First Aid pg 511- 515 Psych Flashcards
of Days to qualify as hypomanic episode?
Last at least 4 consecutive days
What makes a hypomanic episode diff from a manic episode?
Hypomanic is not severe enough to cause marked impairment in social and/or occupational functioning or to necessitate hospitalization. No psychotic features.
Diff between Bipolar I and II
Bipolar I defined by presence of at least 1 manic episode +/− a hypomanic or depressive episode.
Bipolar II defined by presence of a hypomanic and a depressive episode.
Drugs that can ppt mania?
TCAs
Tx for Bipolar disorder?
Treatment: mood stabilizers (eg, lithium, valproic acid,
carbamazepine), atypical antipsychotics.
Minimal duration of cyclothymic disorder?
lasting at least 2 years
How long do major depressive episodes last?
major depressive episodes usually last 6–12
months.
What symptoms are included to Dx Major Depressive disorders?
SIG E CAPS: Depressed mood Sleep disturbance Loss of Interest (anhedonia) Guilt or feelings of worthlessness Energy loss and fatigue Concentration problems Appetite/weight changes Psychomotor retardation or agitation Suicidal ideations
__#__ Sx out of __#__ ttl Sx for ____ (length of time) for diagnose Major Depressive Disorder?
Episodes characterized by at least
5 of the following 9 symptoms for 2 or more
weeks
1st line Tx for Major Depressive Disorder?
CBT and SSRIs
2nd line Tx for Major Depressive Disorder?
SNRIs, mirtazapine, bupropion can also be
considered.
Persistent depressive disorder
depression, often milder, lasting at least
2 years.
Changes in sleep in patients with Depression?
slow-wave sleep REM latency REM early in sleep cycle total REM sleep Repeated nighttime awakenings Early-morning wakening (terminal insomnia)
What makes depression atypical?
Characterized by mood reactivity (being able to
experience improved mood in response to positive events, albeit briefly), “reversed” vegetative
symptoms (hypersomnia, hyperphagia), leaden paralysis (heavy feeling in arms and legs),
long-standing interpersonal rejection sensitivity
Sx of postpartum psychosis?
Characterized by mood-congruent delusions, hallucinations, and thoughts of harming the baby or self.
Most common method to commit suicide? Are men or women more likely to commit suicide?
Most common method in US is firearms, Women attempt suicide more often, men tend to succeed with it.
Symptoms of Panic attack?
PANICS
P = Palpitations, Paresthesias, dePersonalization or
derealization
A = Abdominal distress or Nausea,
I = Intense fear of dying, Intense fear of losing
control or “going crazy,” lIght-headedness,
C = Chest pain, Chills, Choking, Sweating,
S = Shaking, Shortness of breath
How to treat a specific phobia?
Can be treated with systematic desensitization.
** NOTE - Patient does recognize that fear is excessive
Define Gen anxiety disorder
Anxiety lasting > 6 months unrelated to a specific person, situation, or event
How is adjustment disorder different from Gen anxiety disorder?
emotional symptoms (anxiety, depression) causing impairment following an identifiable psychosocial stressor (eg, divorce, illness) and lasting 6 months in presence of chronic stressor).
Key Points - Look for known stresser, and time duration
How is OCD different from OC personality disorder?
Ego-dystonic: behavior inconsistent with one’s own beliefs and attitudes (vs obsessive-compulsive personality disorder
Acute stress disorder v Post traumatic stress disorder?
Acute - lasts between 3 days and 1 month.
PTSD - lasts longer >1 mo
Malingering
Patient consciously fakes, profoundly exaggerates, or claims to have a disorder in order to attain a specific 2° (external) gain (eg, avoiding work, obtaining compensation). Poor compliance with treatment or follow-up of diagnostic tests.
Difference between factitious disorder and malingering?
Complaints in malingering cease after gain obtained (vs factitious disorder).
Patient consciously creates physical and/or psychological symptoms in order to assume “sick role”
and to get medical attention
Factitious disorder
Difference between malingering and somatic symptoms?
Malingering may be unconcious, but it is fabricated or exagerrated symptoms. Somatic illness and motivation are entirely unconscious, but not intentionally produced or feigned
Loss of sensory or motor function (eg, paralysis, blindness, mutism), often following an acute
stressor; patient is aware of but sometimes indifferent toward symptoms
Conversion disorder
Excessive preoccupation with acquiring or having a serious illness, often despite medical
evaluation and reassurance;
Illness anxiety disorder
False, nondelusional belief of being pregnant. May have signs and symptoms of pregnancy but is
not pregnant.
Pseudocyesis
Inflexible, maladaptive, and rigidly pervasive pattern of behavior causing subjective distress
and/or impaired functioning
Personality disorder
Difference between Schizoid vs Schizotypal?
SchizOiD - alOne and Distant - likes to be alone and is fine with it.
Schizotypal - look for eccentric appearence or odd/magical thinking.
Major defense mech in Paranoid type personality disorder ? And define it
Projection
T or F - There are symptoms of psychosis with Paranoid personality disorder?
F - None of the personality disorders show signs of psychosis, but there is a general association with schizophrenia
Which B cluster personality disorder is associated with males?
Antisocial
What differentiates antisocial personality disorder from conduct disorder?
Age - Antisocial personality disorder must
be ≥ 18 years old and have history of conduct
disorder before age 15. Conduct disorder if
Which cluster B disorder is associated with females?
Borderline
self-mutilation, suicidality, sense
of emptiness; females > males
Borderline
Most common defense mech of borderline? and define it
Splitting
sexually provocative, overly
concerned with appearance.
Histrionic
Grandiosity, sense of entitlement; lacks empathy
and requires excessive admiration; often
demands the “best” and reacts to criticism
with rage
Narcissistic
Difference between avoidant and shizoid?
Avoidant desires relationships with others but is alone, Schizoid perfectly happy with being alone
People of this personality type tend to get involved in abusive relationships?
Dependent - Submissive and clingy, excessive need to be taken care of, low self-confidence
