Deck 1 Flashcards by Justin Holmes

Best predictor of outcome in autism

Language development

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Autism is most commonly confused with ____

OCD

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ADHD diagnosis requires __ symptoms present before age __

6; 12

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ADHD is more common in _____ (boys/girls)

girls

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ADHD is most commonly associated with the following two disorders: ______.

ODD, Conduct Disorder

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____ intoxication can mimic ADHD, due to hyperactivity symptoms

Lead

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Atomoxetine use and MOA

ADHD; inhibits norepinephrine presynaptic transport

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5 non-stimulant ADHD pharmacotherpies

atomoxetine, clonidine, guanfacine, bupropion, imipramine

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ADHD psychotherapy

Behavior training, classroom behavior modification

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Length of tics present for Tourette Dx; onset before age ___

1 year; 18

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Genetic inheritance pattern of Tourette

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Which component of Tourette Syndrome typically presents first?

Motor (before 7), Vocal (before 11)

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Which may be confused with Tourette Syndrome, typically presenting with winter-spring seasonal worsening of ticks?

PANDAS

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Duration of transient tic disorder

4 weeks to 1 year

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Tourette Disorder is associated with __ (2)

ADHD, OCD

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Best long term treatment for Tourette Disorder

Habit Reversal Training

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Medications for Tourette Disorder (3)

Antipsychotics (Risperidone best studied/effective), Clonidine, Guanfacine

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Duration of symptoms in schizophrenia

6 months

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Most frequently used substance by patients with schizophrenia, can affect antipsychotic levels

nicotine

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Delusional disorder criteria, including duration

Delusions with no other psychotic symptoms (more than a month)

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Brief Psychotic Disorder duration

1 day to 1 month

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Common causes of medication-induced psychosis (2)

steroids, anticholinergics

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Most effective atypical antipsychotic, has been shown to decrease suicide attempts

Clozapine

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Treatment of acute dystonia (2)

Benztropine, diphenhydramine

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Treatment of akathisia (2)

Benzos, propranolol

Treatment of antipsychotic-induced parkinsonism

Benztropine

Treatment of NMS (2)

Dantrolene, bromocriptine

In epilepsy, psychosis is most common in the ____ period; most common in the ____ period with longterm inadequately treated or treatment-resistant epilepsy

post-octal; inter-ictal

Number of mood episodes per year required for rapid-cycling bipolar

Length of symptoms in mania and hypomania

7 days; 4 days

DIGFAST

Distractibility, indiscretion, grandiosity, flight of ideas, activity increase, sleep deficit, talkativeness/pressured speech

Lithium is FDA approved for bipolar in patients age __ and older

____ should be monitored routinely with lithium therapy

drug levels, thyroid function tests, creatinine

____ should be monitored routinely with carbamazepine therapy

CBC

____ should be monitored routinely with divalproex/valproic acid therapy

LFTs, plt count

Class of medications (other than mood stabilizers) that may be used as mono therapy for mania

Antipsychotics

Lamotrigine is helpful for ___ symptoms of bipolar

depressive

Indicated psychotherapies for bipolar disorder in children/adolescents

Cognitive therapy, family therapy

Duration required for cyclothymia

2 years

Vitamin Deficiency that may cause depression (1) or mania (2)

folate; folate/B12

Neurodegenerative disease that may cause mania

Huntington Disease

Which illicit substance causes mania in intoxication and depression with withdrawal?

