1. Depression (pseudodementia) vs true dementia: 
-Depression is more acute onset, dysphoria, people emphasize failures, says "I don't know" when you ask them hard questions but when you press they often give the right answer, no sundowning, good insight
-True dementia is insidious onset, people "delight in accomplishments", confabulates (makes things up when they don't know), sundowning often present (confusion worse at night), poor insight.
2. Normal grief vs abnormal grief: 
-Normal grief: milder symptoms, minor illusions, no suicidal ideation, worst symptoms <2 mos, all symptoms <1 year
-Abnormal grief: severe, incapacitating symptoms (sleep, functionality, severe guilt'worthlessness), significant hallucinations, +Suicidal ideation, worst symptoms >2 mos, all symptoms >1 year
3. Insomnia in older person: 
-DDx: primary insomnia, medical/psych condition, behavioral problems: alcohol drinking, daytime naps, poor sleep hygiene.
-Tx: avoid benzos, use hydroxyzine (vistaril) or zolpidem (ambien). behavior modification first, better sleep hygiene, don't drink alcohol.
4. Conduct disorder:
-DSM criteria: >1 year of at least 3 acts of: aggression/violence towards people, animals, or things; stealing/lying; serious violations of rules
-Prevalence: 6-16% boys, 2-9% of girls
-40% risk of developing antisocial personality disorder as an adult
-Tx: disciplined environments with regularly enforced rules, behavior modification therapy, lithium/antipsychotics (for aggression),  and SSRIs for impulsivity, mood lability, irritability
5. Oppositional defiant disorder: 
-DSM criteria: >6 months of 4 of the following: displays of frequent loss of temper, arguments with adults, spitefulness, blaming others for things, defying rules, deliberately annoying others, being easily annoyed, harboring anger and resentment,
-Prevalence: 16 to 22% of children >6
-25% remission
-Tx: psychotherapy
6. ADHD:
-Triad of inattention, hyperactivity, impulsivity
-DSM: at least 6 symptoms of inattention, hyperactivity, or both, persisting for >6 months, onset before the age of 7 years
-Inattention: problems listening, completing tasks, loses things, easily distracted, forgetful
-Hyperactivity: problems sitting still, blurting out/interrupting, talking too much
-20% persist into adulthood
-most common comorbidities - ODD in boys, anxiety in girls
-Tx: Ritalin (methylphenidate), Concerta (methylphenidate extended release), Focalin (dexmethylphenidate-- the dextrorotary enantiomer), Adderall (dextroamphetamine/levoamphetamine),
-non stim tx: Strattera (atomoxetine) -not covered by Medicaid, Wellbutrin (norepinephrine helps w focus), tenex (clonidine and guanfacine)
-Theory of pathophysiology- mutation of dopamine R in prefrontal cortex, either increased reuptake or decreased excretion: "Placebo-controlled study examining effects of selegiline in children with attention-deficit/hyperactivity disorder."
7. Autism:
-DSM: at least 6 symptoms from the following three categories: at least 2 problems with social interaction (eye contact, empathy, interest in relationships, etc), at least 1 problem with communication (language development, grammar, vocabulary, repetitive language), at least 1 problem with stereotypy (stereotyped or repetitive movements, inflexible rituals).
-Usually begins before age 3
-Comorbid with tuberous sclerosis, fragile X, mental retardation, seizures
-36% concordance in monozygotic twins
-Tx: remedial education/behavioral therapy; antipsychotics for aggression/lability, SSRIs for stereotyped movements/language
8. Asperger's
-DSM: at least two symptoms of impaired social interaction (empathy, desire for relationships, impaired nonverbal behaviors-- expressions/gestures), at least 1 symptom of stereotypy (inflexible rituals, obsessions, repetitive movements)
9. Other childhood pervasive disorders:
-Rett's disorder- MECP2 gene on X chromosome. Only affects girls, normal development til 5 months, then decreasing head circumference, loss of hand skills (replaced by sterotyped hand movements), loss of social interaction, problems with gait/trunk movements, severely impaired language and psychomotor development (development never progresses beyond 1st year of life), seizures, cyanotic spells. Onset 5-48 months.
-Childhood disintegrative disorder: normal development in first 2 years, then loss of milestones in two of the following: language, social skills, bowel/bladder, motor skills, play.
10. Tic disorders: 
-Motor and verbal = tourette's. Motor or verbal only = motor or verbal tic disorder respectively.
-DSM for Tourettes: motor and verbal tics multiple times a day, every day for >1 year, with no tic-free period >3 months, onset before 18 years of age.
-Tx: haldol, pimozide, clondine, risperiodone