Today we will discuss Circadian Rhythm Sleep-Wake Disorders (CRSWDs). We will cover an introduction, definitions, diagnostic criteria, risk factors, and treatment. Today's Content Level: All levels (Beginner, Intermediate, Advanced) Refresher on the Circadian Rhythm 1 •Circadian rhythm = roughly 24-hour cycle that is synchronized with the day-night cycle of the Earth. •Sometimes called the body’s internal biological clock. It is a timing mechanism in the brain that uses light/dark exposure to synchronize the sleep-wake cycle with the external environment. It also regulates melatonin production ..read more

Today we will begin a new theme: sleep disorders. We will start by providing an overview of important sleep physiology. Today's Content Level: All levels (Beginner, Intermediate, Advanced) Why Do We Sleep? 1, 2 • Why we sleep remains one of nature’s greatest mysteries. •The average person will spend about 27 years of their lifetime sleeping. •Sleep is essential for many vital functions and a number of theories have been proposed regarding the purpose and function of sleep. Somatic theories: energy conservation, physical development, modulation of immune system responses, and physical performa ..read more

Today will be our review quiz for the eating disorders theme. Take a few minutes and check your learning. 1) Which of the following are not recommended admission criteria for patients with anorexia nervosa? a) Heart rate b) Blood pressure c) Cardiac arrhythmia d) BMI 2) For which eating disorder is fluoxetine considered the first-line medication option? a) Anorexia nervosa b) Bulimia nervosa c) Avoidant/restrictive food intake disorder (ARFID) d) Rumination disorder 3) A patient repeatedly regurgitates their food, sometimes spitting it out, and sometimes re-swallowing it. This has been going o ..read more

Today we will continue our current theme of eating disorders as we discuss three less well known eating disorders: Avoidant/Restrictive Food Intake Disorder, Rumination Disorder, and Pica. Today's Content Level: Beginner and Intermediate Introduction 1 Avoidant/Restrictive Food Intake Disorder (ARFID): Eating disturbance characterized by a persistent failure to meet appropriate nutritional and energy needs. The reason for the eating disturbance does not include distorted body image and is often based on a lack of interest in food or avoidance based on food characteristics. Usually a disorder ..read more

Today we will continue our current theme of eating disorders as we discuss binge eating disorder (BED). Today's Content Level: Beginner and Intermediate Introduction 1 Binge-eating disorder (BED) is characterized by recurrent binge eating. Binge eating = Eating a larger-than-normal amount of food in a discrete time period (2 hours). This is accompanied by feeling out of control during the eating episode, such as feeling like they cannot stop eating or control what or how much they are eating. Unlike anorexia and bulimia nervosa, patients with BED do not try to control their weight through com ..read more

Today we will continue our current theme of eating disorders as we discuss bulimia nervosa. In part 1 we detailed an introduction, definitions, diagnostic criteria, epidemiology, and pathogenesis. Today, in part 2, we will cover clinical pearls, physical complications, and treatment. Today's Content Level: Intermediate Clinical Pearls 1, 2, 3, 4 History: Bulimia nervosa (BN) is an eating disorder characterized by recurrent binge eating combined with behaviors intended to counteract the weight gain (purging). See part 1 for complete definitions and diagnostic criteria. The evaluation is simila ..read more

Today will be our last review quiz for the personality disorders theme. Take a few minutes and check your learning. 1) Which of the following evidence-based interventions for borderline personality disorder does not require specialized provider training? a) Dialectical Behavioral Therapy (DBT) b) Mentalization-Based Therapy (MBT) c) Good Psychiatric Management (GPM) d) Transference-Focused Psychotherapy (TFP) 2) Which of the following is not one of the nine diagnostic criteria for borderline personality disorder? a) Easily influenced by others or circumstances b) Chronic feelings of emptiness ..read more

Today we will continue our current theme of cluster B personality disorders as we discuss histrionic personality disorder. Today's Content Level: Beginner and Intermediate Introduction 1 Individuals with histrionic personality disorder (HPD) have a long-standing pattern of excessive emotionality and attention-seeking behavior. Despite their extroverted and flamboyant personality they are often unable to maintain meaningful and long-lasting relationships. Common traits/symptoms may include being -> dramatic, colorful, exaggerated, emotional, flamboyant, theatrical, extroverted, provocative ..read more

Today we will continue our current theme of cluster B personality disorders as we discuss pharmacological options for borderline personality disorder. See day #135 (BPD part 1) for a full discussion on the diagnostic criteria, epidemiology, pathogenesis, and clinical pearls for BPD. See day #136 (BPD part 2) for a full discussion on psychotherapy for borderline personality disorder. Today's Content Level: All levels (Beginner, Intermediate, Advanced) INTRODUCTION ,1, ,2 The first-line treatment for borderline personality disorder (BPD) is psychotherapy. There are a number of specific therap ..read more

Today we will continue our current theme of cluster A personality disorders as we discuss schizotypal personality disorder. Today's Content Level: All levels (Beginner, Intermediate, Advanced) Introduction 1 Individuals with schizotypal personality disorder (SPD) have a lifelong pattern of eccentric behavior and odd thought patterns. They may experience derealization, body illusions, ideas of reference, and display magical thinking (odd beliefs inconsistent with cultural norms). Common traits/symptoms may include being -> peculiar, odd, strange, eccentric, suspicious, withdrawn. Diagnosti ..read more