Anxiety, Personality, Eating Disorders Flashcards
Treatment for MDD refractory to other treatment ad for pregnant women with MDD. Also considered when immediate response is needed (acute suicidality), in depression with psychotic features, and for catatonia
ECT
Produces a painless seizure in an anesthetized patient. Major adverse effects are disorientation and temporary anterograde/retrograde amnesia usually resolving in 6 months.
ECT
Risk factors for suicide completion
SAD PERSONS
S - Sex (male)
A - Age (teenager or elderly(
D - Depression
P - Previous attempt
E - EtoH or drug use
R - loss of Rational though
S - Sickness (medical illness, 3 or more prescription meds)
O - Organized plan
N - No spouse (divorced, widowed, or single, esp. if childless)
S - Social support lacking
_________ try more often, ______ succeed in suicide completion more often
women
men
Inappropriate experience of fear and worry and its physical manifestations (anxiety) when the source of the fear/worry is either not real or insufficient to account for the severity of the symptoms. Symptoms interfere with daily functioning.
Anxiety disorder.
Lifetime prevalence of 30% in women and 19% in men. Includes panic disorder, phobias, PTSD, and GAD.
Anxiety disorder
Defined by the presence of recurrent periods of intense fear and discomfort peaking in 10 minutes with at least 4 of the following: Palpitations, Paresthesias, Abdominal distress, Nausea, Intense fear of dying or losing control, light headedness, chest pain, chills, choking, disconnectedness, sweating, shaking, SOB.
STRONG GENETIC COMPONENT.
Panic disorder
Treatment for panic disorder
CBT, SSRIs, Venlafaxine, Benzos
Person recognizes fear is excessive - cued by presence or anticipation of specific object or situation; treat with desensitization
Specific phobia
Exaggerated fear of embarrassment in social situations - treatment?
Social phobia
Treat: SSRI
Recurring intrusive thoughts, feelings, or sensations (obsessions) that cause severe distress; relieved in part by the performance of repetitive actions (compulsions).
OCD
Behavior inconsistent with one’s own beliefs and attitudes
Ego dystonic
OCD is associated with
Tourette’s
Treatment for OCD
SSRIs, clomipramine
Persistent re-experiencing of traumatic event - may involve nightmares, flashbacks, intense fear, helplessness, or horror. Leads to avoidance of stimuli associated with the trauma and persistently increased arousal. Disturbance lasts >1 month with onset of symptoms beginning anytime after event, and causes significant distress and/or impaired functioning.
PTSD
Treatment for SSRI
Psychotherapy, SSRI
Acute Stress Disorder lasts
between 2 days and 1 month
Pattern of uncontrollable anxiety for at least 6 months that is unrelated to a specific person, situation, or event. Associated with sleep disturbance, fatigue, GI disturbance, and difficulty concentrating.
GAD
GAD Treatment
SSRIs, SNRIs
Emotional symptoms (anxiety, depression) causing impairment following an identifiable psychosocial stressor (e.g. divorce/illness) and lasting < 6months
Adjustment Disorder
Patient consciously fakes or claims to have a disorder in order to attain a specific secondary gain (avoiding work, getting drugs). Poor compliance with treatment or follow-up of diagnostic tests. Complaints cease after gain (vs. factitious disorder).
Malingering
Patient consciously creates physical and/or psychological symptoms in order to assume “sick role” and to get medical attn. (primary gain)
Factitious disorder
Chronic factitious disorder with predominantly physical signs and symptoms. Characterized by a history of multiple hospital admissions and willingness to receive invasive procedures.
Munchausen’s syndrome
When illness in a child or elderly patient is caused by the caregiver. Motivation is to assume a sick role by proxy. Form of child/elder abuse.
Munchausen’s syndrome by proxy
