="flow-arrow" style="visibility:hidden;">β</div> <div class="flow-box red">No Response β ECT</div> </div> </div> </div> </div> <!-- CHAPTER 4: DEPRESSION --> <div class="chapter" id="ch4"> <div class="chapter-header" style="background:linear-gradient(90deg,#2c3e50,#3498db);"> <h2>π Chapter 4: Mood Disorders - Depression</h2> <div class="subtitle">Core symptoms, specifiers, subtypes</div> </div> <h3>Mood vs. Affect</h3> <div class="two-col"> <div class="box box-blue"><b>Mood:</b> Subjective sustained emotion (over a period of time)</div> <div class="box box-teal"><b>Affect:</b> Current objective state of emotion (cross-sectional, observable)</div> </div> <div class="box box-yellow"> <b>Incongruent affect:</b> Disconnect between thoughts & mood β seen in <b>psychosis</b><br/> <b>Blunted/Flat affect:</b> Seen in schizophrenia & depression </div> <h3>π Core Depressive Symptoms</h3> <div class="mnemonic"> <span class="label">π§ Mnemonic: DIGESCAPS</span> <span class="word">D-I-G-E-S-C-A-P-S</span> <table> <tr><td>D</td><td><b>Depressed affect</b></td></tr> <tr><td>I</td><td><b>Interest β (Anhedonia)</b></td></tr> <tr><td>G</td><td><b>Guilt</b> (pathological)</td></tr> <tr><td>E</td><td><b>Energy β</b></td></tr> <tr><td>S</td><td><b>Sleep problems</b> (terminal insomnia / early morning awakening)</td></tr> <tr><td>C</td><td><b>Concentration issues</b></td></tr> <tr><td>A</td><td><b>Appetite changes</b> (βweight)</td></tr> <tr><td>P</td><td><b>Psychomotor changes</b> (agitation/retardation)</td></tr> <tr><td>S</td><td><b>Suicidal behaviour</b></td></tr> </table> </div> <h3>Objective Signs of Depression</h3> <table class="comparison"> <tr><th>Sign</th><th>Described by</th><th>Appearance</th><th>Muscle involved</th></tr> <tr><td>Omega Sign (Ο)</td><td>Charles Darwin</td><td>Omega-shaped fold at root of nose</td><td>Corrugator muscles</td></tr> <tr><td>Veraguth Fold</td><td>Otto Veraguth</td><td>Triangular fold in upper eyelid</td><td>Palpebral muscles</td></tr> </table> <h3>Depression Subtypes</h3> <div class="three-col"> <div class="card teal"> <h4>Dysthymia</h4> <p>Chronic low mood >2 years. Never meets full MDD criteria.</p> </div> <div class="card purple"> <h4>Double Depression</h4> <p>Patient with dysthymia who develops MDD on top.</p> </div> <div class="card yellow"> <h4>Seasonal Affective Disorder</h4> <p>Depressive episodes in winter. Rx: Phototherapy (light therapy)</p> </div> <div class="card red"> <h4>PMDD</h4> <p>Depressive symptoms before menstruation. βRisk of depression if recurrent.</p> </div> <div class="card"> <h4>Atypical Depression</h4> <p>Hypersomnia, Hyperphagia (carb cravings), Leaden paralysis, Preserved reactivity, Interpersonal sensitivity.<br/><b>Rx: MAOIs > SSRIs. Avoid TCAs.</b></p> </div> <div class="card green"> <h4>Psychotic Depression</h4> <p>Depression + psychotic symptoms (mood-congruent delusions/hallucinations). Rx: Antidepressant + Antipsychotic or ECT</p> </div> </div> </div> <!-- CHAPTER 5: ANTIDEPRESSANTS --> <div class="chapter" id="ch5"> <div class="chapter-header" style="background:linear-gradient(90deg,#27ae60,#2ecc71);"> <h2>π Chapter 5: Antidepressants</h2> <div class="subtitle">Types, MOA, Side Effects, DOC</div> </div> <div class="box box-green"><b>Onset of action for ALL antidepressants:</b> 2-3 weeks (delayed due to downregulation of post-synaptic 5HT receptors)</div> <h3>π Antidepressant Comparison Table</h3> <table class="comparison"> <tr><th>Class</th><th>MOA</th><th>Key Drugs</th><th>Side Effects</th><th>Special Notes</th></tr> <tr><td><b>SSRIs</b></td><td>β5HT (block SERT)</td><td>Fluoxetine, Sertraline, Paroxetine, Escitalopram</td><td>GI distress, sexual dysfunction, vivid dreams, initial βanxiety</td><td>Sertraline = DOC in pregnancy. Paroxetine = max withdrawal. Fluoxetine = least withdrawal</td></tr> <tr><td><b>SNRIs</b></td><td>β5HT + βNE</td><td>Venlafaxine, Duloxetine, Milnacipran</td><td>Hypertension (long-term Venlafaxine). Pain management in fibromyalgia (Duloxetine)</td><td>Duloxetine = DOC for diabetic neuropathy pain</td></tr> <tr><td><b>TCAs</b></td><td>β5HT + βNE (non-selective)</td><td>Amitriptyline, Imipramine, Clomipramine</td><td>Most lethal in OD. Cardiac toxicity. Anticholinergic (ABCD). βSeizure threshold</td><td>TCA overdose Rx: Sodium bicarbonate. Avoid in atypical depression.</td></tr> <tr><td><b>MAOIs</b></td><td>Inhibit MAO β β5HT, NE, DA</td><td>Phenelzine, Tranylcypromine, Moclobemide</td><td>Tyramine reaction (hypertensive crisis with aged cheese, wine)</td><td>DOC for atypical depression. Avoid with SSRIs (serotonin syndrome)</td></tr> </table> <div class="mnemonic"> <span class="label">π§ TCA Anticholinergic Side Effects: Mnemonic "ABCDE"</span> <table> <tr><td>A</td><td><b>Arrhythmia / Anticholinergic effects</b></td></tr> <tr><td>B</td><td><b>Blurred vision</b></td></tr> <tr><td>C</td><td><b>Constipation + dry mouth (Colon + Cottonmouth)</b></td></tr> <tr><td>D</td><td><b>Dizziness / Drowsiness / urinary retention (Drain blocked)</b></td></tr> <tr><td>E</td><td><b>Epileptic seizures (βSeizure threshold)</b></td></tr> </table> </div> <h3>Atypical Antidepressants</h3> <div class="two-col"> <div class="box box-purple"> <h4>Mirtazapine (NaSSA)</h4> <ul><li>MOA: Ξ±2 blocker + 5HT2A/2C/3 antagonist</li><li>SE: Weight gain (5HT2C block), Sedation, Agranulocytosis</li><li>Advantage: No sexual dysfunction</li></ul> </div> <div class="box box-teal"> <h4>Trazodone</h4> <ul><li>SE: Priapism (painful prolonged erection) β οΈ</li><li>Used for insomnia in depression</li></ul> </div> </div> <div class="box box-blue"> <h4>Newer Antidepressants</h4> <ul> <li><b>Vilazodone:</b> 5HT1A partial agonist + SSRI</li> <li><b>Vortioxetine:</b> Multimodal serotonergic agent. Procognitive effects (5HT7 antagonist). Used in depression with cognitive symptoms.</li> </ul> </div> <h3>β οΈ Serotonin Syndrome</h3> <div class="box box-red"> <b>Cause:</b> ββSerotonin (usually drug combinations - SSRI + MAOI, SSRI + Tramadol, etc.)<br/> <div class="mnemonic" style="margin-top:10px;"> <span class="label">Mnemonic: "SEROTONIN" - Symptoms Triad</span> <ul> <li>π₯ <b>Autonomic instability</b> - fever, sweating, tachycardia, hypertension</li> <li>π€Έ <b>Neuromuscular changes</b> - clonus (M/c distinguishing feature), tremor, hyperreflexia, ataxia</li> <li>π§ <b>Altered mental status</b> - agitation, confusion</li> </ul> <p><b>Rx:</b> Cyproheptadine (5HT2 antagonist) + supportive care</p> </div> <div class="box box-yellow" style="margin-top:8px;"> <b>β‘ SS vs NMS Quick Comparison:</b><br/> SS: Rapid onset (hours), clonus, hyperreflexia, diarrhea<br/> NMS: Slow onset (days), lead-pipe rigidity, bradyreflexia, caused by antipsychotics </div> </div> </div> <!-- CHAPTER 6: MANIA & BIPOLAR --> <div class="chapter" id="ch6"> <div class="chapter-header" style="background:linear-gradient(90deg,#e67e22,#f39c12);"> <h2>β‘ Chapter 6: Mania & Bipolar Disorder</h2> <div class="subtitle">Criteria, subtypes, mood stabilizers</div> </div> <h3>Manic Episode Symptoms</h3> <div class="mnemonic"> <span class="label">π§ Mnemonic: DIG FAST</span> <span class="word">D-I-G-F-A-S-T</span> <table> <tr><td>D</td><td><b>Distractibility</b></td></tr> <tr><td>I</td><td><b>Impulsivity / Irresponsibility</b></td></tr> <tr><td>G</td><td><b>Grandiosity</b></td></tr> <tr><td>F</td><td><b>Flight of ideas</b> (thoughts racing)</td></tr> <tr><td>A</td><td><b>Activity β (Hyperactivity) / Agitation</b></td></tr> <tr><td>S</td><td><b>Sleep β</b> (without fatigue)</td></tr> <tr><td>T</td><td><b>Talkativeness</b> (pressured speech)</td></tr> </table> <p style="margin-top:8px;">Duration for diagnosis: <b>Mania β₯7 days</b> | <b>Hypomania β₯4 days</b></p> </div> <h3>Bipolar Types</h3> <table class="comparison"> <tr><th>Type</th><th>Episodes</th><th>Psychosis?</th></tr> <tr><td>Bipolar I</td><td>Mania + (may have) Depression</td><td>Possible in mania</td></tr> <tr><td>Bipolar II</td><td>Hypomania + Depression</td><td>No (by definition)</td></tr> <tr><td>Cyclothymia</td><td>Hypomanic + Depressive symptoms >2 years (sub-threshold)</td><td>No</td></tr> <tr><td>Rapid cycling</td><td>β₯4 episodes/year</td><td>Variable</td></tr> </table> <h3>π Mood Stabilizers</h3> <table class="comparison"> <tr><th>Drug</th><th>DOC for</th><th>Side Effects</th><th>Monitoring</th></tr> <tr><td><b>Lithium</b></td><td>Bipolar (classic), mania, suicide prevention</td><td>Tremor, polyuria/polydipsia (nephrogenic DI), hypothyroidism, cardiac (T-wave changes), teratogen (Ebstein's anomaly)</td><td>Serum level (narrow therapeutic index: 0.6-1.2 mEq/L). Monitor TFT, renal function.</td></tr> <tr><td><b>Valproate</b></td><td>Rapid cycling bipolar, mixed states, seizures</td><td>Weight gain, hair loss, tremor, hepatotoxicity, teratogen (neural tube defects)</td><td>LFTs, CBC. Avoid in pregnancy.</td></tr> <tr><td><b>Carbamazepine</b></td><td>Bipolar + partial seizures, trigeminal neuralgia</td><td>Diplopia, ataxia, SIADH, Stevens-Johnson, agranulocytosis, induces CYP450</td><td>CBC, LFTs. Drug interactions (enzyme inducer).</td></tr> <tr><td><b>Lamotrigine</b></td><td>Bipolar depression (best for depressive phase)</td><td>Stevens-Johnson syndrome (start low, go slow)</td><td>Rash monitoring</td></tr> </table> <div class="box box-red"> <b>β οΈ Lithium Toxicity Signs:</b> Coarse tremor, ataxia, vomiting, drowsiness, seizures, confusion<br/> <b>Rx:</b> Stop lithium, hydration, dialysis in severe cases<br/> <b>NSAIDs + Lithium</b> = βLithium toxicity (NSAIDs βrenal clearance) β οΈ </div> </div> <!-- CHAPTER 7: STRESS DISORDERS --> <div class="chapter" id="ch7"> <div class="chapter-header" style="background:linear-gradient(90deg,#7f8c8d,#95a5a6);"> <h2>π° Chapter 7: Stress-Related Disorders</h2> <div class="subtitle">PTSD, Acute Stress Reaction, Adjustment Disorder</div> </div> <table class="comparison"> <tr><th>Feature</th><th>Acute Stress Reaction</th><th>PTSD</th><th>Adjustment Disorder</th></tr> <tr><td>Onset after stressor</td><td>Within hours</td><td>Within 3 months (may be delayed)</td><td>Within 1 month</td></tr> <tr><td>Duration</td><td><1 month</td><td>>1 month (symptoms)</td><td><6 months (after stressor ends)</td></tr> <tr><td>Stressor type</td><td>Extreme/traumatic</td><td>Extreme/traumatic</td><td>Any identifiable stressor</td></tr> </table> <h3>PTSD Symptoms (4 clusters)</h3> <div class="mnemonic"> <span class="label">π§ Mnemonic: "FINE"</span> <table> <tr><td>F</td><td><b>Flashbacks</b> (intrusion / re-experiencing)</td></tr> <tr><td>I</td><td><b>Increased arousal</b> (hyperarousal, exaggerated startle, nightmares)</td></tr> <tr><td>N</td><td><b>Numbing / Negative mood</b> (emotional numbness, anhedonia)</td></tr> <tr><td>E</td><td><b>Evasion / Avoidance</b> (avoidance of triggers)</td></tr> </table> <p style="margin-top:8px;"><b>Duration:</b> β₯4 weeks for PTSD diagnosis</p> </div> <h3>Treatment</h3> <div class="two-col"> <div class="box box-blue"> <h4>Pharmacologic</h4> <ul><li>SSRIs / SNRIs (first-line)</li><li>Prazosin (Ξ±1-blocker) β for nightmares specifically</li></ul> </div> <div class="box box-green"> <h4>Psychologic</h4> <ul><li>CBT (Best overall)</li><li>EMDR (Eye Movement Desensitization & Reprocessing) β Most SPECIFIC for PTSD</li></ul> </div> </div> </div> <!-- CHAPTER 8: ANXIETY --> <div class="chapter" id="ch8"> <div class="chapter-header" style="background:linear-gradient(90deg,#c0392b,#e74c3c);"> <h2>π Chapter 8: Anxiety Disorders</h2> <div class="subtitle">GAD, Panic, Phobias, Social Anxiety</div> </div> <h3>State vs. Trait Anxiety</h3> <div class="two-col"> <div class="box box-blue"><b>State anxiety:</b> Anxiety in response to a specific situation β quicker recovery</div> <div class="box box-purple"><b>Trait anxiety:</b> Chronic baseline anxiety β prone to recurrence</div> </div> <h3>Anxiety Disorder Summary</h3> <table class="comparison"> <tr><th>Disorder</th><th>Key Features</th><th>Duration</th><th>Rx</th></tr> <tr><td><b>GAD</b> (M/c anxiety disorder)</td><td>Free-floating anxiety, motor tension, irritability, sleep disturbance. Females > Males</td><td>>6 months</td><td>SSRIs/SNRIs, Pregabalin, Buspirone (5HT1A agonist - no GABA), CBT</td></tr> <tr><td><b>Panic Disorder</b></td><td>De novo recurrent panic attacks (5-15 min), anticipatory anxiety, Β± agoraphobia</td><td>Recurrent</td><td>SSRIs/SNRIs. BZDs for acute attacks.</td></tr> <tr><td><b>Social Anxiety</b></td><td>Fear of social situations, embarrassment. AKA Social phobia</td><td>Chronic</td><td>SSRIs, beta-blockers (for performance anxiety)</td></tr> <tr><td><b>Specific Phobia</b></td><td>Irrational fear of specific object/situation</td><td>Chronic</td><td>Systematic desensitization (gold standard)</td></tr> </table> <div class="mnemonic"> <span class="label">π§ Specific Phobia Types: Mnemonic "BANSO"</span> <table> <tr><td>B</td><td><b>Blood-injection-injury</b></td></tr> <tr><td>A</td><td><b>Animal</b></td></tr> <tr><td>N</td><td><b>Natural environment</b> (storms, heights)</td></tr> <tr><td>S</td><td><b>Situational</b> (elevators, flying)</td></tr> <tr><td>O</td><td><b>Other</b></td></tr> </table> </div> <h3>Panic Attack Triggers</h3> <div class="box box-yellow"> <b>Remember "3C's + more":</b> Caffeine, Cannabis, Cocaine, CO2/Lactate, Cholecystokinin, Nicotine, Theophylline, Flumazenil, Yohimbine </div> <h3>Behavioural Therapies for Anxiety</h3> <table class="comparison"> <tr><th>Therapy</th><th>Method</th><th>Best for</th></tr> <tr><td>Systematic Desensitization</td><td>Graded exposure + relaxation (slowest)</td><td>Specific phobias (Gold standard)</td></tr> <tr><td>Flooding (Implosion therapy)</td><td>Immediate full exposure to feared stimulus</td><td>When quick result needed</td></tr> <tr><td>JPMR</td><td>Jacobson's Progressive Muscle Relaxation</td><td>GAD, general anxiety</td></tr> <tr><td>CBT</td><td>Cognitive restructuring + behavioral techniques</td><td>All anxiety disorders</td></tr> </table> </div> <!