B7-066 Depression/Suicidal Behavior Flashcards
MDD is characterized by > 5 symptoms nearly every day for […] weeks
two
symptoms of MDD [9]
Sleep disturbances
Interest in pleasurable activities (ahedonia)
Guilt or feelings of worthlessness
Energy (low)
Concentration (poor)
Appetite/weight changes
Psychomotor retardation or agitation
Suicidal ideation
SIG E CAPS
(must have >5 for two weeks and be idiopathic)
screen for manic or hypomanic episodes to rule out […]
bipolar disorder
first line therapy for MDD [2]
CBT
SSRIs
terms like “functional” or “non-organic” indicate
idiopathic
(disease pathology can’t be seen on light microscopy)
what is useful about the psychodynamic approach/model?
recognition of unconscious cognitive processing
explains but does not predict
what is the goal of psychotherapy?
patients learn strategies to cope/change behavior
remodels synaptic connections
major complication of all mental health disorders
suicide
biggest static (distal) risk factor for suicide
psychiatric diagnosis
biggest dynamic (proximal) factor for suicide
under-treatment of mental health diagnosis
anxiety, rage, anger, feeling trapped, psychosocial loss are examples of […] risk factors for suicide
proximal (dynamic)
age, gender, agressive/impulsive traits, terminal illness are examples of […] risk factors for suicide
distal (static)
does asking a person about suicide increase their risk?
no
what is the Columbia Suicide Severity Rating Scale?
rating form for assessing risk of suicide
the risk of suicide is […] making it difficult to prevent
transient
SAD PERSONS mnemonic for suicide risk factors
Sex (male)
Age (young adult or older)
Depression
Previous attempt (highest risk factor)
Ethanol/drug use
Rational thinking loss (psychosis)
Sickness (medical illness)
Organized plan
No spouse/social support
Stated future intent
best prevention of suicide
treatment of underlying medical disorder
(pharmacotherapy/psychotherapy)
suicide intervention tactics from most aggressive to least aggressive [3]
hospitalization/commitment
outpatient safety planning intervention
treat underlying psychiatric disease
what does a safety planning intervention entail?
limit access to lethal means
teach to identify warning signs and formulate coping strategies
[…] is a deadly medication that psychiatrists may only order in short scripts due to toxicity
amitriptyline
reflective rumination is often focusing on feelings of […]
entrapment
[…] psychotherapy is applicable to suicidal ideation across diagnoses
cognitive
[…] psychotherapy is has some selectivity to patients with BPD, but is widely applicable
dialectical behavior
talk therapy for patients who expierience emotions intensely
[…] psychotherapy uses a combinational approach for mindfulness with CBT techniques
mindfulness-based cognitive therapy
public interventions for preventing suicide [3]
public awareness/education
means restriction
restrictions on media reporting
(not a great benefit overall)
one or more symptoms that are distressing or result in significant disruption of daily life
excessive thoughts/behaviors related to symptoms
somatic symptom disorder
treatment of somatic symptom disorder [3]
address in psychotherapy
adjunctive antipsychotic
regular follow up with PCP
preoccupation with acquiring or having a serious illness, despite reassurance
often have minimal/no somatic symptoms
illness anxiety disorder
unexplained loss of voluntary sensory or motor function following an acute stressor
patients may be aware but indifferent of symptoms
conversion disorder
patient consciously creates physical and/or psychological symptoms in order to assume a “sick role” and get medical attention/sympathy for no obvious gain
factitious disorder
one or more bodily complaints lasting months to years
associated with excessive, persistent thoughts/anxiety about symptoms
somatic symptom disorder
symptoms are intentional, motivation is intentional
patiently consciously fakes/exaggerates disorders for a specific gain
malingering
poor compliance with treatments or follow-up of diagnostic tests
complaints cease after gain
malingering
(vs. factitious disorders, complaints do not cease)
in malingering, symptoms are […] and motivation is […]
intentional
intentional
in factitious disorder, symptoms are […] and motivation is […]
intentional
unconscious
in somatic symptom disorder, symptoms are […] and motivation is […]
unconscious
unconscious
[…] conveys a risk of impulsive behavior and may increase the patient’s risk for suicidal action
ADHD
[…] are more at risk for completing suicide, […] attempt more frequently
men are more at risk for completing suicide, women attempt more frequently
assessing if the patient has […] to commit suicide is an important issue when evaluating risk
lethal means
typically speaks to clinical information like symptoms, diagnoses, treatment course
collateral
use of screening tools omits […], which is the gold standard for assessing risk of suicide
clinical judgement
the risk of suicide is […] and difficult to predict
transient
public awareness and education programs have caused a […] in suicides
non-significant reduction
[…] mediates a relationship between rumination and suicide
entrapment
what factor does not increase the risk of suicide?
broaching the topic of suicide
