Behavioral Health Treatments Flashcards
Generalized Anxiety Disorder
() Cognitive Behavioral Therapy
() SSRI (Sertraline or citalopram)
() SNRI (Venlafaxine)
() Short-course Benzos or buspirone
Panic Disorder
() SSRIs (sertraline, citalopram, escitalopram)
() Benzos (Clonazepam, Lorazepam) PRN
Specific Phobias
() Cognitive Behavioral Therapy
Social Anxiety Disorder
CBT, SSRI/SNRI, Benzos PRN, Beta-blockers (propranolol) for anxiety
PTSD
() Antidepressants, SSRIs (sertraline, citalopram) or SNRIs (venlafaxine)
() Prazosin (alpha-receptor antag) for nightmares
() Atypical antipsychotic in severe
() CBT exposure therapy or cognitive processing therapy
Anorexia Nervosa
() Refeeding and nutrition
() If 20-25% below ideal body weight, hospitalization
() Cognitive Behavioral Therapy
() SSRIs
Bulimia Nervosa
() Antidepressants SSRIs = Fluoxetine only FDA-approved
() Psychotherapy = Cognitive Behavioral Therapy, Interpersonal, Group, Family
() Nutritional counseling
()() AVOID BUPROPION because of lower seizure threshold
ADHD
MULTIMODAL
() STIMULANTS ARE #1 treatment = methylphenidate , dextroamphetamine
(O) Also Atomoxetine (NorEpi reuptaike inhibitor)
(O) Also Alpha-2 agnoists that squeeze blood vessels (clonidine, guanfacine)
() Behavioral intervention to reverse
() Educational intervention
Delusional Disorder
() Antipsychotic meds suggested, but little evidence
() Supprotive therapy
()() AVOID GROUP THERAPY d.t. patient suspiciousness
Schizophrenia
“Typical Antipsychotics = Chlorpromazine, Thioridazine, Thiothixene, Perphenazine, Haloperidol, Fluphenazine
Atypical Antipsychotics = Clumsy Old Queens Are Fat Rich Zillionaires = Clozapine, Olanzapine, Quetiapine, Aripiprazole, (FAT side effect), Risperidone, Ziprasidone
• Typicals are mostly dopamine antagonist
○ Extra-pyramidal symptoms are dose-dependent
() Atypicals have greater action at 5HT and some dopamine. Better effect on Negative symptoms. Aripiprazole has partial AGONIST effect at D2 and much stronger affinity for it than any other med, so will kick of others”
Conduct Disorders
() Behavior modification
() Parent management training
() Pharma mx of other comorbidities
Antisocial Personality Disorder
() PSYCHOTHERAPY GENERALLY NOT EFFECTIVE
() Group therapy ill advised because will not work well with group
() Pharmacology for anxiety or depression, but highly addictive personality
Borderline PDO
() Dialectical Behavior Therapy (includes CBT, mindfullness, group)
() Pharma for psychosis or depressive sx
Cyclothymic DO
() Antimanic agents such as mood stabilizers and second-generation antipsychotics, same as bipolar treatment
Persistent Depressive Disorder (Dysthymia)
() Psychotherapy with pharma COMBO is most efficacious
() CBT, interpersonal, insight-oriented
() SSRIs (TCAs, MAOIs)
Exhibitionist DO
”() CBT for all paraphilic DOs
() Restructure faulty cognition
() Relaxation training
() Masturbatory satiation, Covert Sensitization, and Masturbatory Conditioning
() Social skills training
()() NO FDA-appr. MEDS
() Medroxyprogesterone and leuprolide (increases release of LH) combo aims to reduce testosterone levels and reduce sex drive without causing E.D.
() Can use SSRIs to decrease impulsivity
() Naltrexone to decrease dopamine reward center
Fetishistic DO
() CBT for all paraphilic DOs
() Restructure faulty cognition
() Relaxation training
() Masturbatory satiation, Covert Sensitization, and Masturbatory Conditioning
() Social skills training
()() NO FDA-appr. MEDS
() Medroxyprogesterone and leuprolide (increases release of LH) combo aims to reduce testosterone levels and reduce sex drive without causing E.D.