-- CHAPTER 9: OCD --> <div class="chapter" id="ch9"> <div class="chapter-header" style="background:linear-gradient(90deg,#e67e22,#d35400);"> <h2>π Chapter 9: OCD & Related Disorders</h2> <div class="subtitle">OCD spectrum | Body dysmorphic disorder | Hoarding</div> </div> <h3>OCD - Key Points</h3> <div class="two-col"> <div class="box box-orange"> <h4>Obsessions (EGO-DYSTONIC)</h4> <ul><li>Intrusive, unwanted, persistent thoughts/images/urges</li><li>Patient recognizes them as unreasonable</li><li>Causes significant anxiety</li></ul> </div> <div class="box box-yellow"> <h4>Compulsions</h4> <ul><li>Repetitive behaviors/mental acts to reduce anxiety</li><li>Not pleasurable (unlike addictions)</li><li>Temporary relief only</li></ul> </div> </div> <div class="box box-blue"> <b>Most common:</b> Contamination obsessions + Washing compulsions<br/> <b>Pathology:</b> Dysfunction of orbitofrontal cortex - caudate nucleus - thalamus circuit (βserotonin dysfunction) </div> <h3>Treatment</h3> <div class="two-col"> <div class="box box-green"> <h4>Pharmacologic</h4> <ul><li><b>SSRIs</b> (1st line): Higher doses needed than for depression</li><li><b>Clomipramine</b> (TCA - most serotonergic TCA): If SSRI fails</li></ul> </div> <div class="box box-teal"> <h4>Psychotherapy</h4> <ul><li><b>ERP (Exposure & Response Prevention)</b> = Gold standard psychotherapy</li><li>CBT</li></ul> </div> </div> <h3>OCD Spectrum Disorders</h3> <table class="comparison"> <tr><th>Disorder</th><th>Key Feature</th><th>Rx</th></tr> <tr><td>Body Dysmorphic Disorder</td><td>Preoccupation with imagined defect in appearance. βSuicide risk.</td><td>SSRIs + CBT</td></tr> <tr><td>Hoarding Disorder</td><td>Difficulty discarding items, extreme clutter. Ego-syntonic.</td><td>CBT, SSRIs</td></tr> <tr><td>Trichotillomania</td><td>Compulsive hair pulling</td><td>CBT (HRT), N-Acetylcysteine</td></tr> <tr><td>Excoriation Disorder</td><td>Compulsive skin picking</td><td>CBT, SSRIs</td></tr> </table> </div> <!-- CHAPTER 10: SOMATIC --> <div class="chapter" id="ch10"> <div class="chapter-header" style="background:linear-gradient(90deg,#6c3483,#9b59b6);"> <h2>π₯ Chapter 10: Somatic Symptom Disorders</h2> <div class="subtitle">Somatization, conversion, factitious, malingering</div> </div> <table class="comparison"> <tr><th>Disorder</th><th>Key Feature</th><th>Conscious?</th><th>Goal?</th></tr> <tr><td><b>Somatic Symptom Disorder</b></td><td>Physical symptoms + excessive thoughts about them</td><td>No (unconscious)</td><td>No external gain</td></tr> <tr><td><b>Illness Anxiety (Hypochondriasis)</b></td><td>Fear of having a serious illness despite reassurance</td><td>No</td><td>No external gain</td></tr> <tr><td><b>Conversion Disorder (FND)</b></td><td>Neurological symptoms without neurological cause (paralysis, blindness, seizures). "La belle indifference"</td><td>No</td><td>No external gain</td></tr> <tr><td><b>Factitious Disorder (Munchausen)</b></td><td>Deliberately produces symptoms for sick role (internal gain)</td><td>YES</td><td>Sick role (internal)</td></tr> <tr><td><b>Malingering</b></td><td>Deliberately fakes illness for external gain (money, avoiding jail)</td><td>YES</td><td>External gain</td></tr> </table> <div class="example"> <div class="label">π NEET PG Exam Pattern:</div> A patient exaggerates symptoms to avoid military service β <b>Malingering</b><br/> A patient repeatedly gets admitted to hospitals across cities and feigns illness for attention β <b>Munchausen syndrome (Factitious)</b><br/> Munchausen by proxy β Parent induces illness in child </div> <div class="box box-purple"> <h4>Ganser Syndrome</h4> <ul><li>Approximate answers (e.g., 2+2=5)</li><li>Seen in prisoners, forensic settings</li><li>Pseudohallucinations + clouding of consciousness</li></ul> </div> </div> <!-- CHAPTER 11: DISSOCIATIVE --> <div class="chapter" id="ch11"> <div class="chapter-header" style="background:linear-gradient(90deg,#1abc9c,#16a085);"> <h2>π«οΈ Chapter 11: Dissociative Disorders</h2> <div class="subtitle">Amnesia, fugue, depersonalization, DID</div> </div> <table class="comparison"> <tr><th>Disorder</th><th>Key Feature</th></tr> <tr><td>Dissociative Amnesia</td><td>Cannot recall personal information (autobiographical). Retrograde > anterograde.</td></tr> <tr><td>Dissociative Fugue</td><td>Amnesia + unplanned travel + new identity assumed</td></tr> <tr><td>Depersonalization-Derealization Disorder</td><td>Feeling detached from self (depersonalization) or surroundings (derealization). Reality testing intact.</td></tr> <tr><td>DID (Multiple Personality Disorder)</td><td>Two or more distinct personality states. Associated with severe childhood trauma.</td></tr> </table> <div class="box box-teal"> <b>Key Differentiation:</b> In dissociative disorders, reality testing is INTACT (unlike psychosis). Patient knows what is real. </div> </div> <!-- CHAPTER 12: EATING DISORDERS --> <div class="chapter" id="ch12"> <div class="chapter-header" style="background:linear-gradient(90deg,#e91e63,#c2185b);"> <h2>π½οΈ Chapter 12: Eating & Feeding Disorders</h2> <div class="subtitle">Anorexia, Bulimia, Binge eating</div> </div> <table class="comparison"> <tr><th>Feature</th><th>Anorexia Nervosa</th><th>Bulimia Nervosa</th><th>Binge Eating Disorder</th></tr> <tr><td>Body weight</td><td>ββ (BMI <17.5)</td><td>Normal/slightly β</td><td>β (Obese)</td></tr> <tr><td>Core feature</td><td>Restriction of intake + distorted body image</td><td>Binge-purge cycles</td><td>Binge without purge</td></tr> <tr><td>Amenorrhea</td><td>Yes (if <47 kg)</td><td>Sometimes</td><td>No</td></tr> <tr><td>Mortality</td><td>Highest of all psych disorders (cardiac arrhythmias)</td><td>Lower</td><td>Lower</td></tr> <tr><td>Rx</td><td>Nutritional rehabilitation + CBT + SSRI (only for comorbidities)</td><td>CBT (gold std) + Fluoxetine (only FDA-approved drug)</td><td>CBT + Lisdexamfetamine (only FDA-approved)</td></tr> </table> <div class="box box-red"> <h4>Anorexia Nervosa - Lab Findings (Purging type)</h4> <ul> <li>Hypokalemia (M/c electrolyte abnormality)</li> <li>Metabolic alkalosis (from vomiting)</li> <li>Hypoglycemia, βLH/FSH, βT3/T4</li> <li>Russel's sign: Calluses on knuckles (from self-induced vomiting)</li> </ul> </div> </div> <!-- CHAPTER 13: SLEEP --> <div class="chapter" id="ch13"> <div class="chapter-header" style="background:linear-gradient(90deg,#3498db,#2980b9);"> <h2>π΄ Chapter 13: Sleep Disorders</h2> <div class="subtitle">Insomnia, parasomnias, narcolepsy, sleep stages</div> </div> <h3>Sleep Architecture</h3> <div class="mnemonic"> <span class="label">π§ Sleep Stages - Key Facts</span> <table> <tr><td>Stage N1</td><td>Theta waves, hypnic jerks, transition</td></tr> <tr><td>Stage N2</td><td>Sleep spindles + K-complexes (M/c stage in normal sleep)</td></tr> <tr><td>Stage N3</td><td>Slow-wave / Deep sleep (Delta waves) - Parasomnias occur here</td></tr> <tr><td>REM sleep</td><td>Rapid eye movements, dreaming, penile erection, muscle atonia</td></tr> </table> <p style="margin-top:8px;"><b>First REM sleep:</b> ~90 min after sleep onset | REM β as night progresses</p> </div> <h3>Sleep Disorders Summary</h3> <table class="comparison"> <tr><th>Disorder</th><th>Sleep Stage</th><th>Key Features</th><th>Rx</th></tr> <tr><td>Somnambulism (Sleepwalking)</td><td>N3 (SWS)</td><td>Eyes open, unresponsive, amnesia next day</td><td>Safety measures, Clonazepam</td></tr> <tr><td>Sleep Terror (Pavor nocturnus)</td><td>N3 (SWS)</td><td>Screaming, terror, amnesia. Worse than nightmares</td><td>Self-limiting. Clonazepam if severe</td></tr> <tr><td>Nightmares</td><td>REM</td><td>Frightening dreams, full recall on awakening</td><td>CBT, Prazosin</td></tr> <tr><td>REM Sleep Behavior Disorder</td><td>REM (loss of atonia)</td><td>Acts out dreams, may injure partner. βrisk of Parkinson's/LBD.</td><td>Clonazepam (DOC), Melatonin</td></tr> <tr><td>Narcolepsy</td><td>Abnormal REM</td><td>Excessive daytime sleepiness, cataplexy, sleep paralysis, hypnagogic hallucinations. βOrexin/Hypocretin</td><td>Modafinil/Sodium oxybate for sleepiness; SSRIs for cataplexy</td></tr> </table> <div class="mnemonic"> <span class="label">π§ Narcolepsy Tetrad: "CASH"</span> <table> <tr><td>C</td><td><b>Cataplexy</b> (sudden loss of muscle tone triggered by emotion)</td></tr> <tr><td>A</td><td><b>Automatic behavior</b></td></tr> <tr><td>S</td><td><b>Sleep paralysis</b> (can't move on waking/sleeping)</td></tr> <tr><td>H</td><td><b>Hypnagogic hallucinations</b> (on sleep onset) / Hypnopompic (on waking)</td></tr> </table> </div> </div> <!-- CHAPTER 14: SEXUAL DISORDERS --> <div class="chapter" id="ch14"> <div class="chapter-header" style="background:linear-gradient(90deg,#9b59b6,#8e44ad);"> <h2>π Chapter 14: Sexual Disorders & Gender Identity</h2> <div class="subtitle">Paraphilias, dysfunction, gender dysphoria</div> </div> <h3>Sexual Dysfunctions</h3> <table class="comparison"> <tr><th>Phase</th><th>Dysfunction</th></tr> <tr><td>Desire</td><td>Hypoactive sexual desire disorder</td></tr> <tr><td>Arousal</td><td>Erectile disorder (male) / Female sexual arousal disorder</td></tr> <tr><td>Orgasm</td><td>Anorgasmia / Delayed ejaculation / Premature ejaculation</td></tr> <tr><td>Pain</td><td>Genito-pelvic pain/penetration disorder (vaginismus/dyspareunia)</td></tr> </table> <h3>Paraphilias (require distress or harm to others for disorder)</h3> <table class="comparison"> <tr><th>Paraphilia</th><th>Description</th></tr> <tr><td>Exhibitionism</td><td>Exposing genitals to unsuspecting stranger</td></tr> <tr><td>Voyeurism/Peeping Tom</td><td>Watching others undress/sexual acts. Diagnosed only if >18 yrs.</td></tr> <tr><td>Pedophilia</td><td>Sexual activity with prepubescent children (<13 years)</td></tr> <tr><td>Sadism</td><td>Inflicting pain/humiliation on others for sexual gratification</td></tr> <tr><td>Masochism</td><td>Self-inflicting pain for sexual gratification</td></tr> <tr><td>Transvestic Fetishism</td><td>Wearing opposite gender's clothes for sexual arousal</td></tr> <tr><td>Frotteurism</td><td>Rubbing against non-consenting person</td></tr> </table> <div class="box box-purple"> <b>Gender Dysphoria (DSM) / Gender Incongruence (ICD-11):</b><br/> Disconnect between perceived gender and assigned gender at birth.<br/> Gender identity develops at <b>3-6 years</b>.<br/> Cross-dressing alone = NOT a sexual paraphilia </div> </div> <!-- CHAPTER 15: PERSONALITY DISORDERS --> <div class="chapter" id="ch15"> <div class="chapter-header" style="background:linear-gradient(90deg,#2c3e50,#34495e);"> <h2>π Chapter 15: Personality Disorders</h2> <div class="subtitle">Cluster A/B/C | DSM vs ICD-11</div> </div> <div class="mnemonic"> <span class="label">π§ Cluster ABC Mnemonic: "A = Weird, B = Wild, C = Worried"</span> <table> <tr><td><b>Cluster A</b> (Odd/Eccentric)</td><td>Paranoid, Schizoid, Schizotypal PD | Schizotypal β risk for Schizophrenia</td></tr> <tr><td><b>Cluster B</b> (Emotional/Dramatic)</td><td>Borderline (EUPD), Histrionic, Narcissistic, Antisocial PD | Borderline β Dialectical Behavior Therapy (DBT)</td></tr> <tr><td><b>Cluster C</b> (Anxious/Fearful)</td><td>Obsessive-Compulsive (Anankastic), Dependent, Anxious-Avoidant PD | OC PD β prone to depression</td></tr> </table> </div> <div class="mindmap"> <div class="center">BORDERLINE PD (BPD/EUPD)</div> <div class="branches"> <div class="branch">Unstable relationships</div> <div class="branch">Identity disturbance</div> <div class="branch">Impulsivity</div> <div class="branch">Suicidal/self-harm</div> <div class="branch">Affective instability</div> <div class="branch">Chronic emptiness</div> <div class="branch">Paranoid ideation</div> <div class="branch">Splitting (black & white)</div> </div> <p style="margin-top:12px;font-weight:700;color:var(--purple);">Rx: Dialectical Behavior Therapy (DBT) = Gold Standard</p> </div> <h3>Big 5 Personality Traits</h3> <div class="mnemonic"> <span class="label">π§ Mnemonic: OCEAN</span> <table> <tr><td>O</td><td><b>Openness</b></td></tr> <tr><td>C</td><td><b>Conscientiousness</b></td></tr> <tr><td>E</td><td><b>Extraversion</b></td></tr> <tr><td>A</td><td><b>Agreeableness</b></td></tr> <tr><td>N</td><td><b>Neuroticism</b></td></tr> </table> </div> <div class="box box-teal"> <b>ICD-11 Update:</b> No more named personality disorders. Now classified by severity (mild/moderate/severe) + 5 trait domains:<br/> Negative Affectivity | Detachment | Disinhibition | Dissocial | Anankastia </div> </div> <!