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Psychiatric Disorders
An overview of psychiatric conditions and related syndromes, covering clinical features, contributing factors, diagnosis, treatments, severity and health impacts.
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An overview of psychiatric conditions and related syndromes, covering clinical features, contributing factors, diagnosis, treatments, severity and health impacts.
120records
17columns
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| # | TextID | TextDisease Name | TextCategory | TextPrevalence | TextInheritance Pattern | TextAffected Gene(s) | LocationChromosome Location | TextKey Symptoms | TextTypical Age of Onset | TextDiagnosis Methods | TextAvailable Treatments | TextOrphan Drug Designation | TextICD-10 Code | NumberOMIM Number | TextAffected System | TextDisease Severity | TextLife Expectancy Impact |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 01 | 1 | Neuroleptic Malignant Syndrome (NMS) | Psychiatric Emergency | 0.01-3.2% of patients exposed to antipsychotics (approximately 1-2% incidence); ~2,000 cases/year in US | Not inherited (idiosyncratic drug reaction); possible genetic susceptibility via dopamine D2 receptor polymorphisms | DRD2 (susceptibility), RYR1 (in rare overlap with malignant hyperthermia) | 11q23 (DRD2); 19q13.2 (RYR1) | Tetrad: hyperthermia (>38°C), severe muscle rigidity ('lead-pipe'), autonomic instability (labile BP, tachycardia, diaphoresis), altered mental status; elevated CK (>1000 U/L), leukocytosis, metabolic acidosis | Any age; typically within 2 weeks of initiating or increasing dopamine antagonist | Clinical diagnosis per DSM-5-TR criteria; CK elevation; exclusion of infection, heat stroke, malignant hyperthermia, serotonin syndrome, malignant catatonia | Immediate discontinuation of offending agent; supportive care (cooling, IV fluids, electrolyte correction, ICU monitoring); dantrolene (Dantrium) for severe rigidity/hyperthermia; bromocriptine or amantadine (dopamine agonists); benzodiazepines (lorazepam); ECT for refractory cases | No | G21.0 | N/A | Central and peripheral nervous system, autonomic, musculoskeletal | Life-threatening | Mortality 5-10% with treatment (historically 20-30%); full recovery typical if recognized early |
| 02 | 2 | Serotonin Syndrome | Psychiatric Emergency | Incidence rising with SSRI/SNRI use; ~15% of SSRI overdoses develop symptoms; underreported | Not inherited (drug-drug interaction); CYP2D6 poor metabolizer status may increase risk | CYP2D6, CYP3A4 (pharmacogenetic risk), SLC6A4 (serotonin transporter) | 22q13.2 (CYP2D6); 7q11.2 (CYP3A4); 17q11.2 (SLC6A4) | Hunter Criteria triad: neuromuscular hyperactivity (clonus, hyperreflexia, tremor - lower limbs > upper), autonomic hyperactivity (hyperthermia, tachycardia, diaphoresis, mydriasis), altered mental status (agitation, confusion) | Any age; onset within 24 hours (often within 6 hours) of serotonergic agent or dose change | Hunter Serotonin Toxicity Criteria (preferred); Sternbach criteria; exclusion of NMS, anticholinergic toxicity, malignant hyperthermia; medication history essential | Immediate discontinuation of serotonergic agents; supportive care (IV fluids, cooling, benzodiazepines for agitation/clonus); cyproheptadine (5-HT2A antagonist) for moderate-severe cases; intubation/paralysis for severe hyperthermia; avoid antipyretics, dantrolene, bromocriptine | No | G90.81 | N/A | Central and autonomic nervous system, neuromuscular | Life-threatening in severe cases; typically mild-moderate | Resolves within 24-72 hours with treatment; mortality <1% with recognition; severe cases may require ICU |
| 03 | 3 | Malignant Catatonia | Psychiatric Emergency | Rare; ~0.07-0.5 per 100,000; historically up to 10% of catatonia cases | Not inherited; can occur in any catatonic patient; genetic vulnerability to mood/psychotic disorders may contribute | Unknown; possible GABA-A receptor dysfunction | N/A | Catatonic features (stupor, mutism, posturing, rigidity, negativism, waxy flexibility) PLUS hyperthermia, autonomic instability, altered consciousness; elevated CK; may progress from simple catatonia | Any age; often abrupt onset over days | Bush-Francis Catatonia Rating Scale (≥2 of 14 signs); DSM-5-TR catatonia criteria; lorazepam challenge test; exclusion of NMS (often clinically indistinguishable) | High-dose lorazepam (Ativan) 8-24+ mg/day (first-line); ECT (definitive treatment, bilateral, frequent sessions) - treatment of choice; avoid antipsychotics (may worsen); supportive ICU care; NMDA antagonists (amantadine, memantine) in refractory cases | No | F06.1 | N/A | Central nervous system, autonomic, musculoskeletal | Life-threatening | Untreated mortality ~50%; with ECT/lorazepam, mortality ~9%, complete remission ~58% |
| 04 | 4 | Catatonia Associated with Another Mental Disorder | Psychiatric Emergency | Present in ~10% of acute psychiatric admissions; 20% of mood disorder, 10-15% of schizophrenia admissions | Not inherited directly; associated with underlying mood/psychotic disorder heritability | Associated with underlying disorder genetics | N/A | DSM-5-TR: ≥3 of 12 features - stupor, catalepsy, waxy flexibility, mutism, negativism, posturing, mannerisms, stereotypies, agitation, grimacing, echolalia, echopraxia | Any age; most common in young adults with mood/psychotic disorders | Bush-Francis Catatonia Rating Scale; DSM-5-TR diagnostic criteria; lorazepam challenge (2 mg IV/IM - rapid improvement is diagnostic); treat underlying disorder | Lorazepam (Ativan) first-line (6-24 mg/day); ECT (second-line or first-line if severe); treat underlying psychiatric disorder; avoid first-generation antipsychotics (risk of NMS) | No | F06.1 | N/A | Central nervous system, psychomotor | Moderate-severe; can progress to malignant catatonia | Generally good with prompt treatment; 70-80% respond to lorazepam; ECT effective in refractory cases |
| 05 | 5 | Catatonic Disorder Due to Another Medical Condition | Psychiatric Emergency | Accounts for 20-39% of catatonia cases; rising recognition with autoimmune encephalitis | Not inherited; secondary to underlying medical condition | Variable; depends on underlying etiology (e.g., NMDAR, LGI1 antibodies) | N/A | Catatonic features (DSM-5-TR: ≥3 of 12) directly attributable to medical condition (e.g., encephalitis, metabolic, endocrine, neoplastic, infectious) | Any age; depends on underlying condition | DSM-5-TR criteria; identification of underlying medical cause (neuroimaging, CSF analysis, autoimmune encephalitis panel, metabolic workup, EEG); Bush-Francis Scale | Treat underlying medical condition; lorazepam for symptomatic relief; ECT if refractory; immunotherapy if autoimmune (IVIG, steroids, rituximab, plasmapheresis); avoid antipsychotics | No | F06.1 | N/A | Central nervous system (secondary to underlying condition) | Variable; depends on underlying condition | Depends on underlying etiology; autoimmune causes have good prognosis with treatment |
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