Chapter 6 Flashcards

1
Q

List the axes of DSM 4

A
  1. Major psych illnesses
  2. Personality disorders
  3. General medical conditions
  4. Psychosocial and environmental problems
  5. GAF score
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is range for GAF scores qnd ehat is range for near normal and for sig. diff functioning

A

Total range 1-100.
91-100 near normal.
51-60 sig diff functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the 4 mood disorders

A
  1. Depression
  2. Dysthymia
  3. Bipolar 1 & 2
  4. Cyclothymia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which mood disorder has the strongest genetic component

A

Bipolar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What diseases (not psych) Are commonly seen in association with depression

A

Heart disease, cancer, central nervous system diseases, endocrine diseases and connective tissue diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common mood disorder

A

Depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the median age of onset of depression

A

34

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Are males or females more affected by depression and what is the theory why

A

Two females are affected for every male and it is felt that genetic predisposition is the main cause of the increased instance and females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Depression is characterized by what three main symptoms

A
  1. Loss of energy (anergia)
  2. Loss of ability to experience pleasure (anhedonia)
  3. Loss of sexual desire or libido
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

According to the DSM5 criteria to diagnose depression there should be five or more of the 8 symptoms during a two week period and at least once something should be depressed mood or loss of interest or pleasure. Name the 8 symptoms

A
  1. Depressed mood most of the day nearly every day
  2. Markedly diminished interest or pleasure in all or almost all activities most of the day nearly every day
  3. Significant weight loss when not dieting or weight gain or decrease or increase an appetite nearly every day
  4. Slowing down of thought or a reduction of physical movement
  5. Fatigue or loss of energy nearly every day
  6. Feelings of worthlessness or excessive inappropriate guilt
  7. Diminished ability to think or concentrate or indecisiveness
  8. Recurrent thoughts of death recurrent suicidal ideation or a suicide attempt or specific plan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is dysthymia

A

The presence of chronic depressive symptoms for two years that are not severe enough to be diagnosed as major depressive disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many people with depression do not receive treatment

A

70%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the three types of treatment available to treat depression

A

Psychotherapy, ECT, medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does the medical adverse effects that can result from ECT

A

Cardio pulmonary events, aspiration pneumonia, dental and tongue injuries, headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the possible cognitive adverse effects from ECT

A

Acute confusion, Anterograde amnesia, retrograde amnesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the mortality rate of ECT

A

2-4 deaths for 100,000 treatments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Mortality from ECTs mostly related to what

A

Cardio pulmonary events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Does do use of anti-depressants mean that an individual has MDD

A

No not necessarily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

For major depressive disorder how many months of medication treatment is recommended

A

At least 6 to 9 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Depression and all mood disorders are associated with an increased mortality risk primarily due to ________

A

Accidents, suicides, the first affects on other illnesses.
Depression has been shown to increase the mortality risk of heart disease,cancer, stroke, diabetes, and other illnesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the name of the test used to measure the severity of depression

A

The Beck Depression inventory or BDI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the characteristics of mania

A

Distractability, rapid flight of ideas, excessive involvement and pleasurable activities, also economic and social judgment, impaired social function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does bipolar one manifest with

A

Bipolar one manifest with episodes of major depression and mania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Does bipolar one occur more in males or females

A

Bipolar one occurs equally in males and females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the mean age of onset of bipolar one

A

19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Bipolar 2 will have at least ___ major depression episodes and _____ episodes

A

At least two major depression episodes and at least two hypomantic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Is bipolar two more common in males or females

A

Females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How do hypomanic episodes differ in bipolar two compared to bipolar 1

A

Symptoms of hypo manic episodes are less intense in bipolar two

29
Q

What is cyclothymia characterized by

A

Fluctuating periods of depressive and hypo manic symptoms for at least two years with the symptoms not meeting the criteria for a major depressive episode or manic episode

30
Q

What is rapid cycling

A

Four or more episodes of mania per year occurring in 10 to 15% of people with bipolar disorder

31
Q

Does rapid cycling occur more in female males or males and is the prognosis better or worse

A

It occurs more often and females in carries a worse prognosis

32
Q

Suicide risk is increased during the ______ phase of bipolar and accidents and injuries are more common during the _____ phase

A

Suicide is increased during the depression face and accidents and injuries are more common during the manic phase

33
Q

What is the treatment of choice for bipolar

A

Meds With lithium being the most commonly used

34
Q

What are the two most prevalent psychiatric disorders

A

Depression and anxiety

35
Q

As an illness anxiety is associated with what five disorders

A
  1. Panic disorder
  2. Phobias
  3. GAD
  4. OCD
  5. PTSD
36
Q

Anxiety disorders occur to to three times more often in which sex

A

Females

37
Q

Are anxiety disorders curable

A

No

38
Q

mood disorders and substance abuse have an increased incidence in individuals with anxiety disorders. True or false

A

True

39
Q

is panic disorder more common in males or females

A

twice as common in females

40
Q

onset of panic disorder over age ____ is unusual

A

50

41
Q

is GAD more common in women or men?