-- CHAPTER 16: NEURODEVELOPMENTAL --> <div class="chapter" id="ch16"> <div class="chapter-header" style="background:linear-gradient(90deg,#00897b,#00796b);"> <h2>π§ Chapter 16: Neurodevelopmental Disorders</h2> <div class="subtitle">ADHD, ASD, Intellectual Disability, Learning Disorders</div> </div> <h3>HEADSSS Assessment (Adolescent psychosocial history)</h3> <div class="mnemonic"> <span class="label">Mnemonic: HEADSSS</span> <table> <tr><td>H</td><td><b>Home</b> (structure/environment)</td></tr> <tr><td>E</td><td><b>Education</b> (school regularity)</td></tr> <tr><td>A</td><td><b>Activities</b> (extracurricular)</td></tr> <tr><td>D</td><td><b>Drugs/alcohol use</b></td></tr> <tr><td>S</td><td><b>Sexuality</b></td></tr> <tr><td>S</td><td><b>Suicidality</b></td></tr> <tr><td>S</td><td><b>Safety</b> (abuse, violence)</td></tr> </table> </div> <h3>ADHD</h3> <div class="two-col"> <div class="box box-blue"> <h4>Key Features</h4> <ul> <li>Inattention + Hyperactivity + Impulsivity</li> <li>Symptoms present in β₯2 settings</li> <li>Onset before age 12 (DSM-5)</li> <li>More common in males (3:1)</li> </ul> </div> <div class="box box-green"> <h4>Treatment</h4> <ul> <li><b>Stimulants (1st line):</b> Methylphenidate, Amphetamines</li> <li><b>Non-stimulant:</b> Atomoxetine (NE reuptake inhibitor), Guanfacine, Clonidine</li> <li><b>Behavioral therapy</b> in preschool age</li> </ul> </div> </div> <h3>Autism Spectrum Disorder (ASD)</h3> <div class="box box-purple"> <h4>Core Features (DSM-5)</h4> <ul> <li>Persistent deficits in social communication & interaction (3 domains)</li> <li>Restricted, repetitive behaviors/interests (2+ domains)</li> <li>Symptoms from early developmental period</li> </ul> <b>Rx:</b> Applied Behavior Analysis (ABA therapy) - Gold standard. No drug cures ASD; risperidone/aripiprazole for behavioral symptoms. </div> <h3>Intellectual Disability (ID)</h3> <table class="comparison"> <tr><th>Severity</th><th>IQ Range</th><th>Mental Age</th><th>Education potential</th></tr> <tr><td>Mild</td><td>50-69</td><td>9-12 yrs</td><td>Educable (up to 6th grade)</td></tr> <tr><td>Moderate</td><td>35-49</td><td>6-9 yrs</td><td>Trainable</td></tr> <tr><td>Severe</td><td>20-34</td><td>3-6 yrs</td><td>Can do simple tasks</td></tr> <tr><td>Profound</td><td><20</td><td><3 yrs</td><td>Needs full care</td></tr> </table> </div> <!-- CHAPTER 17: SUBSTANCE USE --> <div class="chapter" id="ch17"> <div class="chapter-header" style="background:linear-gradient(90deg,#d32f2f,#b71c1c);"> <h2>π Chapter 17: Substance Use Disorders</h2> <div class="subtitle">Alcohol, opioids, stimulants, cannabis</div> </div> <h3>Alcohol Use Disorder</h3> <div class="flowchart"> <b>Alcohol Withdrawal Timeline:</b> <div style="margin-top:10px;"> <div class="flow-step"> <div class="flow-box orange">6-24h: Tremor, anxiety, diaphoresis, tachycardia</div> <div class="flow-arrow">β</div> <div class="flow-box yellow">24-48h: Seizures (Grand mal)</div> <div class="flow-arrow">β</div> <div class="flow-box red">48-72h: Delirium Tremens (DTs)</div> </div> </div> <p style="margin-top:10px;"><b>Rx:</b> Benzodiazepines (DOC for all stages). Long-acting BZDs (Diazepam/Chlordiazepoxide) preferred.</p> </div> <div class="box box-red"> <h4>Delirium Tremens (DTs) - Medical Emergency</h4> <ul> <li>Confusion, agitation, visual hallucinations (M/c hallucination in alcohol withdrawal)</li> <li>Autonomic instability (fever, tachycardia, hypertension, diaphoresis)</li> <li>Mortality: 5-15% if untreated</li> <li><b>Rx:</b> IV Diazepam/Lorazepam + thiamine (Wernicke's prevention) + supportive care</li> </ul> </div> <h3>Alcohol Use - Special Syndromes</h3> <table class="comparison"> <tr><th>Syndrome</th><th>Deficiency</th><th>Features</th><th>Rx</th></tr> <tr><td>Wernicke's Encephalopathy</td><td>Thiamine (B1)</td><td>Triad: Ophthalmoplegia + Ataxia + Confusion. GIVE THIAMINE BEFORE GLUCOSE!</td><td>IV Thiamine</td></tr> <tr><td>Korsakoff Psychosis</td><td>Thiamine (B1) - chronic</td><td>Anterograde amnesia + confabulation + disorientation. Often irreversible.</td><td>Thiamine (may be irreversible)</td></tr> <tr><td>Alcoholic Hallucinosis</td><td>-</td><td>Auditory hallucinations DURING intoxication (clear consciousness)</td><td>Antipsychotics</td></tr> <tr><td>Fetal Alcohol Syndrome</td><td>-</td><td>IUGR, microcephaly, heart defects, intellectual disability, characteristic facies</td><td>Prevention</td></tr> </table> <h3>Opioid Use Disorder</h3> <div class="two-col"> <div class="box box-red"> <h4>Opioid Overdose (Triad)</h4> <ul> <li>Coma/unconsciousness</li> <li>Respiratory depression</li> <li>Pinpoint pupils (miosis)</li> </ul> <b>Rx:</b> Naloxone (ΞΌ antagonist) - DOC </div> <div class="box box-green"> <h4>Opioid Withdrawal Symptoms</h4> <ul> <li>Rhinorrhea, lacrimation, yawning</li> <li>Piloerection (gooseflesh)</li> <li>Diarrhea, vomiting</li> <li>Restlessness, anxiety</li> </ul> <p><i>Opposite of intoxication!</i></p> </div> </div> <h3>Opioid Dependence Treatment</h3> <table class="comparison"> <tr><th>Drug</th><th>Class</th><th>Notes</th></tr> <tr><td>Naltrexone</td><td>ΞΌ antagonist (oral & depot)</td><td>βCraving. Depot every 3 months. No abuse potential.</td></tr> <tr><td>Methadone</td><td>Long-acting ΞΌ agonist</td><td>Harm reduction. Habit forming. Supervised dispensing.</td></tr> <tr><td>Buprenorphine</td><td>Partial ΞΌ agonist</td><td>βHarm reduction, βhabit forming. Ceiling effect on respiratory depression.</td></tr> <tr><td>Buprenorphine + Naloxone</td><td>Partial agonist + antagonist</td><td>Currently used. Naloxone prevents IV misuse.</td></tr> </table> <h3>Nicotine Cessation</h3> <div class="three-col"> <div class="card green"><h4>Nicotine Replacement</h4><p>Patches, gum (chew & park method), lozenges, inhalers</p></div> <div class="card blue"><h4>Bupropion</h4><p>βCraving. Avoid in seizure disorders. SE: βseizure threshold</p></div> <div class="card teal"><h4>Varenicline</h4><p>Ξ±4Ξ²2 nicotinic partial agonist. Most effective. Monitor mood changes.</p></div> </div> </div> <!-- CHAPTER 18: NEUROCOGNITIVE / DEMENTIA --> <div class="chapter" id="ch18"> <div class="chapter-header" style="background:linear-gradient(90deg,#455a64,#546e7a);"> <h2>π§ Chapter 18: Neurocognitive Disorders</h2> <div class="subtitle">Delirium vs. Dementia | Alzheimer's | Other dementias</div> </div> <h3>Delirium vs. Dementia</h3> <table class="comparison"> <tr><th>Feature</th><th>π΄ Delirium</th><th>π΅ Dementia</th></tr> <tr><td>Onset</td><td>Acute (hours-days)</td><td>Insidious (months-years)</td></tr> <tr><td>Course</td><td>Fluctuating</td><td>Progressive</td></tr> <tr><td>Consciousness</td><td>Clouded</td><td>Clear (until late stages)</td></tr> <tr><td>Attention</td><td>Severely impaired</td><td>Relatively preserved early</td></tr> <tr><td>Reversible?</td><td>Usually YES (treat cause)</td><td>Usually NO</td></tr> <tr><td>Hallucinations</td><td>Common (visual)</td><td>Less common</td></tr> </table> <h3>Dementia Types</h3> <table class="comparison"> <tr><th>Type</th><th>Key Features</th><th>Pathology</th></tr> <tr><td><b>Alzheimer's</b> (M/c)</td><td>Memory loss (anterograde first), language, executive function. Gradual.</td><td>Amyloid plaques, neurofibrillary tangles. βACh</td></tr> <tr><td><b>Vascular (Multi-infarct)</b></td><td>Stepwise decline. CVD risk factors. Focal neuro deficits.</td><td>Multiple cortical/subcortical infarcts</td></tr> <tr><td><b>Lewy Body (DLB)</b></td><td>Fluctuating cognition + visual hallucinations + Parkinsonism. REM sleep behavior disorder. Sensitive to antipsychotics.</td><td>Alpha-synuclein Lewy bodies</td></tr> <tr><td><b>Frontotemporal (FTD/Pick's)</b></td><td>Personality/behavior change first (disinhibition, apathy). Relatively preserved memory early.</td><td>Pick bodies (tau). Frontal/temporal atrophy.</td></tr> </table> <div class="box box-green"> <h4>Alzheimer's Treatment</h4> <ul> <li><b>Mild-moderate:</b> Donepezil, Rivastigmine, Galantamine (AChE inhibitors)</li> <li><b>Moderate-severe:</b> + Memantine (NMDA antagonist)</li> <li><b>BPSD:</b> Risperidone/Quetiapine (cautiously)</li> </ul> </div> </div> <!-- CHAPTER 19: ECT & BIOLOGICAL THERAPIES --> <div class="chapter" id="ch19"> <div class="chapter-header" style="background:linear-gradient(90deg,#f57c00,#ef6c00);"> <h2>β‘ Chapter 19: ECT & Biological Therapies</h2> <div class="subtitle">ECT, TMS, DBS, Light therapy</div> </div> <h3>Electroconvulsive Therapy (ECT)</h3> <div class="box box-yellow"> <h4>Indications (NEET PG high yield)</h4> <ul> <li>Severe/Psychotic depression (Most common indication)</li> <li>Suicidal risk requiring rapid response</li> <li>Treatment-resistant depression (failed 2+ drugs)</li> <li>Catatonia (not responding to Lorazepam)</li> <li>Mania (medication-resistant)</li> <li>Depression in pregnancy (safer than drugs)</li> <li>NMS (when other treatments fail)</li> </ul> </div> <div class="two-col"> <div class="box box-green"> <h4>Procedure</h4> <ul> <li>General anesthesia + muscle relaxant (succinylcholine)</li> <li>Electrical stimulus β brief generalized seizure</li> <li>Bilateral (more effective) vs. unilateral (fewer cognitive SE)</li> <li>Typical course: 6-12 sessions (3x/week)</li> </ul> </div> <div class="box box-red"> <h4>Side Effects</h4> <ul> <li>Anterograde & retrograde amnesia (most common)</li> <li>Confusion (post-ictal)</li> <li>Headache, myalgia</li> <li><b>No absolute contraindications</b> (only relative)</li> </ul> </div> </div> <h3>Other Biological Therapies</h3> <table class="comparison"> <tr><th>Therapy</th><th>Indication</th><th>Notes</th></tr> <tr><td>TMS (Transcranial Magnetic Stimulation)</td><td>Treatment-resistant depression</td><td>Non-invasive, outpatient, no anesthesia needed</td></tr> <tr><td>Deep Brain Stimulation (DBS)</td><td>Treatment-resistant OCD, depression</td><td>Invasive surgical procedure</td></tr> <tr><td>Phototherapy (Light therapy)</td><td>Seasonal Affective Disorder</td><td>10,000 lux for 30 min in the morning</td></tr> <tr><td>rTMS</td><td>Depression, OCD</td><td>Repetitive TMS</td></tr> </table> </div> <!-- CHAPTER 20: PSYCHOTHERAPY --> <div class="chapter" id="ch20"> <div class="chapter-header" style="background:linear-gradient(90deg,#6a1b9a,#7b1fa2);"> <h2>ποΈ Chapter 20: Psychotherapy, Defense Mechanisms & Freud</h2> <div class="subtitle">Models of mind, defense mechanisms, psychotherapy types</div> </div> <h3>Freud's Models of Mind</h3> <div class="two-col"> <div class="box box-purple"> <h4>Structural Theory</h4> <table style="width:100%;border-collapse:collapse;margin-top:8px;font-size:0.9em;"> <tr style="background:#8e44ad;color:white;"><td style="padding:6px"><b>ID</b></td><td style="padding:6px"><b>EGO</b></td><td style="padding:6px"><b>SUPEREGO</b></td></tr> <tr><td style="padding:6px;border:1px solid #ddd">Pleasure principle. Impulsive. Present at birth.</td><td style="padding:6px;border:1px solid #ddd">Reality principle. Uses defense mechanisms. 4-6 months.</td><td style="padding:6px;border:1px solid #ddd">Morality principle. Higher concepts. 2-3 years.</td></tr> </table> </div> <div class="box box-blue"> <h4>Topographical Theory (Iceberg Model)</h4> <ul> <li>Conscious (tip of iceberg)</li> <li>Preconscious (accessible when needed)</li> <li>Unconscious (majority - inaccessible)</li> </ul> <p style="font-size:0.85em;margin-top:6px;">Id = Completely unconscious. Superego has both conscious and unconscious parts.</p> </div> </div> <h3>Defense Mechanisms</h3> <div class="mnemonic"> <span class="label">π§ Defense Mechanism Hierarchy (from Mature to Primitive)</span> <table> <tr><td>π’ <b>Mature</b></td><td>Humor, Anticipation, Altruism, Asceticism, Sublimation, Suppression (conscious)</td></tr> <tr><td>π‘ <b>Neurotic</b></td><td>Intellectualization, Displacement, Repression, Reaction Formation, Undoing</td></tr> <tr><td>π <b>Immature</b></td><td>Regression, Passive aggression, Somatization, Acting out, Isolation</td></tr> <tr><td>π΄ <b>Psychotic/Narcissistic</b></td><td>Denial, Splitting (black & white), Psychotic projection</td></tr> </table> </div> <h3>Psychotherapy Types</h3> <table class="comparison"> <tr><th>Therapy</th><th>Type</th><th>Best for</th></tr> <tr><td>CBT (Cognitive Behavioral Therapy)</td><td>Cognitive + behavioral</td><td>Depression, anxiety, OCD, eating disorders</td></tr> <tr><td>DBT (Dialectical Behavior Therapy)</td><td>Acceptance + change</td><td>Borderline PD, self-harm</td></tr> <tr><td>Psychoanalysis</td><td>Psychodynamic</td><td>Understanding unconscious conflicts (long-term)</td></tr> <tr><td>Interpersonal Therapy (IPT)</td><td>Interpersonal</td><td>Depression</td></tr> <tr><td>Motivational Interviewing</td><td>Brief, patient-centered</td><td>Substance use disorders</td></tr> <tr><td>EMDR</td><td>Trauma-focused</td><td>PTSD (most specific)</td></tr> <tr><td>Systematic Desensitization</td><td>Behavioral</td><td>Phobias (gold standard)</td></tr> </table> <h3>Transference vs. Countertransference</h3> <div class="two-col"> <div class="box box-blue"><b>Transference:</b> Patient's feelings towards therapist (can be positive or negative)</div> <div class="box box-red"><b>Countertransference:</b> Therapist's feelings towards patient</div> </div> <h3>Projective Tests</h3> <table class="comparison"> <tr><th>Test</th><th>What it uses</th><th>What it measures</th></tr> <tr><td>Rorschach Inkblot Test</td><td>Ambiguous ink blots</td><td>Unconscious perceptions and conflicts</td></tr> <tr><td>TAT (Thematic Apperception Test)</td><td>Ambiguous pictures</td><td>Interpersonal themes, motives</td></tr> <tr><td>Children's Apperception Test (CAT)</td><td>Animals in situations</td><td>Child's relationships and concerns</td></tr> <tr><td>MMPI</td><td>Questionnaire</td><td>Personality, psychopathology (objective)</td></tr> </table> <div class="box box-teal"> <h4>Important Psychology Concepts</h4> <ul> <li><b>Catharsis:</b> Ventilation of emotions = therapeutic (important aspect of therapy)</li> <li><b>Abreaction:</b> Abnormal/exaggerated emotional reaction (not always therapeutic)</li> <li><b>Free Association:</b> Freud's technique - patient says anything that comes to mind</li> <li><b>Dream Analysis:</b> "Royal road to the unconscious" (Freud)</li> </ul> </div> </div> <!