() Can use SSRIs to decrease impulsivity
() Naltrexone to decrease dopamine reward center
Pedophilic DO
() CBT for all paraphilic DOs
() Restructure faulty cognition
() Relaxation training
() Masturbatory satiation, Covert Sensitization, and Masturbatory Conditioning
() Social skills training
()() NO FDA-appr. MEDS
() Medroxyprogesterone and leuprolide (increases release of LH) combo aims to reduce testosterone levels and reduce sex drive without causing E.D.
() Can use SSRIs to decrease impulsivity
() Naltrexone to decrease dopamine reward center
Sexual Masochism DO
() CBT for all paraphilic DOs
() Restructure faulty cognition
() Relaxation training
() Masturbatory satiation, Covert Sensitization, and Masturbatory Conditioning
() Social skills training
()() NO FDA-appr. MEDS
() Medroxyprogesterone and leuprolide (increases release of LH) combo aims to reduce testosterone levels and reduce sex drive without causing E.D.
() Can use SSRIs to decrease impulsivity
() Naltrexone to decrease dopamine reward center
Female Sexual Interest/ Arousal DO
() Sex therapy (as a couple) focuses on sensory awareness and increases sexual contact
() CBT treats as a sex dysfnc as a learned maladaptive behavior, tries to expose to greater stimuli to provoke anxiety and respond appropriately
() Hypnosis with anxiety
() Analytically oriented (Psychodynamic) therapy (talk)
() Testosterone replacement
Male Sexual Interest/ Arousal DO (Male Hypoactive Sexual Desire DO)
() Sex therapy (as a couple) focuses on sensory awareness and increases sexual contact
() CBT treats as a sex dysfnc as a learned maladaptive behavior, tries to expose to greater stimuli to provoke anxiety and respond appropriately
() Hypnosis with anxiety
() Analytically oriented (Psychodynamic) therapy (talk)
() Testosterone replacement
() Phosphodiesterase indhibitors (Sildenafil)
() SSRIs or TCAs for premature ejac.
Voyeuristic DO
() CBT for all paraphilic DOs () Restructure faulty cognition () Relaxation training () Masturbatory satiation () Covert Sensitization () Masturbatory Conditioning () Social skills training ()() NO FDA-appr. MEDS () Medroxyprogesterone and leuprolide (increases release of LH) combo aims to reduce testosterone levels and reduce sex drive without causing E.D. () Can use SSRIs to decrease impulsivity () Naltrexone to decrease dopamine reward center
Schizoaffective DO
() Hospitalization if psychotic () Antipsychotics (atypicals may geta both mood and psychotic sx) () Mood stabilizers () Antidepressants () Electroconvulsive therapy for mood
Schizophreniform DO
Same as schizophrenia
() Hospitalization
() At least six months of antipsychotics, usually continued for AT LEAST TWO YEARS after stable
() Psychotherapy
Avoidant PDO
() Psychotherapy, Assertiveness and social skills
() Group therapy
() SSRIs for comorbid social anxiety DO
Dependent PDO
() Psychotherapy = CBT, assertiveness, social skills
() Pharma for anxiety or depression
Histrionic PDO
() Psychothreapy = supportive, problem-solving, interpersonal, group
() Pharma for anxiety or depression
Narcissistic PDO
() Psychotherapy
() Antidepressant if comorbid DO
Obsessive Compulsive PDO
() Psychotherapy = CBT
() Pharma for anxiety or depression as needed
Paranoid PDO
() INDIVIDUAL Psychotherapy = NO GROUP THERAPY
() Short-course antipsychotics for transient psychosis
Schizoid PDO
() NO THERAPY = Usu. lack insight necessary for individual therapy and threatened by group therapy
() Day program or drop-in centers
() Antidepressant if necessary
Schizotypal PDO
() Psychotherapy = social skills
() Short course antipsychotics for transient psychosis and social anxiety and suspicion
Somatic Symptom Disorder
() Regularly scheduled visits with a single provider
() MUST INVESTIGATE ALL COMPLAINTS to rule out actual physiological problem
() However, minimize unnecessary workup
Illness Anxiety DO
() Regularly scheduled visits with a single provider
() Psychotherapy = CBT
() Pharma for anxiety or depression (SSRI)
Factitious DO
() Investigate lifestyle
() Find information from family and friends
() Possible hospitalization
() Investigate child abuse, if suspected
Oppisitional Defiant Disorder (ODD)
() Behavior modification, conflict management, problem-solving
() Parent training
() Pharma mx for ADHD if necessary
