Deck 1 Flashcards
Best predictor of outcome in autism
Language development
Autism is most commonly confused with ____
OCD
ADHD diagnosis requires __ symptoms present before age __
6; 12
ADHD is more common in _____ (boys/girls)
girls
ADHD is most commonly associated with the following two disorders: ______.
ODD, Conduct Disorder
____ intoxication can mimic ADHD, due to hyperactivity symptoms
Lead
Atomoxetine use and MOA
ADHD; inhibits norepinephrine presynaptic transport
5 non-stimulant ADHD pharmacotherpies
atomoxetine, clonidine, guanfacine, bupropion, imipramine
ADHD psychotherapy
Behavior training, classroom behavior modification
Length of tics present for Tourette Dx; onset before age ___
1 year; 18
Genetic inheritance pattern of Tourette
AD
Which component of Tourette Syndrome typically presents first?
Motor (before 7), Vocal (before 11)
Which may be confused with Tourette Syndrome, typically presenting with winter-spring seasonal worsening of ticks?
PANDAS
Duration of transient tic disorder
4 weeks to 1 year
Tourette Disorder is associated with __ (2)
ADHD, OCD
Best long term treatment for Tourette Disorder
Habit Reversal Training
Medications for Tourette Disorder (3)
Antipsychotics (Risperidone best studied/effective), Clonidine, Guanfacine
Duration of symptoms in schizophrenia
6 months
Most frequently used substance by patients with schizophrenia, can affect antipsychotic levels
nicotine
Delusional disorder criteria, including duration
Delusions with no other psychotic symptoms (more than a month)
Brief Psychotic Disorder duration
1 day to 1 month
Common causes of medication-induced psychosis (2)
steroids, anticholinergics
Most effective atypical antipsychotic, has been shown to decrease suicide attempts
Clozapine
Treatment of acute dystonia (2)
Benztropine, diphenhydramine
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
4
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
12
____ 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
2
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
5
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
4
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
80
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
9
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