-- QUICK REFERENCE TABLES --> <div class="chapter"> <div class="chapter-header" style="background:linear-gradient(90deg,#e74c3c,#c0392b);"> <h2>β NEET PG Quick Reference: DOCs & Must-Know Facts</h2> <div class="subtitle">High-frequency exam topics - study these last!</div> </div> <h3>Drug of Choice (DOC) Summary</h3> <table class="comparison"> <tr><th>Condition</th><th>DOC</th></tr> <tr><td>Treatment-resistant schizophrenia</td><td><b>Clozapine</b></td></tr> <tr><td>Depression in pregnancy</td><td><b>Sertraline</b></td></tr> <tr><td>Atypical depression</td><td><b>MAOIs</b></td></tr> <tr><td>OCD pharmacotherapy</td><td><b>SSRIs (high dose)</b></td></tr> <tr><td>Bipolar depression</td><td><b>Lamotrigine</b></td></tr> <tr><td>Mania</td><td><b>Lithium</b></td></tr> <tr><td>Akathisia</td><td><b>Propranolol</b></td></tr> <tr><td>Acute dystonia</td><td><b>Anticholinergics (Benztropine/Trihexyphenidyl)</b></td></tr> <tr><td>Tardive Dyskinesia</td><td><b>Valbenazine / Deutetrabenazine</b></td></tr> <tr><td>NMS</td><td><b>Dantrolene + Bromocriptine</b></td></tr> <tr><td>Serotonin syndrome</td><td><b>Cyproheptadine</b></td></tr> <tr><td>Alcohol withdrawal/DTs</td><td><b>Benzodiazepines (Diazepam)</b></td></tr> <tr><td>Opioid overdose</td><td><b>Naloxone</b></td></tr> <tr><td>Opioid dependence maintenance</td><td><b>Buprenorphine + Naloxone</b></td></tr> <tr><td>Narcolepsy (sleepiness)</td><td><b>Modafinil / Sodium oxybate</b></td></tr> <tr><td>PTSD nightmares</td><td><b>Prazosin</b></td></tr> <tr><td>PTSD psychotherapy</td><td><b>EMDR</b></td></tr> <tr><td>Phobia</td><td><b>Systematic desensitization</b></td></tr> <tr><td>Catatonia (1st line)</td><td><b>Lorazepam</b></td></tr> <tr><td>Catatonia (if BZD fails)</td><td><b>ECT</b></td></tr> <tr><td>Smoking cessation (most effective)</td><td><b>Varenicline</b></td></tr> <tr><td>Wernicke's encephalopathy</td><td><b>IV Thiamine (BEFORE glucose)</b></td></tr> <tr><td>TCA overdose</td><td><b>Sodium bicarbonate</b></td></tr> <tr><td>Bulimia nervosa (drug)</td><td><b>Fluoxetine (only FDA-approved)</b></td></tr> <tr><td>Borderline PD (therapy)</td><td><b>DBT</b></td></tr> <tr><td>REM sleep behavior disorder</td><td><b>Clonazepam</b></td></tr> <tr><td>GAD non-sedating option</td><td><b>Buspirone</b></td></tr> <tr><td>Seasonal affective disorder</td><td><b>Phototherapy (light therapy)</b></td></tr> <tr><td>Alzheimer's (mild-moderate)</td><td><b>Donepezil (AChE inhibitor)</b></td></tr> <tr><td>Alzheimer's (moderate-severe)</td><td><b>Memantine (NMDA antagonist)</b></td></tr> </table> <h3>π― High-Yield One-Liners</h3> <div class="box box-yellow"> <ul> <li>Clozapine: Most effective antipsychotic BUT watch for agranulocytosis</li> <li>Lithium: Narrow therapeutic window β 0.6-1.2 mEq/L. Teratogen: Ebstein's anomaly</li> <li>Fluoxetine: Longest half-life SSRI (least discontinuation syndrome)</li> <li>Paroxetine: Shortest half-life SSRI (most discontinuation syndrome). Avoid in pregnancy.</li> <li>Valproate in pregnancy: Neural tube defects (worst teratogen)</li> <li>Carbamazepine: Enzyme inducer (CYP450) β multiple drug interactions</li> <li>ECT: No absolute contraindications. SAE = cognitive impairment/amnesia</li> <li>Suicide: SSRIs β may increase suicidal ideation in first 2 weeks (black box warning)</li> <li>Wernicke: Give thiamine BEFORE glucose (glucose consumes thiamine β worsen Wernicke's)</li> <li>Schizophrenia prognosis: Female, late onset, positive symptoms, family support = better</li> <li>Anorexia nervosa: Highest mortality of ALL psychiatric disorders (cardiac arrhythmias)</li> <li>REM sleep behavior disorder: Precursor to Parkinson's disease / Lewy body dementia</li> <li>Capgras = known person replaced by impostor | Fregoli = stranger is known enemy</li> <li>Cotard = "I am dead/my organs are missing" (nihilistic delusion)</li> <li>Othello syndrome: Delusion of jealousy β seen in chronic alcoholism</li> <li>Ganser syndrome: Approximate answers ("2+2=5") β prisoners</li> <li>Munchausen = patient self-induces illness | Munchausen by proxy = parent induces in child</li> </ul> </div> </div> <div style="text-align:center;padding:30px;background:#2c3e50;color:white;margin-top:20px;"> <h3>π§ Psychiatry NEET PG Master Guide</h3> <p>Based on Marrow Revision Edition 8 (2024) | Compiled for NEET PG / USMLE</p> <p style="opacity:0.7;margin-top:8px;font-size:0.9em;">All topics covered | Mnemonics | Flowcharts | Tables | DOC Lists</p> </div> </body> </html> HTMLEOF echo "HTML written. Size: $(wc -c < /tmp/workspace/psych-neetpg/psychiatry_neetpg.html) bytes"
??
psychiatry neetpg
HTML File Β· HTML
| # | Topic | What's included |
|---|---|---|
| 1 | Psychosis, Delusions & Hallucinations | Named syndromes table, character memory tricks |
| 2 | Schizophrenia | Bleuler's 4A's, Schneider's 3+3+3 rule, prognosis mnemonic |
| 3 | Antipsychotics & Catatonia | Generation comparison, Clozapine CLOZAPINE mnemonic, EPS timeline flowchart, NMS FALTER mnemonic |
| 4 | Depression | DIGESCAPS mnemonic, Omega/Veraguth signs, all subtypes |
| 5 | Antidepressants | Full comparison table, TCA ABCDE mnemonic, SS vs NMS comparison |
| 6 | Mania & Bipolar | DIG FAST mnemonic, mood stabilizer table, Lithium toxicity |
| 7 | Stress Disorders | PTSD FINE mnemonic, EMDR vs CBT |
| 8 | Anxiety Disorders | BANSO mnemonic, panic triggers, therapy comparison |
| 9 | OCD | ERP gold standard, OCD spectrum |
| 10-14 | Somatic, Dissociative, Eating, Sleep, Sexual | Key differentials, Narcolepsy CASH mnemonic |
| 15 | Personality Disorders | ABC cluster "Weird/Wild/Worried" trick, ICD-11 update |
| 16 | Neurodevelopmental | HEADSSS, ADHD, ASD, IQ table |
| 17 | Substance Use | Alcohol withdrawal timeline flowchart, opioid triad |
| 18 | Dementia | Delirium vs Dementia table, all 4 dementia types |
| 19 | ECT & Biological Therapies | Indications, SE, TMS/DBS/Phototherapy |
| 20 | Psychotherapy & Defense Mechanisms | Freud's models, defense hierarchy, therapy DOC list |
Create a PDF version I can download and print
python3 -c " from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.units import mm, cm from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_RIGHT from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, HRFlowable, PageBreak, KeepTogether) from reportlab.platypus.flowables import BalancedColumns from reportlab.lib.colors import HexColor, white, black import os # Colors BLUE = HexColor('#1a73e8') DARK_BLUE = HexColor('#0d47a1') GREEN = HexColor('#27ae60') RED = HexColor('#e74c3c') YELLOW = HexColor('#f39c12') PURPLE = HexColor('#8e44ad') TEAL = HexColor('#16a085') ORANGE = HexColor('#e67e22') DARK = HexColor('#2c3e50') LIGHT_BLUE = HexColor('#ebf5fb') LIGHT_GREEN = HexColor('#eafaf1') LIGHT_YELLOW = HexColor('#fef9e7') LIGHT_RED = HexColor('#fdedec') LIGHT_PURPLE = HexColor('#f5eef8') LIGHT_TEAL = HexColor('#e8f8f5') LIGHT_ORANGE = HexColor('#fef3e2') LIGHT_GRAY = HexColor('#f8f9fa') MID_GRAY = HexColor('#dee2e6') W, H = A4 styles = getSampleStyleSheet() def style(name='Normal', **kwargs): base = styles[name] if name in styles else styles['Normal'] s = ParagraphStyle(name+'_custom', parent=base, **kwargs) return s # Paragraph styles TITLE_STYLE = style('Title', fontSize=22, textColor=white, alignment=TA_CENTER, spaceAfter=4, fontName='Helvetica-Bold') SUBTITLE_STYLE = style(fontSize=11, textColor=LIGHT_BLUE, alignment=TA_CENTER, fontName='Helvetica', spaceAfter=6) CH_TITLE = style(fontSize=15, textColor=white, fontName='Helvetica-Bold', spaceAfter=2, spaceBefore=2) CH_SUBTITLE = style(fontSize=9, textColor=LIGHT_BLUE, fontName='Helvetica') H3 = style(fontSize=12, textColor=BLUE, fontName='Helvetica-Bold', spaceBefore=10, spaceAfter=4) H4 = style(fontSize=10, textColor=PURPLE, fontName='Helvetica-Bold', spaceBefore=6, spaceAfter=3) BODY = style(fontSize=8.5, fontName='Helvetica', leading=12, spaceAfter=2) BODY_BOLD = style(fontSize=8.5, fontName='Helvetica-Bold', leading=12) BULLET = style(fontSize=8.5, fontName='Helvetica', leading=11, leftIndent=12, firstLineIndent=-8, spaceAfter=1) MNEM_TITLE = style(fontSize=9, textColor=ORANGE, fontName='Helvetica-Bold', spaceAfter=2) MNEM_WORD = style(fontSize=13, textColor=DARK, fontName='Helvetica-Bold', letterSpacing=3, spaceAfter=4) SMALL = style(fontSize=7.5, fontName='Helvetica', textColor=HexColor('#555555'), leading=10) SMALL_BOLD = style(fontSize=7.5, fontName='Helvetica-Bold') CENTER = style(fontSize=8.5, fontName='Helvetica', alignment=TA_CENTER) def P(text, s=None): return Paragraph(text, s or BODY) def B(text): return f'<b>{text}</b>' def I(text): return f'<i>{text}</i>' def C(text, color='#1a73e8'): return f'<font color=\"{color}\">{text}</font>' def SP(n=4): return Spacer(1, n) def HR(): return HRFlowable(width='100%', thickness=0.5, color=MID_GRAY, spaceAfter=4) def chapter_header(title, subtitle='', color1=BLUE, color2=TEAL): data = [[Paragraph(title, CH_TITLE), ''], [Paragraph(subtitle, CH_SUBTITLE) if subtitle else '', '']] t = Table(data, colWidths=[W-2*cm, 0]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), color1), ('TOPPADDING', (0,0), (-1,-1), 10), ('BOTTOMPADDING', (0,0), (-1,-1), 8), ('LEFTPADDING', (0,0), (-1,-1), 14), ('RIGHTPADDING', (0,0), (-1,-1), 14), ('SPAN', (0,0), (-1,0)), ('SPAN', (0,1), (-1,1)), ])) return t def mnemonic_box(label, word, rows, bg=LIGHT_YELLOW, border=YELLOW): items = [] items.append(P(f'π§ {label}', MNEM_TITLE)) if word: items.append(P(word, MNEM_WORD)) for letter, meaning in rows: items.append(P(f'<b><font color=\"#e67e22\" size=\"11\">{letter}</font></b> {meaning}', BULLET)) return colored_box(items, bg, border) def colored_box(items, bg=LIGHT_BLUE, border=BLUE): content = [] for item in items: content.append([item]) if not content: return SP(2) t = Table(content, colWidths=[W-2*cm-24]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), bg), ('LEFTPADDING', (0,0), (-1,-1), 10), ('RIGHTPADDING', (0,0), (-1,-1), 10), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 4), ('LINEAFTER', (0,0), (0,-1), 4, border), ])) return t def comparison_table(headers, rows, col_widths=None): data = [[P(h, style(fontSize=8.5, textColor=white, fontName='Helvetica-Bold')) for h in headers]] for row in rows: data.append([P(str(c), BODY) for c in row]) n = len(headers) if col_widths is None: total = W - 2*cm col_widths = [total/n]*n t = Table(data, colWidths=col_widths) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,0), BLUE), ('ROWBACKGROUNDS', (0,1), (-1,-1), [white, LIGHT_GRAY]), ('GRID', (0,0), (-1,-1), 0.5, MID_GRAY), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 4), ('LEFTPADDING', (0,0), (-1,-1), 6), ('RIGHTPADDING', (0,0), (-1,-1), 6), ('VALIGN', (0,0), (-1,-1), 'TOP'), ])) return t def two_col_boxes(left_items, right_items, left_bg=LIGHT_BLUE, right_bg=LIGHT_GREEN, left_border=BLUE, right_border=GREEN): def make_inner(items, bg, border): content = [[item] for item in items] if not content: content = [[SP(2)]] t = Table(content, colWidths=[(W-2*cm)/2 - 10]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), bg), ('LEFTPADDING', (0,0), (-1,-1), 8), ('RIGHTPADDING', (0,0), (-1,-1), 8), ('TOPPADDING', (0,0), (-1,-1), 4), ('BOTTOMPADDING', (0,0), (-1,-1), 4), ('LINEAFTER', (0,0), (0,-1), 4, border), ])) return t outer = Table([[make_inner(left_items, left_bg, left_border), make_inner(right_items, right_bg, right_border)]], colWidths=[(W-2*cm)/2, (W-2*cm)/2]) outer.setStyle(TableStyle([ ('TOPPADDING', (0,0), (-1,-1), 0), ('BOTTOMPADDING', (0,0), (-1,-1), 0), ('LEFTPADDING', (0,0), (-1,-1), 0), ('RIGHTPADDING', (0,0), (-1,-1), 6), ])) return outer print('Functions defined OK') " 2>&1
Where