A

equal in women and men

42
Q

what is the different between obsessions and compulsions

A

obsessions are intrusive thoughts or ideas. compulsions are repetitive behaviors performed to reduce the anxiety associated with obsessive thoughts

43
Q

is OCD more common in men or women

A

more common in males and firstborn children

44
Q

what are the three types of personality disorders

A
  1. odd/eccentric group - schizoid (socially indifferent), paranoid (Suspicious), schizotypal (eccentric) patterns 2. dramatic/impulsive group - anti-social (disagreeable), borderline (unstable), histrionic (attention seeking), narcissistic (Self-centered) patterns. anti-social personality disorder (Sociopathic personality), is 4 x more common in males. 3. anxious/fearful group - dependent (Submissive), avoidant (inhibited), obsessive (perfectionistic), passive-aggressive (negativistic), and depressive (pessimistic)
45
Q

what are the main underwriting concerns with personality disorders

A

impulsive behavior, suicide attempt, and especially comorbidities

46
Q

what are the comorbidities often seen with personality disorders

A

depression, alcoholism, eating disorders, panic attacks, phobias, tobacco addiction. also criminal and aggressive behaviors with the anti-social personality.

47
Q

what are somatoform disorders

A

symptoms and complaints that cannot be explained by a known medical condition medication or mood-altering substance

48
Q

what are 4 recognized type of somatoform disorders

A
  1. conversion disorder (transformation of an emotion into a physical manifestation). 2. hypochondriasis (being hypochondriac) 3. body dysmorphic disorder (when individual has a distorted view of his/her physical body) 4. factitious disorder- feigning illness and assuming the role of a sick person.
49
Q

what is the key to underwriting somatoform disorders

A

look for comorbidities, especially substance abuse and depression

50
Q

what are thought disorders

A

group of psychiatric disorders characterized by delusions

51
Q

what are the 2 main types of thought disorders

A

delusional disorders and schizophrenia

52
Q

what are delusions

A

abnormal mental state of false beliefs regarding self or individuals, or objects.

53
Q

how long would delusions last in delusional disorders

A

at least one month

54
Q

what is the most common thought disorder

A

schizophrenia

55
Q

how long should symptoms be present for schizophrenia dx

A

at least 6 months

56
Q

what are classic symptoms of schizophrenia

A

disorganized behavior with delusions, hallucinations, disorganized speech or negative symptoms.

57
Q

what are unfavorable symptoms of schizophrenia

A

loss of function, pleasure, emotional expression and concentration, decreased social engagement

58
Q

what are 4 subtypes of schizophrenia

A
  1. catatonic subtype 2. paranoid 3. disorganized subtype 4. residual subtype (negative symptoms without delusions, hallucinations or decreased motor activity)
59
Q

what is the treatment of choice for schizophrenia

A

anti-psychoticsl

60
Q

is schizophrenia associated with increased mortality rate

A

yes, but to 8 times normal. high risk of suicide attempt. 10% suicide rate usually in males within one year of diagnosis.

61
Q

what is the 20 year mortality rate with anorexia

A

10-20%

62
Q

what is the key to underwriting history of eating disorder

A

look for several years of stability in body weight and symptoms and to look for comorbidities especially depression, OCD and substance abuse

63
Q

about how many suicide attempts for every committed suicide

A

12

64
Q

which gender attempts suicide more

A

females attempt suicide more but males are 4 times more successful

65
Q

do suicide rates increase or decrease with age

A

increase

66
Q
maladaptive behavior patterns to personal and social stress are characteristic of: 
A. thought disorders
B. personality disorders
3. anxiety disorders
4. panic disorders
A

personality disorders

67
Q
all of the following are considered mood disorders except:
A. depression
B. cyclothymia
C. bipolar disorder
D. panic disorder
A

panic disorder

68
Q

which of the following can be used to diagnosis psychiatric disorders:
A. subjective symptoms
B. brain imaging scans
C. biological markers

A

A only (subjective symptoms

69
Q

which of the following are considered anxiety disorders:
A. panic disorder
B. OCD
C. body dysmorphic disorder

A

A and B only