Cocaine

Duration of symptoms for MDD

2 weeks

Length of antidepressant therapy for first episode of MDD

6-12 months at therapeutic levels (with 2-3 month taper)

First-line psychotherapy in MDD

CBT

MDD is more common in ____ (women/men)

women

Suicide risk _____ with age

increases

Suicide risk _____ with previous attempts

increases

Suicide risk ____ with family history of suicide

increases

Signs of postpartum mood disorder necessitating treatment or hospitalization (2)

Suicidal ideation, psychosis

Recurrent rate of MDD: 1 year, lifetime

40%, 85%

Duration required for PDD

2 years (1 year for children/adolescents)

Number of symptoms required for PDD

Psychotherapies useful for PDD (3)

CBT, insight-oriented psychotherapy, interpersonal psychotherapy

Duration required for Premenstrual Dysphoric Disorder

Majority of cycles over past year

Number of symptoms required for Premenstrual Dysphoric Disorder

Difference between PMDD and PMS

Less mood change in PMS

Treatment of PMDD (2)

SSRIs, OCPs

Psychotherapy for PMDD

CBT

Panic Disorder requires intense fear/discomfort plus ___ symptoms that are not provoked by a stimulus

Duration required for Panic Disorder

1 month of concerns/worry/maladaptive changes related to attacks

Treatment of Panic Disorder (4)

SSRIs/SNRIs/TCAs, short-term benzos

First-line psychotherapy for Panic Disorder

CBT

Duration required for specific phobia

6 months

Treatment of Specific Phobia (3)

Exposure therapy (first-line), short-term benzos, possibly SSRIs

Duration required for separation anxiety disorder

4 weeks

Usually age of separation anxiety disorder

9-10

Treatment of Separation Anxiety Disorder

Exposure therapy (first-line), SSRIs in conjunction with psychotherapy

Duration required for social anxiety disorder

6 months

Psychotherapy for Social Anxiety Disorder is CBT that emphasizes _____ (3).

Desensitization, Exposure, Rehearsal

Pharmacotherapy for Social Anxiety Disorder (5)

SSRIs, SNRIs, Benzos, Buspirone (esp. as SSRI adjunct), propranolol/beta blockers (performance situations)

Duration required for Generalized Anxiety Disorder

6 months

Which disorders should be treated with exposure therapy? (3)

Specific Phobia, Separation Anxiety Disorder, Social Anxiety Disorder

Psychotherapy for Generalized Anxiety Disorder

CBT, Psychodynamic therapy

First-line pharmacotherapy for Generalized Anxiety Disorder

SSRIs

Second-line pharmacotherapy for Generalized Anxiety Disorder

SNRIs/TCAs

Third-line/Adjunctive Treatment for Generalized Anxiety Disorder (4)

Benzos (short-term), buspirone, mirtazapine, hydroxyzine

OCD is more common in ___ (men/women)

equal

OCD is associated with ____ (2)

Tic Disorder, Tourette Disorder

Pathophysiology underlying OCD

Glamatergic transmission in cingulate gyrus

Medical cause of OCD symptoms in children

PANDAS

Treatment of OCD (3)

CBT: exposure/response prevention, SSRIs, clomipramine

Anxiety disorder with less evidence for SSRI use (2)

Specific phobia, Separation Anxiety Disorder

Duration required for PTSD

1 month

4 areas of symptoms required in PTSD

Intrusion, Avoidance, Cognitive/Mood, Arousal

__% of patients with PTSD have a comorbid psychiatric illness

Pharmacotherapy in PTSD (4)

SSRIs, SNRIs, Prazosin (nightmares), atypical antipsychotic (adjunct)

Psychotherapy in PTSD

CBT: exposure therapy, cognitive processing therapy

Time course of Adjustment disorder

Starts within 3 months of trigger; resolves within 6 months of onset

Pharmacotherapy for Adjustment Disorder

None

Psychotherapy for Adjustment Disorder

Group Therapy, Supportive Psychotherapy

Duration required for Acute Stress Disorder`

3 days to 1 month

Number of Symptoms required for Acute Stress Disorder

Symptoms types in acute stress disorder (5)

Avoidance, Mood, Dissociation, Arousal, Intrusion

Treatment for acute stress disorder (4)

social supports, critical incident stress debriefing (CISD, questionable efficacy), hypnotics/anxiolytics (short-term), propranolol

Which medication can reduce the risk of developing PTSD?

Propranolol