mkdir -p /tmp/workspace/psych-neetpg && python3 << 'PYEOF' from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.units import mm, cm from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.enums import TA_LEFT, TA_CENTER, TA_RIGHT from reportlab.platypus import (SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, HRFlowable, PageBreak, KeepTogether) from reportlab.lib.colors import HexColor, white, black # ββ Colors ββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ BLUE = HexColor('#1a73e8') GREEN = HexColor('#27ae60') RED = HexColor('#e74c3c') YELLOW = HexColor('#f39c12') PURPLE = HexColor('#8e44ad') TEAL = HexColor('#16a085') ORANGE = HexColor('#e67e22') DARK = HexColor('#2c3e50') LIGHT_BLUE = HexColor('#ebf5fb') LIGHT_GRN = HexColor('#eafaf1') LIGHT_YEL = HexColor('#fef9e7') LIGHT_RED = HexColor('#fdedec') LIGHT_PUR = HexColor('#f5eef8') LIGHT_TEAL = HexColor('#e8f8f5') LIGHT_ORG = HexColor('#fef3e2') LIGHT_GRAY = HexColor('#f8f9fa') MID_GRAY = HexColor('#dee2e6') W, H = A4 # ββ Base styles βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ def PS(name, **kw): return ParagraphStyle(name, fontName='Helvetica', fontSize=8.5, leading=12, spaceAfter=2, **kw) S_BODY = PS('body') S_BOLD = PS('bold', fontName='Helvetica-Bold') S_H3 = PS('h3', fontName='Helvetica-Bold', fontSize=11, textColor=BLUE, spaceBefore=8, spaceAfter=4) S_H4 = PS('h4', fontName='Helvetica-Bold', fontSize=9.5, textColor=PURPLE, spaceBefore=5, spaceAfter=3) S_BLET = PS('blet', fontSize=8.5, leftIndent=12, firstLineIndent=-8, leading=11, spaceAfter=1) S_SMALL = PS('small', fontSize=7.5, textColor=HexColor('#555555'), leading=10) S_MNT = PS('mnt', fontName='Helvetica-Bold', fontSize=8.5, textColor=ORANGE, spaceAfter=1) S_MNW = PS('mnw', fontName='Helvetica-Bold', fontSize=12, textColor=DARK, spaceAfter=3, leading=14) S_CTR = PS('ctr', alignment=TA_CENTER) S_WHTBOLD = PS('whtb', fontName='Helvetica-Bold', fontSize=8.5, textColor=white) S_WHTCTR = PS('whtc', fontName='Helvetica-Bold', fontSize=8, textColor=white, alignment=TA_CENTER) S_TBLHDR = PS('tblhdr', fontName='Helvetica-Bold', fontSize=7.5, textColor=white) def P(txt, s=None): return Paragraph(str(txt), s or S_BODY) def SP(n=5): return Spacer(1, n) def HR(): return HRFlowable(width='100%', thickness=0.4, color=MID_GRAY, spaceAfter=3) # ββ Layout helpers ββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ def ch_header(title, subtitle='', bg=BLUE): rows = [[P(title, PS('cht', fontName='Helvetica-Bold', fontSize=13, textColor=white))]] if subtitle: rows.append([P(subtitle, PS('chs', fontSize=8, textColor=HexColor('#bbdefb')))]) t = Table(rows, colWidths=[W - 2*cm]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), bg), ('LEFTPADDING', (0,0), (-1,-1), 12), ('RIGHTPADDING', (0,0), (-1,-1), 12), ('TOPPADDING', (0,0), (-1,-1), 8), ('BOTTOMPADDING', (0,0), (-1,-1), 8), ])) return t def box(items, bg=LIGHT_BLUE, border=BLUE, pad=8): if not items: return SP(2) rows = [[item] for item in items] t = Table(rows, colWidths=[W - 2*cm - 2*pad]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), bg), ('LEFTPADDING', (0,0), (-1,-1), pad), ('RIGHTPADDING', (0,0), (-1,-1), pad), ('TOPPADDING', (0,0), (-1,-1), 3), ('BOTTOMPADDING', (0,0), (-1,-1), 3), ('LINEAFTER', (0,0), (0,-1), 4, border), ])) return t def mnem(label, word, rows, bg=LIGHT_YEL, border=YELLOW): items = [P(f'π§ {label}', S_MNT)] if word: items.append(P(word, S_MNW)) for L, meaning in rows: items.append(P(f'<b><font color="#e67e22" size="11">{L}</font></b> {meaning}', S_BLET)) return box(items, bg, border) def cmp_table(headers, rows, cws=None, hbg=BLUE): data = [[P(h, S_TBLHDR) for h in headers]] for row in rows: data.append([P(str(c), S_BODY) for c in row]) if cws is None: total = W - 2*cm cws = [total / len(headers)] * len(headers) t = Table(data, colWidths=cws) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,0), hbg), ('ROWBACKGROUNDS',(0,1), (-1,-1), [white, LIGHT_GRAY]), ('GRID', (0,0), (-1,-1), 0.4, MID_GRAY), ('TOPPADDING', (0,0), (-1,-1), 3), ('BOTTOMPADDING', (0,0), (-1,-1), 3), ('LEFTPADDING', (0,0), (-1,-1), 5), ('RIGHTPADDING', (0,0), (-1,-1), 5), ('VALIGN', (0,0), (-1,-1), 'TOP'), ])) return t def two_col(L_items, R_items, lbg=LIGHT_BLUE, rbg=LIGHT_GRN, lb=BLUE, rb=GREEN): W2 = (W - 2*cm) / 2 - 4 def inner(items, bg, br): rows = [[i] for i in items] if not rows: rows = [[SP(2)]] t = Table(rows, colWidths=[W2]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), bg), ('LEFTPADDING', (0,0), (-1,-1), 7), ('RIGHTPADDING', (0,0), (-1,-1), 7), ('TOPPADDING', (0,0), (-1,-1), 3), ('BOTTOMPADDING', (0,0), (-1,-1), 3), ('LINEAFTER', (0,0), (0,-1), 4, br), ])) return t t = Table([[inner(L_items, lbg, lb), inner(R_items, rbg, rb)]], colWidths=[W2 + 4, W2 + 4]) t.setStyle(TableStyle([ ('TOPPADDING', (0,0), (-1,-1), 0), ('BOTTOMPADDING', (0,0), (-1,-1), 0), ('LEFTPADDING', (0,0), (-1,-1), 0), ('RIGHTPADDING', (0,0), (-1,-1), 0), ])) return t # ββ Cover page ββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ def cover_page(): cover_data = [[P('π§ PSYCHIATRY', PS('cvt', fontName='Helvetica-Bold', fontSize=28, textColor=white, alignment=TA_CENTER))], [P('NEET PG / Medical PG Master Revision Guide', PS('cvs', fontSize=12, textColor=HexColor('#bbdefb'), alignment=TA_CENTER))], [SP(6)], [P('Marrow Revision Edition 8 | 2024', PS('cvb', fontSize=9, textColor=HexColor('#90caf9'), alignment=TA_CENTER))], [SP(4)], [P('Mnemonics β’ Flowcharts β’ Tables β’ DOC Lists β’ One-Liners', PS('cvtag', fontSize=9, textColor=white, alignment=TA_CENTER))], ] t = Table(cover_data, colWidths=[W - 2*cm]) t.setStyle(TableStyle([ ('BACKGROUND', (0,0), (-1,-1), DARK), ('TOPPADDING', (0,0), (-1,-1), 12), ('BOTTOMPADDING', (0,0), (-1,-1), 12), ('LEFTPADDING', (0,0), (-1,-1), 20), ('RIGHTPADDING', (0,0), (-1,-1), 20), ])) return [t, SP(12)] # ββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CONTENT # ββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story = [] # ββ Cover βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story += cover_page() # ββ TOC ββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Table of Contents', bg=DARK)) story.append(SP(6)) toc = [ ('1', 'Psychosis, Delusions & Hallucinations'), ('2', 'Schizophrenia'), ('3', 'Antipsychotics & Catatonia'), ('4', 'Mood Disorders β Depression'), ('5', 'Antidepressants'), ('6', 'Mania & Bipolar Disorder'), ('7', 'Stress-Related Disorders (PTSD)'), ('8', 'Anxiety Disorders'), ('9', 'OCD & Related Disorders'), ('10', 'Somatic Symptom Disorders'), ('11', 'Dissociative Disorders'), ('12', 'Eating & Feeding Disorders'), ('13', 'Sleep Disorders'), ('14', 'Sexual Disorders & Gender Identity'), ('15', 'Personality Disorders'), ('16', 'Neurodevelopmental Disorders'), ('17', 'Substance Use Disorders'), ('18', 'Neurocognitive Disorders / Dementia'), ('19', 'ECT & Biological Therapies'), ('20', 'Psychotherapy & Defense Mechanisms'), ('β ', 'Quick Reference: DOCs & High-Yield One-Liners'), ] for num, title in toc: story.append(P(f'<b><font color="#1a73e8">{num}.</font></b> {title}', S_BODY)) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 1: PSYCHOSIS # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 1: Psychosis, Delusions & Hallucinations', 'Foundation | High Yield', PURPLE)) story.append(SP(6)) story.append(P('Neurotic vs. Psychotic', S_H3)) story.append(cmp_table( ['Feature', 'π’ Neurotic', 'π΄ Psychotic'], [['Insight', 'Present', 'Absent'], ['Judgement', 'Intact', 'Impaired'], ['Reality contact','Maintained', 'Lost'], ['Personality', 'Minimal change', 'Significant change']], cws=[55*mm, 60*mm, 60*mm] )) story.append(SP(4)) story.append(P('Delusions', S_H3)) story.append(box([ P('<b>Delusion</b> = False, FIXED belief not consistent with culture, held despite evidence to contrary.'), P('<b>Idea</b> = False FLUCTUATING belief β NOT a delusion.'), ], LIGHT_RED, RED)) story.append(SP(4)) story.append(P('Types by Content', S_H4)) story.append(cmp_table( ['Type', 'Associated with', 'Example'], [['Persecution/Paranoid (M/C)', 'Schizophrenia', '"Someone is following me"'], ['Grandiosity', 'Mania', '"I am the richest person alive"'], ['Poverty', 'Depression', '"I have nothing left"'], ['Reference', 'Schizophrenia', '"That TV anchor is talking about me"'], ['Nihilistic', 'Severe depression','I don\'t exist / am dead'], ['Control/Somatic passivity', 'Schizophrenia FRS','Controlled by external agency']], cws=[55*mm, 50*mm, 70*mm] )) story.append(SP(6)) story.append(P('Named Delusion Syndromes', S_H4)) story.append(mnem( 'Named Syndromes β Memory Table', '', [('π Othello', 'Delusion of jealousy/infidelity β seen in CHRONIC ALCOHOLISM'), ('π Magnan', 'Cocaine bugs = formication + persecution + tactile hallucination'), ("π De Clerambault",'Erotomania β delusion that a famous person loves you'), ('π Cotard', 'Nihilistic delusion: "I am dead / organs do not exist" β severe depression'), ('π¦ Ekbom', 'Delusional parasitosis = Match-box sign (+). Also a RLS variant.'), ('π₯ Capgras', 'Known person is a STRANGER (negative misidentification)'), ('ποΈ Fregoli', 'Stranger is believed to be a known PERSECUTOR (positive misidentification)')], LIGHT_YEL, YELLOW )) story.append(SP(4)) story.append(P('Hallucinations', S_H3)) story.append(box([ P('<b>Definition:</b> Perception WITHOUT a stimulus (vs. Illusion = misinterpretation of an existing stimulus)'), ], LIGHT_PUR, PURPLE)) story.append(cmp_table( ['Type', 'Most Common In'], [['Auditory', 'Schizophrenia (M/C overall)'], ['Visual', 'Organic mental illness / Neurocognitive disorders'], ['Tactile', 'Cocaine use ("cocaine bugs")'], ['Olfactory','Temporal lobe epilepsy']], cws=[55*mm, 120*mm] )) story.append(SP(4)) story.append(P('Special Hallucination Types', S_H4)) story.append(cmp_table( ['Type', 'Definition', 'Example'], [['True Hallucination', 'From outer objective space', 'Voice heard from outside'], ['Pseudohallucination', 'From inner subjective space', 'Voice inside the head'], ['Extracampine', 'Beyond normal sensory field', 'Seeing someone behind a wall'], ['Functional', 'Stimulus & hallucination = SAME modality', 'Another voice heard when someone speaks'], ['Reflex (Synesthesia)', 'Stimulus & hallucination = DIFFERENT modality','Voice heard when light is switched on']], cws=[45*mm, 70*mm, 60*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 2: SCHIZOPHRENIA # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 2: Schizophrenia', 'Most tested psychiatric disorder', PURPLE)) story.append(SP(6)) story.append(P('Famous Contributors', S_H3)) story.append(two_col( [P('<b>Eugene Bleuler</b> β Coined "Schizophrenia"'), P('Described the <b>4 A\'s of Bleuler:</b>'), P('β’ Autism (social withdrawal)', S_BLET), P('β’ Ambivalence (contradictory feelings)', S_BLET), P('β’ Affect blunting/flattening', S_BLET), P('β’ Associations β loosened', S_BLET), P('<i>β οΈ Auditory hallucination is NOT part of Bleuler\'s 4 A\'s</i>', S_SMALL)], [P('<b>Emil Kraepelin</b> β Called it "Dementia Praecox"'), P('3 types: Hebephrenic, Catatonic, Paranoid'), SP(4), P('<b>Kurt Schneider</b> β First Rank Symptoms (FRS)'), P('Most specific for schizophrenia. See below.', S_SMALL)], LIGHT_PUR, LIGHT_BLUE, PURPLE, BLUE )) story.append(SP(6)) story.append(P("Kurt Schneider's First Rank Symptoms β 3+3+3 Rule", S_H3)) story.append(cmp_table( ['3 Auditory Hallucinations', '3 Made Phenomena', '3 Thought Phenomena'], [['1st person (own thoughts aloud)\n2nd person (commanding & commentary)\n3rd person (discussing patient)', 'Made impulse\nMade volition\nMade affect', 'Thought insertion\nThought broadcast\nThought withdrawal']], cws=[58*mm, 58*mm, 59*mm], hbg=PURPLE )) story.append(box([P('Also: <b>Somatic passivity</b> (believes body controlled by external agency) + <b>Primary delusional experience</b>')], LIGHT_PUR, PURPLE)) story.append(SP(5)) story.append(P('Diagnostic Criteria', S_H3)) story.append(two_col( [P('<b>π΄ Positive Symptoms</b> (Mesolimbic pathway βDA)', S_BOLD), P('β’ Delusions', S_BLET), P('β’ Hallucinations', S_BLET), P('β’ Disorganized thinking', S_BLET), P('β’ Disorganized behaviour', S_BLET), P('<b>β οΈ At least 1 of: Hallucination / Delusion / Disorganized thinking must be present</b>', S_SMALL)], [P('<b>π΅ Negative Symptoms</b> (Mesocortical pathway βDA)', S_BOLD), P('Mnemonic: <b>5 A\'s</b>', S_MNT), P('β’ Apathy', S_BLET), P('β’ Avolition', S_BLET), P('β’ Attention deficit', S_BLET), P('β’ Anhedonia', S_BLET), P('β’ Alogia (poverty of speech)', S_BLET)], LIGHT_RED, LIGHT_BLUE, RED, BLUE )) story.append(SP(4)) story.append(box([P('<b>Duration:</b> ICD = β₯1 month | DSM = β₯6 months')], LIGHT_YEL, YELLOW)) story.append(SP(6)) story.append(P('Prognostic Factors', S_H3)) story.append(mnem( 'Better Prognosis Mnemonic: LAGO-MFC', 'L-A-G-O-M-F-C', [('L', 'Late onset'), ('A', 'Acute onset'), ('G', 'Girl (Female gender)'), ('O', 'Obvious stressor present'), ('M', 'Mood symptoms present'), ('F', 'Family support +'), ('C', 'Compliant with medications')], )) story.append(box([P('<b>Worse prognosis:</b> Opposite of above. More negative symptoms, male, early onset, gradual onset, no stressor.')], LIGHT_RED, RED)) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 3: ANTIPSYCHOTICS # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 3: Antipsychotics & Catatonia', 'Generations, EPS, Clozapine, NMS', TEAL)) story.append(SP(6)) story.append(P('Antipsychotic Generations', S_H3)) story.append(cmp_table( ['Feature', '1st Gen (Typical)', '2nd Gen (Atypical)', '3rd Gen'], [['MOA', 'Block ALL D2 receptors', '80% D2 block + 5HT2A block', '5HT1A partial agonist'], ['EPS risk','High', 'Low', 'Minimal'], ['Metabolic SE','Low', 'High (weight gain, DM)', 'Low'], ['Examples','Haloperidol, Chlorpromazine','Olanzapine, Risperidone, Clozapine','Aripiprazole, Brexpiprazole']], cws=[38*mm, 52*mm, 58*mm, 45*mm] )) story.append(SP(6)) story.append(P('CLOZAPINE β Most Important Drug in Psychiatry', S_H3)) story.append(box([ P('<b>Most effective antipsychotic.