12: Severe Mental Health Disorders

Question 1

A mix of intrusive thoughts that produce worry combined with repetitive behaviors aimed at reducing the associated anxiety.

Answer 1

Obsessive-Compulsive Disorder (OCD)

Question 2

80% of people with OCD will start having symptoms before the age of _____.

Answer 2

18

Question 3

When do schizophrenic symptoms usually first occur?

Answer 3

Late adolescence and early 20s

Question 4

What is the role of the FNP in schizophrenia?

Answer 4

Treatment is only in conjunction with psychiatry. So, FNPs address cleanliness, smoking, safety checks (living alone?), coordination of care, and side effects of meds (weight gain, elevated blood sugar).

Question 5

Positive or negative symptoms of schizophrenia?

Indicates lack of a full emotional life.

Answer 5

Negative

Question 6

Thought disturbances, disrupted social behavior, and inability to determine what is real.

Answer 6

Schizophrenia

Question 7

This type of bipolar has dysthymia or another disorder attached to bipolar diagnosis, with cycling.

Answer 7

Mixed Bipolar

Question 8

What is a concern to consider when medicating a depressed person?

Answer 8

Are they really bipolar? If so, giving them an antidepressant without a mood stabilizer can lead to a manic state.

Question 9

Most severe form of bipolar. There is true differentiation between high-highs and high-lows.

Answer 9

Bipolar 1

Question 10

T/F Cellulitis can be a sign of OCD.

Answer 10

True, from excessive hand washing.

Question 11

Positive or negative symptoms of schizophrenia?

Patients experience things others do not.

Answer 11

Positive

Question 12

T/F Bipolar requires treatment for life.

Answer 12

True. Recurs even if treated.

Question 13

How do you manage OCD (3)?

Answer 13

1. CBT + exposure-ritual prevention therapy
2. Medications (SSRIs, SNRIs, tricyclics)
3. ECT

Question 14

What are s/sx of mania (6)?

Answer 14

1. Racing thoughts
2. Lack of needing sleep
3. Excess energy
4. Grandiosity
5. Hyperactivity
6. Impulsivity

Question 15

T/F Schizophrenics may have word salad or poverty of speech.

Answer 15

True. Along with inability to experience pleasure, emotional blunting, inability to form relationships.

Question 16

What are clues to bipolar (6)?

Answer 16

1. Family hx
2. Input from family members often different than patient
3. Marked changes in mood, behavior, productivity
4. Failure of multiple antidepressants
5. On/off response to antidepressants
6. Hypomanic response to antidepressants

Question 17

T/F Benzos can help calm OCD patients so that they worry less and thus have fewer compulsions.

Answer 17

False. It will not treat OCD and may become a compulsion.

Question 18

T/F Unless patient is stable, cooperation between NP and mental health counselor is required with bipolar.

Answer 18

True

Question 19

Is schizophrenia more common in males or females?

Answer 19

Males

Question 20

This is the most genetic of all mental illnesses.

Answer 20

Bipolar

Question 21

This type of bipolar has low-lows but not high-highs. May get back to normal, or a little above normal (not completely manic).

Answer 21

Bipolar 2

Question 22

Bipolar is often misdiagnosed as _____ in early childhood.

Answer 22

ADHD

Question 23

T/F Schizophrenia is caused by genetics and prenatal development.

Answer 23

False. Definitive cause unknown. Likely a combination of genetics, prenatal development, early environment, neurobiology, psychological/social processes.

Question 24

What are common compulsions with OCD (4)?

Answer 24

1. Washing/cleanliness
2. Repeat checking
3. Hoarding/compulsive buying
4. Harmful acts