Chapter 10 - Psychiatric and Cognitive Disorders Part 1

Question 1

Reisburg’s Stages of Dementia
Stage 1 - No disability noted
Stage 2 - Complains about forgetting normal age-related information
Stage 3 - Beginning signs and deficits are noted

Answer 1

Stage 3 -
Strengths: Remains Independent in ADL, can recognize challenging situations to avoid; in order to minimalize manifested deficit, can utilize compensation as an adaptive mechanism
Weaknesses: Forgets important information for first time in one’s life, experiences difficulty completing complex tasks and negotiating directions to new location

Question 2

Reisburg’s Stages of Dementia

Stage 4: Deficits are noted in all IADL

Answer 2

Strengths: Can still perform simple, repetitive ADL independently, can live at home with supports, and can follow simple verbal and demonstrational cues
Weaknesses: Becomes increasingly forgetful, becomes unable to follow and sequence written cues or to perform familiar, challenging activities, experiences difficulty in word finding and cannot manage at home without assistance

Question 3

Reisburg’s Stages of Dementia

Stage 5: Person cannot function independently

Answer 3

Strengths: Can perform ADL and some IADL with correct cues and assistance, can respond to encouragement, and becomes unable to safely drive a car
Weaknesses: demonstrates poor judgement, experiences difficulty with all decision making, forgets to take care of hygiene

Question 4

Reisburg’s Stages of Dementia

Stage 6: Person cannot perform ADL without cues

Answer 4

Strengths: can perform components of familiar tasks, can follow demonstration/hand over hand cues
Weaknesses: Demonstrate significant deficits in following 2-steps of a task, cannot sequence steps of ADL tasks, cannot speak in full sentences, becomes incontinent of bowel and bladder.

Question 5

Reisburg’s Stages of Dementia

Stage 7

Answer 5

Person can be in a vegetative state. They are usually bedbound and unable to respond verbally or non-verbally to questions or commands

Question 6

Schizophrenia

Answer 6

1) The presence of two or more: delusions, hallucinations, disorganized speech, positive symptoms and negative symptoms
2) Disturbance in 1 or more areas of function such as work, relations or self care
3) Continuous signs of illness for 6 months including at least 1 months of symptoms in (1)

Question 7

Schizophreniform Disorder

Answer 7

Individual meets the criteria for schizophrenia but the episode lasts more than 1 month but less than 6 months (required for diagnosis)

Question 8

Schizo affective Disorder

Answer 8

Uninterrupted period of illness during which at some time there is a major depressive episode, a major manic episode, or a mixed episode concurrent with symptoms that meet (1) for schizophrenia

Question 9

Delusional Disorder

Answer 9

Predominant symptoms are non-bizarre delusions with the absence of other criteria (1) symptoms

Question 10

Brief Psychotic Disorder

Answer 10

At least 1 day but less than 1 month with 1 or more criterion (1) symptoms of schizophrenia which result from severe psychosocial stress

Question 11

Bipolar I

Answer 11

1 or more manic episodes, may be combined with depressive episodes

Question 12

Bipolar II

Answer 12

1 or more major depressive episodes, at least 1 hypomanic episode, no history of manic episode

Question 13

Dysthymia

Answer 13

At least 2 years of depressed mood, most days with depressive symptoms that are not severe enough to be major depressive disorder

Question 14

Cyclothymic Disorder

Answer 14

At least 2 years with numerous periods of hypomanic and depressive symptoms that do not meet the criteria for manic episodes or a major depressive episode

Question 15

Manic Episode

Answer 15

Abnormally and persistently elevated expansive or irritable mood lasting at least 1 week
3 or more of these symptoms: inflated self-esteem/grandiosity, decreased need for sleep, more talkative, flight of ideas/racing thoughts, distractibility, increase in goal-directed activity or psychomotor agitation, and excessive involvement in pleasurable activities that have a high potential for painful consequences

Question 16

Major depressive episode

Answer 16

A 2 week period of depressed mood or loss of interest
5 or more of these symptoms: depressed mood most of day, markedly diminished interest/pleasure, weight loss/gain, increase/decrease in appetite, insomnia/hypersomnia, psychomotor retardation/agitation, fatigue, feelings of worthlessness/guilt, diminished ability to concentrate/make decisions, or recurrent thoughts of death/suicide/attempt

Question 17

Monoamine Oxidase Inhibitors (MAOIs)

Nardil and Farnate

Answer 17

Antidepressants - side effects: weight gain, hypotension, insomnia and liver damage
Precautions: over the counter meds: cold, sinus, hay fever, nasal decongestants, asthma inhalants, pep pills, and appetite suppressants
Food with amino acid tyramine (can increase BP) - aged cheese, pickled foods, cured/smoked meats, liver, yogurt, sour cream, fruits that must ripen before eating, fava beans, peapods, chocolate, beer, red wine, meat tenderizers, soy, yeast extracts (and any item not properly stored, expired, overly ripened, or not fresh)

Question 18

Mixed Episodes

Answer 18

Criteria met for both a manic episode and major depressive episode for at least 1 week

Question 19

Hypomanic Episode

Answer 19

not severe enough to cause marked impairment in social or occupational function or require hospitalization

Question 20

Disruptive mood dysregulation disorder

Answer 20

Child is chronically irritable and experiences frequent, severe temper outbursts that seem grossly out of proportion to situation at hand

Question 21

Paranoid Personality Disorder

Answer 21

Suspicious and mistrust of people in general, assign responsibility of their feelings to others - hostile, irritable and angry

Question 22

Schizoid personality disorder

Answer 22

Lifelong pattern of social withdrawal, discomfort with human interaction, introversion, and bland affect - eccentric, isolated, or lonely

Question 23

Schizotypical personality disorder

Answer 23

Appear odd or strange in their thinking and behavior to those who meet them - magical thinking, peculiar ideas, ideas of reference, illusions, or derealization

Question 24

Antisocial personality disorder

Answer 24

Continued antisocial or criminal acts, but it is not synonymous with criminality. Inability to conform to social norms - no regard for safety or feelings of others

Question 25

Borderline personality disorder

Answer 25

Unstable affect, mood, behavior, relationships, and self image - fear of real/imagined abandonment leads to frantic efforts to avoid it.
Recurrent self-destructive behavior either threatened or carried out - majority of people have a history of physical, emotional or sexual abuse

Question 26

Narcissistic personality disorder

Answer 26

Heightened sense of self-importance and a grandiose feeling that they are special in some way

Question 27

Histrionic personality disorder

Answer 27

Colorful, dramatic, extroverted behavior in excitable, emotional people.
Inability to maintain deep, long-lasting attachments with accompanying flamboyant presentation

Question 28

Avoidant personality disorder

Answer 28

Extreme sensitivity to rejection, leading to possible socially withdrawn life - however they do show great desire for companionship and need unusually strong and repeated guarantees of uncritical acceptance

Question 29

Dependent Personality disorder

Answer 29

Subordinate their own needs to those of others and need others to assume responsibility for major areas in their lives - lack self-confidence and feel discomfort when left alone for a while

Question 30

Obsessive-Compulsive personality disorder

Answer 30

Emotional constriction, orderliness, perseverance, stubbornness, and indecisiveness - pervasive pattern of perfectionism and inflexibility.