</b>'), P('<b>DOC:</b> Treatment-resistant schizophrenia (failed β₯2 different antipsychotics)'), ], LIGHT_GRN, GREEN)) story.append(mnem( 'Clozapine Side Effects: "CLOZAPINE"', 'C-L-O-Z-A-P-I-N-E', [('C', 'Cardiomyopathy / Myocarditis'), ('L', 'Lowered seizure threshold (dose-dependent)'), ('O', 'Obesity / Metabolic syndrome (weight gain, dyslipidemia, hyperglycemia)'), ('Z', 'Zero WBCs = AGRANULOCYTOSIS β οΈ Monitor CBC weekly initially!'), ('A', 'Autonomic effects / Sedation'), ('P', 'Profuse salivation (sialorrhea)'), ], LIGHT_RED, RED )) story.append(SP(6)) story.append(P('Extrapyramidal Side Effects (EPS) β Timeline', S_H3)) story.append(cmp_table( ['Timing', 'EPS Type', 'Features', 'Treatment'], [['HoursβDays', 'Acute Dystonia', 'Oculogyric crisis, orolingual, laryngeal, limb dystonia', 'Anticholinergics / Antihistamines'], ['DaysβWeeks', 'Akathisia', 'Inner restlessness, βlower limb movements. β οΈ βSuicide risk!', 'Propranolol (M/C), Benzodiazepines'], ['WeeksβMonths', 'Drug-induced Parkinsonism', 'Tremor, bradykinesia, rigidity', 'Reduce dose / Anticholinergics'], ['MonthsβYears', 'Tardive Dyskinesia','Involuntary orofacial movements (M/C). Irreversible risk.', 'Valbenazine / Deutetrabenazine (VMAT2 inhibitors)']], cws=[25*mm, 40*mm, 65*mm, 45*mm] )) story.append(SP(6)) story.append(P('Neuroleptic Malignant Syndrome (NMS)', S_H3)) story.append(mnem( 'NMS Features: FALTER', 'F-A-L-T-E-R', [('F', 'Fever (hyperthermia)'), ('A', 'Autonomic instability (BP/HR swings, diaphoresis)'), ('L', 'Lead-pipe rigidity + ββCK (rhabdomyolysis)'), ('T', 'Tremor'), ('E', 'Encephalopathy (altered consciousness)'), ('R', 'Rhabdomyolysis β myoglobinuria β AKI')], LIGHT_RED, RED )) story.append(box([P('<b>Rx NMS:</b> STOP antipsychotic + Dantrolene + Bromocriptine + ICU care')], LIGHT_RED, RED)) story.append(SP(6)) story.append(P('Catatonia', S_H3)) story.append(two_col( [P('<b>Aetiology:</b> Frontal lobe dysfunction', S_BOLD), P('β’ Mood disorders', S_BLET), P('β’ Schizophrenia', S_BLET), P('β’ Organic mental illness', S_BLET), SP(3), P('<b>Features:</b>', S_BOLD), P('β’ Catalepsy / Waxy flexibility', S_BLET), P('β’ Psychological pillow', S_BLET), P('β’ Automatic obedience', S_BLET), P('β’ Mutism + Withdrawal', S_BLET)], [P('<b>Management Flowchart:</b>', S_BOLD), SP(3), P('1. Lorazepam trial', S_BLET), P(' β Improves in 48-72h β Continue', S_BLET), P(' β No response:', S_BLET), P('2. ECT (Electroconvulsive Therapy)', S_BLET)], LIGHT_TEAL, LIGHT_GRN, TEAL, GREEN )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 4: DEPRESSION # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 4: Mood Disorders β Depression', 'Core symptoms, subtypes, objective signs', DARK)) story.append(SP(6)) story.append(P('Mood vs. Affect', S_H3)) story.append(two_col( [P('<b>Mood</b> = Sustained subjective emotion over time')], [P('<b>Affect</b> = Current objective emotional state (cross-sectional, observable)')], LIGHT_BLUE, LIGHT_GRN, BLUE, GREEN )) story.append(box([ P('<b>Incongruent affect:</b> Disconnect between thoughts & mood β Psychosis'), P('<b>Blunted/Flat affect:</b> Schizophrenia & depression | <b>Reactivity β</b> in both'), ], LIGHT_YEL, YELLOW)) story.append(SP(5)) story.append(P('Core Depressive Symptoms', S_H3)) story.append(mnem( 'DIGESCAPS Mnemonic', 'D-I-G-E-S-C-A-P-S', [('D', 'Depressed affect'), ('I', 'Interest β (Anhedonia)'), ('G', 'Guilt (pathological)'), ('E', 'Energy β'), ('S', 'Sleep problems β Terminal insomnia / Early morning awakening'), ('C', 'Concentration issues'), ('A', 'Appetite changes (β weight)'), ('P', 'Psychomotor changes (agitation / retardation)'), ('S', 'Suicidal behaviour')], )) story.append(SP(5)) story.append(P('Objective Signs of Depression', S_H4)) story.append(cmp_table( ['Sign', 'Described by', 'Appearance', 'Muscle'], [['Omega Sign (Ο)', 'Charles Darwin', 'Omega-shaped fold at root of nose', 'Corrugator muscles'], ['Veraguth Fold', 'Otto Veraguth', 'Triangular fold in upper eyelid', 'Palpebral muscles']], cws=[35*mm, 40*mm, 68*mm, 32*mm] )) story.append(SP(5)) story.append(P('Depression Subtypes', S_H3)) story.append(cmp_table( ['Subtype', 'Key Feature', 'Treatment'], [['Dysthymia', 'Chronic low mood >2 years (never meets full MDD criteria)', 'SSRIs + CBT'], ['Double Depression', 'Dysthymia + MDD episode on top', 'Treat MDD'], ['Seasonal Affective', 'Depressive episodes in winter; no other triggers', 'Phototherapy (10,000 lux)'], ['PMDD', 'Depressive symptoms before menstruation; βrisk depression', 'SSRIs (luteal phase)'], ['Atypical Depression', 'Hypersomnia, hyperphagia (carb cravings), leaden paralysis, preserved reactivity, interpersonal sensitivity', 'MAOIs > SSRIs. Avoid TCAs.'], ['Psychotic Depression', 'Depression + mood-congruent delusions/hallucinations', 'Antidepressant + Antipsychotic or ECT']], cws=[40*mm, 85*mm, 50*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 5: ANTIDEPRESSANTS # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 5: Antidepressants', 'Types, MOA, Side Effects, DOCs', GREEN)) story.append(SP(6)) story.append(box([P('<b>Onset of action for ALL antidepressants = 2β3 weeks</b> (due to downregulation of post-synaptic 5HT receptors)')], LIGHT_GRN, GREEN)) story.append(SP(5)) story.append(P('Antidepressant Comparison', S_H3)) story.append(cmp_table( ['Class', 'Key Drugs', 'Side Effects', 'Special Notes'], [['SSRIs', 'Fluoxetine, Sertraline, Paroxetine, Escitalopram', 'GI distress, sexual dysfunction, vivid dreams, initial anxiety', 'Sertraline = DOC in pregnancy\nParoxetine = max withdrawal\nFluoxetine = least withdrawal (longest half-life)'], ['SNRIs', 'Venlafaxine, Duloxetine, Milnacipran', 'HTN (long-term Venlafaxine)', 'Duloxetine = DOC for fibromyalgia & diabetic neuropathy pain'], ['TCAs', 'Amitriptyline, Imipramine, Clomipramine', 'Cardiac toxicity, anticholinergic (ABCDE), βseizure threshold. MOST LETHAL in OD.', 'OD Rx: Sodium bicarbonate\nAvoid in atypical depression'], ['MAOIs', 'Phenelzine, Tranylcypromine, Moclobemide', 'Tyramine reaction (hypertensive crisis with aged cheese, wine)', 'DOC: Atypical depression\nAvoid with SSRIs (serotonin syndrome)']], cws=[25*mm, 48*mm, 60*mm, 42*mm] )) story.append(SP(5)) story.append(mnem( 'TCA Anticholinergic Side Effects: ABCDE', 'A-B-C-D-E', [('A', 'Arrhythmia / Anticholinergic effects'), ('B', 'Blurred vision'), ('C', 'Constipation + dry mouth'), ('D', 'Dizziness / Drowsiness / urinary retention'), ('E', 'Epileptic seizures (βseizure threshold)')], )) story.append(SP(5)) story.append(P('Atypical & Newer Antidepressants', S_H3)) story.append(cmp_table( ['Drug', 'MOA', 'Key Side Effect / Note'], [['Mirtazapine (NaSSA)', 'Ξ±2-blocker + 5HT2A/2C/3 antagonist', 'Weight gain, sedation, agranulocytosis. No sexual SE.'], ['Trazodone', 'SARI (5HT2 antagonist + SERT inhib)', 'PRIAPISM β οΈ. Used for insomnia in depression.'], ['Vilazodone', 'SSRI + 5HT1A partial agonist', 'Fewer sexual side effects'], ['Vortioxetine', 'Multimodal serotonergic agent', 'Procognitive effects (5HT7 antagonist). Best for cognitive symptoms in depression.'], ['Bupropion', 'NE + DA reuptake inhibitor', 'No sexual SE. SE: βseizure threshold. Used for smoking cessation.']], cws=[38*mm, 60*mm, 77*mm] )) story.append(SP(5)) story.append(P('Serotonin Syndrome', S_H3)) story.append(box([ P('<b>Cause:</b> ββSerotonin β usually drug combinations (SSRI + MAOI, SSRI + Tramadol, SSRI + Linezolid)'), P('<b>Triad:</b> Autonomic instability + Neuromuscular changes (CLONUS is hallmark) + Altered mental status'), P('<b>Rx:</b> Cyproheptadine (5HT2 antagonist) + supportive care'), ], LIGHT_RED, RED)) story.append(cmp_table( ['Feature', 'Serotonin Syndrome', 'NMS'], [['Cause', 'Serotonergic drugs (SSRI+MAOI)', 'Antipsychotics (DA blockers)'], ['Onset', 'Rapid (hours)', 'Slow (days)'], ['Tone', 'Clonus, hyperreflexia', 'Lead-pipe rigidity, bradyreflexia'], ['GI', 'Diarrhea', 'Constipation'], ['Rx', 'Cyproheptadine', 'Dantrolene + Bromocriptine']], cws=[40*mm, 80*mm, 55*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 6: MANIA & BIPOLAR # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 6: Mania & Bipolar Disorder', 'DIG FAST | Mood stabilizers | Lithium', ORANGE)) story.append(SP(6)) story.append(mnem( 'Manic Episode Symptoms: DIG FAST', 'D-I-G-F-A-S-T', [('D', 'Distractibility'), ('I', 'Impulsivity / Irresponsibility'), ('G', 'Grandiosity'), ('F', 'Flight of ideas (racing thoughts)'), ('A', 'Activity β / Agitation'), ('S', 'Sleep β (without fatigue)'), ('T', 'Talkativeness (pressured speech)')], LIGHT_ORG, ORANGE )) story.append(box([P('<b>Duration:</b> Mania β₯7 days | Hypomania β₯4 days')], LIGHT_YEL, YELLOW)) story.append(SP(5)) story.append(P('Bipolar Spectrum', S_H3)) story.append(cmp_table( ['Type', 'Episodes', 'Psychosis?'], [['Bipolar I', 'Mania Β± Depression', 'Possible in mania'], ['Bipolar II', 'Hypomania + Depression (never full mania)', 'No (by definition)'], ['Cyclothymia', 'Hypomanic + depressive symptoms >2 yrs (sub-threshold)', 'No'], ['Rapid cycling', 'β₯4 episodes/year', 'Variable']], cws=[40*mm, 105*mm, 30*mm] )) story.append(SP(5)) story.append(P('Mood Stabilizers', S_H3)) story.append(cmp_table( ['Drug', 'DOC for', 'Key Side Effects', 'Monitoring'], [['Lithium', 'Bipolar (classic), mania, suicide prevention', 'Tremor, polyuria (nephrogenic DI), hypothyroidism, Ebstein\'s anomaly (teratogen)', 'Serum level 0.6β1.2 mEq/L. TFTs + renal function.'], ['Valproate', 'Rapid cycling, mixed states', 'Weight gain, hair loss, hepatotoxicity. Neural tube defects (teratogen).', 'LFTs, CBC. Avoid in pregnancy.'], ['Carbamazepine','Bipolar + partial seizures', 'Diplopia, SIADH, Stevens-Johnson, agranulocytosis. CYP450 INDUCER.', 'CBC, LFTs. Drug interactions!'], ['Lamotrigine', 'Bipolar depression (best for depressive phase)', 'Stevens-Johnson syndrome (start low, go slow β titrate slowly)', 'Rash monitoring']], cws=[32*mm, 42*mm, 68*mm, 33*mm] )) story.append(SP(4)) story.append(box([ P('<b>Lithium toxicity signs:</b> Coarse tremor, ataxia, vomiting, drowsiness, seizures, confusion'), P('<b>NSAIDs + Lithium</b> = βLithium toxicity (NSAIDs β renal clearance) β οΈ'), P('<b>Rx:</b> Stop lithium, IV hydration, dialysis in severe cases'), ], LIGHT_RED, RED)) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 7: PTSD # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 7: Stress-Related Disorders', 'PTSD | Acute Stress | Adjustment Disorder', HexColor('#607d8b'))) story.append(SP(6)) story.append(cmp_table( ['Feature', 'Acute Stress Reaction', 'PTSD', 'Adjustment Disorder'], [['Onset after stressor', 'Within hours', 'Within 3 months', 'Within 1 month'], ['Duration', '<1 month', '>1 month', '<6 months (after stressor ends)'], ['Stressor type', 'Extreme/traumatic', 'Extreme/traumatic','Any identifiable stressor']], cws=[42*mm, 47*mm, 47*mm, 39*mm] )) story.append(SP(5)) story.append(mnem( 'PTSD 4 Symptom Clusters: FINE', 'F-I-N-E', [('F', 'Flashbacks β intrusion / re-experiencing'), ('I', 'Increased arousal β hyperarousal, exaggerated startle, nightmares'), ('N', 'Numbing / Negative mood β emotional numbness, anhedonia'), ('E', 'Evasion / Avoidance β avoidance of reminders/triggers')], )) story.append(box([P('<b>Duration β₯4 weeks</b> required for PTSD diagnosis')], LIGHT_YEL, YELLOW)) story.append(SP(5)) story.append(P('PTSD Management', S_H3)) story.append(two_col( [P('<b>Pharmacologic:</b>', S_BOLD), P('β’ SSRIs / SNRIs (first-line)', S_BLET), P('β’ Prazosin (Ξ±1-blocker) β for NIGHTMARES specifically', S_BLET)], [P('<b>Psychotherapy:</b>', S_BOLD), P('β’ EMDR β Most SPECIFIC for PTSD', S_BLET), P('β’ CBT (Trauma-focused) β Best overall', S_BLET)], LIGHT_BLUE, LIGHT_GRN, BLUE, GREEN )) story.append(SP(6)) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 8: ANXIETY # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 8: Anxiety Disorders', 'GAD | Panic | Phobias | Social Anxiety', RED)) story.append(SP(6)) story.append(cmp_table( ['Disorder', 'Key Features', 'Duration', 'Treatment'], [['GAD (M/C anxiety disorder)', 'Free-floating anxiety, motor tension, irritability, sleep disturbance. Females > Males.', '>6 months', 'SSRIs/SNRIs, Pregabalin, Buspirone (no GABA), CBT, JPMR'], ['Panic Disorder', 'Recurrent panic attacks (5β15 min), anticipatory anxiety, Β± agoraphobia', 'Recurrent', 'SSRIs/SNRIs; BZDs for acute attacks'], ['Social Anxiety', 'Fear of social situations; embarrassment. AKA Social phobia.', 'Chronic', 'SSRIs; Propranolol for performance anxiety'], ['Specific Phobia', 'Irrational fear of specific object/situation', 'Chronic', 'Systematic desensitization (gold standard)']], cws=[38*mm, 70*mm, 23*mm, 44*mm] )) story.append(SP(5)) story.append(mnem( 'Specific Phobia Types: BANSO', 'B-A-N-S-O', [('B', 'Blood-injection-injury'), ('A', 'Animal'), ('N', 'Natural environment (storms, heights, water)'), ('S', 'Situational (elevators, flying, driving)'), ('O', 'Other')], )) story.append(SP(4)) story.append(P('Panic Attack Triggers', S_H4)) story.append(box([P('Caffeine β’ Cannabis β’ Cocaine β’ COβ / Lactate accumulation β’ Cholecystokinin β’ Nicotine β’ Theophylline β’ Flumazenil β’ Yohimbine')], LIGHT_YEL, YELLOW)) story.append(SP(5)) story.append(P('Behavioural Therapies', S_H4)) story.append(cmp_table( ['Therapy', 'Method', 'Best for'], [['Systematic Desensitization', 'Graded exposure + relaxation techniques (slowest)', 'Specific phobias β Gold Standard'], ['Flooding (Implosion)', 'Immediate full exposure to feared stimulus', 'When rapid result needed'], ['JPMR', 'Progressive muscle relaxation (Jacobson\'s)', 'GAD, general anxiety'], ['CBT', 'Cognitive restructuring + behavioural techniques', 'All anxiety disorders'], ['EMDR', 'Eye movement desensitization & reprocessing', 'PTSD (most specific)']], cws=[48*mm, 80*mm, 47*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 9: OCD # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 9: OCD & Related Disorders', 'ERP gold standard | OCD spectrum', ORANGE)) story.append(SP(6)) story.append(two_col( [P('<b>Obsessions (EGO-DYSTONIC)</b>', S_BOLD), P('β’ Intrusive, unwanted, persistent thoughts/images/urges', S_BLET), P('β’ Patient recognises them as unreasonable', S_BLET), P('β’ Cause significant anxiety', S_BLET), P('β’ M/C: Contamination obsessions', S_BLET)], [P('<b>Compulsions</b>', S_BOLD), P('β’ Repetitive acts to reduce anxiety', S_BLET), P('β’ NOT pleasurable (unlike addiction)', S_BLET), P('β’ Temporary relief only', S_BLET), P('β’ M/C: Washing compulsions', S_BLET)], LIGHT_ORG, LIGHT_YEL, ORANGE, YELLOW )) story.append(box([P('<b>Pathology:</b> Orbitofrontal cortex β Caudate nucleus β Thalamus circuit dysfunction (βserotonin dysfunction)')], LIGHT_BLUE, BLUE)) story.append(SP(4)) story.append(two_col( [P('<b>Pharmacologic (1st line): SSRIs</b> at HIGHER doses than for depression', S_BOLD), P('If SSRI fails β Clomipramine (most serotonergic TCA)', S_BLET)], [P('<b>Psychotherapy: ERP = Gold Standard</b>', S_BOLD), P('Exposure & Response Prevention', S_BLET), P('CBT', S_BLET)], LIGHT_BLUE, LIGHT_GRN, BLUE, GREEN )) story.append(SP(5)) story.append(P('OCD Spectrum Disorders', S_H3)) story.append(cmp_table( ['Disorder', 'Key Feature', 'Treatment'], [['Body Dysmorphic Disorder', 'Preoccupation with imagined physical defect. βSuicide risk.', 'SSRIs + CBT'], ['Hoarding Disorder', 'Difficulty discarding items; extreme clutter. Ego-syntonic.', 'CBT, SSRIs'], ['Trichotillomania', 'Compulsive hair pulling', 'CBT (Habit Reversal Training), N-Acetylcysteine'], ['Excoriation Disorder', 'Compulsive skin picking', 'CBT, SSRIs']], cws=[50*mm, 90*mm, 35*mm] )) story.append(SP(6)) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 10: SOMATIC # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 10: Somatic Symptom Disorders', 'Somatization | Conversion | Factitious | Malingering', PURPLE)) story.append(SP(6)) story.append(cmp_table( ['Disorder', 'Key Feature', 'Conscious?', 'Goal'], [['Somatic Symptom Disorder', 'Physical symptoms + excessive thoughts/anxiety about them', 'No', 'None (no external gain)'], ['Illness Anxiety (Hypochondriasis)', 'Fear of serious illness despite reassurance', 'No', 'None'], ['Conversion Disorder (FND)', 'Neurological symptoms without neuro cause (paralysis, blindness). "La belle indiffΓ©rence"', 'No', 'None'], ['Factitious (Munchausen)', 'Deliberately produces/feigns symptoms for SICK ROLE (internal gain)', 'YES', 'Sick role (internal)'], ['Malingering', 'Deliberately fakes illness for EXTERNAL gain (money, avoiding jail)', 'YES', 'External gain']], cws=[45*mm, 75*mm, 22*mm, 33*mm] )) story.append(SP(4)) story.append(box([ P('<b>Ganser Syndrome:</b> Approximate answers (2+2=5) + pseudohallucinations + clouding of consciousness. Seen in prisoners.'), P('<b>Munchausen by proxy:</b> Parent/caregiver induces illness in a child for sick role.'), ], LIGHT_PUR, PURPLE)) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 11-12: DISSOCIATIVE & EATING # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 11: Dissociative Disorders', 'Amnesia | Fugue | Depersonalization | DID', TEAL)) story.append(SP(6)) story.append(cmp_table( ['Disorder', 'Key Feature'], [['Dissociative Amnesia', 'Cannot recall personal/autobiographical info. Retrograde > anterograde.'], ['Dissociative Fugue', 'Amnesia + unplanned travel + assumes new identity'], ['Depersonalization-Derealization', 'Detached from self (depersonalization) or surroundings (derealization). Reality testing INTACT.'], ['DID (Multiple Personality)', 'Two or more distinct personality states. Linked to severe childhood trauma.']], cws=[55*mm, 120*mm] )) story.append(box([P('<b>Key rule:</b> In dissociative disorders, reality testing is INTACT β unlike psychosis.')], LIGHT_TEAL, TEAL)) story.append(SP(8)) story.append(ch_header('Ch 12: Eating & Feeding Disorders', 'Anorexia | Bulimia | Binge Eating', HexColor('#c2185b'))) story.append(SP(6)) story.append(cmp_table( ['Feature', 'Anorexia Nervosa', 'Bulimia Nervosa', 'Binge Eating Disorder'], [['Body weight', 'ββ BMI <17.5', 'Normal / slightly β', 'β Obese'], ['Core feature', 'Restriction + distorted body image', 'Binge-purge cycles', 'Binge WITHOUT purge'], ['Amenorrhea', 'Yes (if <47 kg)', 'Sometimes', 'No'], ['Mortality', 'HIGHEST of ALL psychiatric disorders (cardiac arrhythmias)', 'Lower', 'Lower'], ['Drug Rx', 'SSRIs for comorbidities only (not for weight restoration)', 'Fluoxetine (only FDA-approved drug)', 'Lisdexamfetamine (only FDA-approved)'], ['Psychotherapy','CBT + nutritional rehab', 'CBT (gold standard)', 'CBT']], cws=[38*mm, 55*mm, 55*mm, 27*mm] )) story.append(SP(4)) story.append(box([ P('<b>Anorexia Electrolytes (purging type):</b> Hypokalemia (M/C), metabolic alkalosis, hypoglycemia, βLH/FSH'), P('<b>Russell\'s sign:</b> Calluses on knuckles from self-induced vomiting'), ], LIGHT_RED, RED)) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 13: SLEEP # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 13: Sleep Disorders', 'Sleep stages | Parasomnias | Narcolepsy', BLUE)) story.append(SP(6)) story.append(P('Sleep Architecture', S_H3)) story.append(cmp_table( ['Stage', 'EEG waves', 'Key Features'], [['N1 (Transition)', 'Theta waves', 'Hypnic jerks; lightest sleep'], ['N2 (Light sleep)', 'Sleep spindles + K-complexes','M/C stage in normal night sleep'], ['N3 (Deep/SWS)', 'Delta waves (slow-wave)', 'Parasomnias occur here (sleepwalking, night terrors). Growth hormone released.'], ['REM sleep', 'Sawtooth/mixed', 'Dreaming, penile erection, muscle ATONIA. Nightmares occur here. REM β as night progresses.']], cws=[35*mm, 45*mm, 95*mm] )) story.append(box([P('<b>First REM sleep:</b> ~90 min after sleep onset | Acetylcholine drives REM')], LIGHT_BLUE, BLUE)) story.append(SP(5)) story.append(P('Sleep Disorders Summary', S_H3)) story.append(cmp_table( ['Disorder', 'Stage', 'Features', 'Treatment'], [['Somnambulism (Sleepwalking)', 'N3 (SWS)', 'Eyes open, unresponsive, amnesia next day', 'Safety measures; Clonazepam if severe'], ['Sleep Terror (Pavor nocturnus)', 'N3 (SWS)', 'Screaming, terror, amnesia, harder to console than nightmares', 'Self-limiting; Clonazepam'], ['Nightmares', 'REM', 'Frightening dreams; FULL recall on awakening', 'CBT, Prazosin'], ['REM Sleep Behavior Disorder', 'REM (loss of atonia)', 'Acts out dreams, may injure bed partner. β οΈ Precursor to Parkinson\'s/LBD.', 'Clonazepam (DOC), Melatonin'], ['Narcolepsy', 'Abnormal REM entry', 'See CASH tetrad below. βOrexin/Hypocretin.', 'Modafinil / Sodium oxybate (sleepiness); SSRIs (cataplexy)']], cws=[42*mm, 20*mm, 70*mm, 43*mm] )) story.append(SP(5)) story.append(mnem( 'Narcolepsy Tetrad: CASH', 'C-A-S-H', [('C', 'Cataplexy β sudden loss of muscle tone triggered by strong emotion'), ('A', 'Automatic behaviour'), ('S', 'Sleep paralysis β cannot move on waking / going to sleep'), ('H', 'Hypnagogic hallucinations (on sleep onset) / Hypnopompic (on waking)')], )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 14-15: SEXUAL & PERSONALITY # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 14: Sexual Disorders & Gender Identity', 'Paraphilias | Dysfunction | Gender Dysphoria', PURPLE)) story.append(SP(6)) story.append(cmp_table( ['Paraphilia', 'Description'], [['Exhibitionism', 'Exposing genitals to an unsuspecting stranger'], ['Voyeurism (Peeping Tom)','Watching others undress or engage in sex. Diagnosed if >18 yrs.'], ['Pedophilia', 'Sexual activity with prepubescent children (<13 yrs)'], ['Sadism', 'Inflicting pain/humiliation on others for sexual gratification'], ['Masochism', 'Self-inflicting pain for sexual gratification'], ['Transvestic Fetishism', 'Wearing opposite gender\'s clothes for sexual arousal (NOT cross-dressing)'], ['Frotteurism', 'Rubbing genitals against non-consenting person']], cws=[50*mm, 125*mm] )) story.append(box([ P('<b>Gender Dysphoria (DSM) / Gender Incongruence (ICD-11):</b> Disconnect between perceived & assigned gender'), P('Gender identity develops at <b>3β6 years</b>. Cross-dressing alone β a paraphilia.'), P('<b>Nymphomania</b> = βsexual desire in females | <b>Satyriasis</b> = βsexual desire in males'), ], LIGHT_PUR, PURPLE)) story.append(SP(8)) story.append(ch_header('Ch 15: Personality Disorders', 'Cluster A/B/C | DSM | ICD-11', DARK)) story.append(SP(6)) story.append(mnem( 'Cluster Mnemonic: A=Weird | B=Wild | C=Worried', '', [('A', 'Cluster A (Odd/Eccentric): Paranoid, Schizoid, Schizotypal PD β Schizotypal β risk for Schizophrenia'), ('B', 'Cluster B (Emotional/Dramatic): Borderline (EUPD), Histrionic, Narcissistic, Antisocial β BPD Rx: DBT'), ('C', 'Cluster C (Anxious/Fearful): OC/Anankastic, Dependent, Anxious-Avoidant β OC PD prone to depression')], LIGHT_BLUE, BLUE )) story.append(SP(5)) story.append(P('Borderline PD (BPD / EUPD) β High Yield', S_H4)) story.append(cmp_table( ['Feature', 'Description'], [['Core features', 'Unstable relationships, identity disturbance, impulsivity, self-harm/suicidality, affective instability, chronic emptiness, paranoid ideation'], ['Defence mechanism', 'Splitting (black & white thinking)'], ['Comorbidity', 'Prone to bipolar disorder; high substance use'], ['DOC Psychotherapy', 'Dialectical Behavior Therapy (DBT) β Gold Standard'], ['Drug Rx', 'Low-dose atypical antipsychotics for psychotic features; SSRIs for mood; mood stabilizers']], cws=[45*mm, 130*mm] )) story.append(SP(4)) story.append(mnem('Big 5 Personality Traits: OCEAN', 'O-C-E-A-N', [('O','Openness'),('C','Conscientiousness'),('E','Extraversion'),('A','Agreeableness'),('N','Neuroticism')])) story.append(box([ P('<b>ICD-11 Update:</b> No more named PDs. Classified by severity (mild/moderate/severe) + 5 trait domains:'), P('Negative Affectivity | Detachment | Disinhibition | Dissocial | Anankastia'), ], LIGHT_TEAL, TEAL)) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 16: NEURODEVELOPMENTAL # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 16: Neurodevelopmental Disorders', 'ADHD | ASD | Intellectual Disability', TEAL)) story.append(SP(6)) story.append(mnem('Adolescent Psychosocial Assessment: HEADSSS', 'H-E-A-D-S-S-S', [('H','Home (structure/environment)'), ('E','Education (school regularity/absenteeism)'), ('A','Activities (extracurricular)'), ('D','Drugs/alcohol use'), ('S','Sexuality'), ('S','Suicidality'), ('S','Safety (abuse, violence)')])) story.append(SP(5)) story.append(P('ADHD', S_H3)) story.append(two_col( [P('<b>Features:</b>', S_BOLD), P('β’ Inattention + Hyperactivity + Impulsivity', S_BLET), P('β’ Symptoms in β₯2 settings', S_BLET), P('β’ Onset before age 12 (DSM-5)', S_BLET), P('β’ Males > Females (3:1)', S_BLET)], [P('<b>Treatment:</b>', S_BOLD), P('1st line: Stimulants β Methylphenidate, Amphetamines', S_BLET), P('Non-stimulant: Atomoxetine (SNRI), Guanfacine, Clonidine', S_BLET), P('Preschool: Behavioral therapy preferred', S_BLET)], LIGHT_BLUE, LIGHT_GRN, BLUE, GREEN )) story.append(SP(5)) story.append(P('ASD β Core Features (DSM-5)', S_H3)) story.append(box([ P('1. Persistent deficits in social communication & interaction (all 3 domains)'), P('2. Restricted, repetitive behaviours/interests (β₯2 domains)'), P('3. Symptoms present from early developmental period'), P('<b>Rx:</b> Applied Behavior Analysis (ABA) β Gold Standard. Risperidone / Aripiprazole for BPSD.'), ], LIGHT_PUR, PURPLE)) story.append(SP(5)) story.append(P('Intellectual Disability β IQ Classification', S_H3)) story.append(cmp_table( ['Severity', 'IQ Range', 'Mental Age', 'Educational Potential'], [['Mild', '50β69', '9β12 yrs', 'Educable (up to ~6th grade)'], ['Moderate', '35β49', '6β9 yrs', 'Trainable'], ['Severe', '20β34', '3β6 yrs', 'Can do simple tasks with support'], ['Profound', '<20', '<3 yrs', 'Needs full-time care']], cws=[30*mm, 25*mm, 25*mm, 95*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 17: SUBSTANCE USE # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 17: Substance Use Disorders', 'Alcohol | Opioids | Nicotine | Cannabis', RED)) story.append(SP(6)) story.append(P('Alcohol Withdrawal Timeline', S_H3)) story.append(cmp_table( ['Timing', 'Features', 'Treatment'], [['6β24 h', 'Tremor, anxiety, diaphoresis, tachycardia, hypertension', 'Benzodiazepines (DOC)'], ['24β48 h', 'Grand mal seizures', 'BZDs (long-acting: Diazepam/Chlordiazepoxide preferred)'], ['48β72 h', 'DELIRIUM TREMENS β confusion, visual hallucinations (M/C), autonomic instability. Mortality 5β15% untreated!', 'IV Diazepam/Lorazepam + IV Thiamine + supportive care']], cws=[22*mm, 95*mm, 58*mm] )) story.append(SP(5)) story.append(P('Alcohol-Related Syndromes', S_H3)) story.append(cmp_table( ['Syndrome', 'Deficiency', 'Features', 'Treatment'], [['Wernicke\'s Encephalopathy', 'Thiamine (B1)', 'TRIAD: Ophthalmoplegia + Ataxia + Confusion. GIVE THIAMINE BEFORE GLUCOSE!', 'IV Thiamine'], ['Korsakoff Psychosis', 'Thiamine (B1 chronic)', 'Anterograde amnesia + confabulation + disorientation. Often IRREVERSIBLE.', 'Thiamine (may be irreversible)'], ['Alcoholic Hallucinosis', 'β', 'Auditory hallucinations DURING drinking (clear sensorium)', 'Antipsychotics'], ['Fetal Alcohol Syndrome', 'β', 'IUGR, microcephaly, cardiac defects, ID, characteristic facies', 'Prevention']], cws=[40*mm, 25*mm, 80*mm, 30*mm] )) story.append(SP(5)) story.append(P('Opioid Use Disorder', S_H3)) story.append(two_col( [P('<b>Overdose Triad:</b>', S_BOLD), P('β’ Coma / unconsciousness', S_BLET), P('β’ Respiratory depression', S_BLET), P('β’ Pinpoint pupils (miosis)', S_BLET), SP(3), P('<b>Rx:</b> Naloxone IV (ΞΌ antagonist β DOC)', S_BOLD)], [P('<b>Withdrawal Symptoms:</b>', S_BOLD), P('β’ Rhinorrhea, lacrimation, yawning', S_BLET), P('β’ Piloerection (gooseflesh)', S_BLET), P('β’ Diarrhea, vomiting', S_BLET), P('β’ Restlessness, anxiety', S_BLET), P('<i>Opposite of intoxication!</i>', S_SMALL)], LIGHT_RED, LIGHT_GRN, RED, GREEN )) story.append(SP(4)) story.append(cmp_table( ['Drug', 'Class', 'Key Notes'], [['Naltrexone', 'ΞΌ antagonist (oral & depot every 3 months)', 'βCraving. No abuse potential.'], ['Methadone', 'Long-acting ΞΌ agonist', 'Harm reduction. Habit-forming. Supervised dispensing.'], ['Buprenorphine', 'Partial ΞΌ agonist', 'βHarm reduction, βhabit-forming. Ceiling on respiratory depression.'], ['Buprenorphine + Naloxone','Partial agonist + antagonist', 'Currently preferred. Naloxone prevents IV misuse.']], cws=[45*mm, 65*mm, 65*mm] )) story.append(SP(5)) story.append(P('Nicotine Cessation', S_H3)) story.append(cmp_table( ['Option', 'Notes'], [['Nicotine Replacement (patch/gum/inhaler)', 'Gum: chew & park method to avoid gastric denaturation'], ['Bupropion', 'βCraving; βseizure threshold SE; avoidabove in seizure Hx'], ['Varenicline', 'Ξ±4Ξ²2 nicotinic partial agonist. MOST EFFECTIVE. Monitor mood/suicidality.']], cws=[60*mm, 115*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 18: DEMENTIA # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 18: Neurocognitive Disorders / Dementia', 'Delirium vs Dementia | Alzheimer\'s | DLB | FTD', HexColor('#455a64'))) story.append(SP(6)) story.append(P('Delirium vs. Dementia', S_H3)) story.append(cmp_table( ['Feature', 'π΄ Delirium', 'π΅ Dementia'], [['Onset', 'Acute (hoursβdays)', 'Insidious (monthsβyears)'], ['Course', 'Fluctuating', 'Progressive & steady'], ['Consciousness','Clouded', 'Clear (until late stage)'], ['Attention', 'Severely impaired', 'Relatively preserved early'], ['Reversible?', 'Usually YES β treat cause', 'Usually NO'], ['Hallucinations','Common (visual)', 'Less common']], cws=[40*mm, 75*mm, 60*mm] )) story.append(SP(5)) story.append(P('Dementia Types', S_H3)) story.append(cmp_table( ['Type', 'Key Features', 'Pathology', 'Treatment'], [["Alzheimer's (M/C)",'Memory loss (anterograde first), language, executive function. Gradual.', 'Amyloid plaques, neurofibrillary tangles. βACh', 'AChE inhibitors (mild-mod): Donepezil, Rivastigmine\nMemantine (mod-severe): NMDA antagonist'], ['Vascular (Multi-infarct)','Stepwise decline + CVD risk factors + focal neuro signs', 'Multiple cortical/subcortical infarcts', 'Treat CVD risk factors; aspirin'], ['Lewy Body (DLB)','Fluctuating cognition + visual hallucinations + Parkinsonism + REM sleep behavior disorder. β οΈ Sensitive to antipsychotics!', 'Alpha-synuclein Lewy bodies', 'AChE inhibitors; avoid typical antipsychotics'], ["Frontotemporal (FTD/Pick's)",'Personality/behaviour change FIRST (disinhibition, apathy). Memory relatively preserved early.', 'Pick bodies (tau). Frontal/temporal atrophy.', 'SSRIs for behaviour; no disease-modifying Rx']], cws=[38*mm, 65*mm, 37*mm, 35*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 19: ECT # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 19: ECT & Biological Therapies', 'Indications | Side effects | TMS | Phototherapy', ORANGE)) story.append(SP(6)) story.append(P('ECT β Indications (High Yield)', S_H3)) story.append(box([ P('β’ Severe / Psychotic depression (M/C indication)'), P('β’ Immediate suicidal risk requiring rapid response'), P('β’ Treatment-resistant depression (failed β₯2 drug trials)'), P('β’ Catatonia not responding to Lorazepam'), P('β’ Medication-resistant mania'), P('β’ Depression in pregnancy (safer than drugs in first trimester)'), P('β’ NMS (when other treatments fail)'), P('<b>β οΈ NO ABSOLUTE contraindications to ECT</b>'), ], LIGHT_YEL, YELLOW)) story.append(SP(5)) story.append(two_col( [P('<b>Procedure:</b>', S_BOLD), P('β’ General anaesthesia + succinylcholine (muscle relaxant)', S_BLET), P('β’ Electrical stimulus β brief generalised seizure', S_BLET), P('β’ Bilateral (more effective) vs. Unilateral (fewer cognitive SE)', S_BLET), P('β’ Typical course: 6β12 sessions (3x/week)', S_BLET)], [P('<b>Side Effects:</b>', S_BOLD), P('β’ Anterograde & retrograde AMNESIA (M/C)', S_BLET), P('β’ Post-ictal confusion', S_BLET), P('β’ Headache, myalgia', S_BLET), P('β’ Transient βBP during seizure', S_BLET)], LIGHT_BLUE, LIGHT_RED, BLUE, RED )) story.append(SP(5)) story.append(P('Other Biological Therapies', S_H3)) story.append(cmp_table( ['Therapy', 'Indication', 'Notes'], [['TMS (Transcranial Magnetic Stimulation)', 'Treatment-resistant depression', 'Non-invasive, outpatient, no anaesthesia'], ['Deep Brain Stimulation (DBS)', 'Treatment-resistant OCD, depression', 'Invasive surgical procedure'], ['Phototherapy (Light Therapy)', 'Seasonal Affective Disorder', '10,000 lux for 30 min in the morning'], ['rTMS', 'Depression, OCD', 'Repetitive TMS; less invasive than DBS']], cws=[55*mm, 60*mm, 60*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # CH 20: PSYCHOTHERAPY # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('Ch 20: Psychotherapy & Defense Mechanisms', 'Freud | Defense mechanisms | Therapy types', PURPLE)) story.append(SP(6)) story.append(P("Freud's Models of Mind", S_H3)) story.append(cmp_table( ['', 'ID', 'EGO', 'SUPEREGO'], [['Develops at', 'Birth', '4β6 months', '2β3 years'], ['Principle', 'Pleasure principle', 'Reality principle', 'Morality principle'], ['Function', 'Impulsive, seeks immediate gratification', 'Uses defence mechanisms to balance Id & Superego', 'Higher moral concepts']], cws=[30*mm, 47*mm, 73*mm, 25*mm], hbg=PURPLE )) story.append(box([P('<b>Topographical model (Iceberg):</b> Conscious (tip) β Preconscious β Unconscious (majority; Id is completely unconscious)')], LIGHT_PUR, PURPLE)) story.append(SP(5)) story.append(P('Defence Mechanisms β Hierarchy', S_H3)) story.append(cmp_table( ['Level', 'Mechanisms'], [['π’ Mature (healthy)', 'Humor, Anticipation, Altruism, Asceticism, Sublimation, Suppression (conscious)'], ['π‘ Neurotic', 'Intellectualization, Displacement, Repression, Reaction Formation, Undoing'], ['π Immature', 'Regression, Passive aggression, Somatization, Acting out, Isolation'], ['π΄ Psychotic / Narcissistic', 'Denial (Ostrich phenomenon), Splitting (black & white thinking), Psychotic projection']], cws=[50*mm, 125*mm] )) story.append(SP(5)) story.append(P('Psychotherapy Types', S_H3)) story.append(cmp_table( ['Therapy', 'Best for'], [['CBT (Cognitive Behavioral Therapy)', 'Depression, anxiety, OCD, eating disorders β most versatile'], ['DBT (Dialectical Behavior Therapy)', 'Borderline PD, self-harm β Gold Standard for BPD'], ['EMDR', 'PTSD β most SPECIFIC'], ['Systematic Desensitization', 'Specific phobias β Gold Standard'], ['IPT (Interpersonal Therapy)', 'Depression'], ['Motivational Interviewing', 'Substance use disorders'], ['Psychoanalysis / Psychodynamic', 'Understanding unconscious conflicts (long-term)']], cws=[70*mm, 105*mm] )) story.append(SP(5)) story.append(two_col( [P('<b>Transference</b> β Patient\'s feelings towards therapist (positive or negative)', S_BODY)], [P('<b>Countertransference</b> β Therapist\'s feelings towards patient', S_BODY)], LIGHT_BLUE, LIGHT_RED, BLUE, RED )) story.append(SP(4)) story.append(P('Projective Tests', S_H4)) story.append(cmp_table( ['Test', 'Material used', 'Measures'], [['Rorschach Inkblot', 'Ambiguous ink blots', 'Unconscious perceptions and conflicts'], ['TAT', 'Ambiguous pictures', 'Interpersonal themes, motives'], ['CAT (children)', 'Animals in social situations','Child\'s relationships and concerns'], ['MMPI', 'Questionnaire (structured)', 'Personality & psychopathology (objective test)']], cws=[45*mm, 50*mm, 80*mm] )) story.append(PageBreak()) # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ # QUICK REFERENCE # βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ story.append(ch_header('β Quick Reference: DOCs & Must-Know Facts', 'High-Frequency NEET PG Exam Topics', RED)) story.append(SP(6)) story.append(P('Drug of Choice (DOC) β Master List', S_H3)) doc_rows = [ ['Treatment-resistant schizophrenia', 'Clozapine'], ['Depression in pregnancy', 'Sertraline (FDA approved)'], ['Atypical depression', 'MAOIs > SSRIs'], ['OCD pharmacotherapy', 'SSRIs (at higher doses)'], ['Bipolar depression', 'Lamotrigine'], ['Mania / Bipolar prophylaxis', 'Lithium'], ['Akathisia', 'Propranolol (Ξ²-blocker)'], ['Acute dystonia', 'Anticholinergics (Benztropine / Trihexyphenidyl)'], ['Tardive Dyskinesia', 'Valbenazine / Deutetrabenazine (VMAT2 inhibitors)'], ['NMS', 'Dantrolene + Bromocriptine'], ['Serotonin syndrome', 'Cyproheptadine'], ['Alcohol withdrawal / DTs', 'Benzodiazepines (Diazepam IV)'], ['Opioid overdose', 'Naloxone IV (ΞΌ antagonist)'], ['Opioid dependence maintenance', 'Buprenorphine + Naloxone'], ['Narcolepsy (sleepiness)', 'Modafinil / Sodium oxybate'], ['PTSD nightmares', 'Prazosin (Ξ±1-blocker)'], ['PTSD β most specific psychotherapy', 'EMDR'], ['Specific phobia β psychotherapy', 'Systematic desensitization'], ['Catatonia (1st line)', 'Lorazepam'], ['Catatonia (if BZD fails)', 'ECT'], ['Smoking cessation (most effective)', 'Varenicline'], ['Wernicke\'s encephalopathy', 'IV Thiamine (BEFORE glucose!)'], ['TCA overdose', 'Sodium bicarbonate'], ['Bulimia nervosa (drug)', 'Fluoxetine (only FDA-approved)'], ['Binge eating disorder (drug)', 'Lisdexamfetamine (only FDA-approved)'], ['Borderline PD (therapy)', 'DBT'], ['REM sleep behavior disorder', 'Clonazepam'], ['GAD non-sedating option', 'Buspirone (5HT1A partial agonist)'], ['Seasonal affective disorder', 'Phototherapy (10,000 lux)'], ["Alzheimer's (mildβmoderate)", 'AChE inhibitors: Donepezil, Rivastigmine'], ["Alzheimer's (moderateβsevere)", 'Memantine (NMDA antagonist)'], ['Fibromyalgia / Diabetic neuropathy', 'Duloxetine (SNRI)'], ['Panic disorder', 'SSRIs/SNRIs; Propranolol for situational'], ] story.append(cmp_table(['Condition', 'Drug / Therapy'], doc_rows, cws=[95*mm, 80*mm])) story.append(SP(8)) story.append(P('High-Yield One-Liners', S_H3)) oneliners = [ 'Clozapine = Most effective antipsychotic BUT monitor CBC (agranulocytosis risk)', 'Lithium therapeutic window: 0.6β1.2 mEq/L | Teratogen: Ebstein\'s anomaly | NSAIDs β toxicity', 'Fluoxetine = longest half-life SSRI β least discontinuation syndrome', 'Paroxetine = shortest half-life SSRI β most discontinuation syndrome; AVOID in pregnancy', 'Valproate in pregnancy = neural tube defects (worst teratogen among mood stabilizers)', 'Carbamazepine = CYP450 enzyme INDUCER β multiple drug interactions', 'ECT has NO absolute contraindications. M/C SE = anterograde + retrograde amnesia', 'SSRIs may β suicidal ideation in first 2 weeks (Black Box Warning, especially <25 yrs)', 'Give Thiamine BEFORE Glucose in Wernicke\'s β glucose depletes residual thiamine!', 'Schizophrenia better prognosis: Female, late onset, acute onset, positive symptoms, family support', 'Anorexia nervosa = HIGHEST mortality of ALL psychiatric disorders (cardiac arrhythmias)', 'REM sleep behavior disorder = precursor to Parkinson\'s disease / Lewy Body dementia', 'Capgras = known person replaced by an impostor | Fregoli = stranger is known persecutor in disguise', 'Cotard syndrome = nihilistic delusion ("I am dead / my organs don\'t exist") in severe depression', 'Othello syndrome = delusion of jealousy β most common in chronic alcoholism', 'Ganser syndrome = approximate answers (2+2=5) β seen in prisoners/forensic settings', 'Munchausen = self-induces illness (internal gain) | Munchausen by proxy = induces in child', 'La belle indiffΓ©rence = emotional indifference to neurological symptoms in conversion disorder', 'Buspirone = no sedation, no addiction, no GABA action; late onset; good for GAD elderly', 'Narcolepsy: ββ Orexin/Hypocretin in CSF is diagnostic', 'DLB: Sensitive to antipsychotics β can cause severe EPS/NMS! Use with extreme caution.', 'Bleuler\'s 4 A\'s: Autism, Ambivalence, Affect, Association β Auditory hallucination is NOT included', 'Kurt Schneider\'s FRS (3+3+3): Auditory hallucinations + Made phenomena + Thought phenomena', 'Systematic desensitization = graded exposure + relaxation = gold standard for specific phobias', 'EMDR = most specific therapy for PTSD | CBT = best overall for anxiety/depression', ] for line in oneliners: story.append(P(f'β’ {line}', S_BLET)) story.append(SP(12)) # Footer note story.append(HR()) story.append(P('Psychiatry NEET PG Master Guide | Based on Marrow Revision Ed. 8 (2024) | For educational use', PS('foot', fontSize=7, textColor=HexColor('#888888'), alignment=TA_CENTER))) # ββ Build PDF βββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββββ OUT = '/tmp/workspace/psych-neetpg/Psychiatry_NEETPG_MasterGuide.pdf' doc = SimpleDocTemplate( OUT, pagesize=A4, rightMargin=1*cm, leftMargin=1*cm, topMargin=1.5*cm, bottomMargin=1.5*cm, title='Psychiatry NEET PG Master Guide', author='Marrow Revision Ed. 8', ) doc.build(story) import os size = os.path.getsize(OUT) print(f'PDF created: {OUT}') print(f'Size: {size/1024:.1f} KB') PYEOF