Intro adol. psych Flashcards
what is epi of dep in adols
- 6-8%
- 2:1 females
- high risk for recurrence
what is diagnosis issue for dep in adols
- only 50% diagnosed before adults
- only 50% receive treatment
reasons diagnosis is missed
- lack of confidence
- fluctuating course
- social stressors of time
diffs. in adol vs. adult
- more irritbality
- mood reactivity
- low self esteem
general features of treatment
- engage and educate
- assess for hopelessness
- suicide risk
4 types of antideps.
SSRIs
SNRIs
TCAs
antypicals
how to start meds
start slow, but if not working in 2-4 weeks move up
best evidence for treatament
SSRI - fluoxetine
- NOT TCAs
what is effect on suicide
doesn’t seem to increase
what is use for CBT
not that great
- can be good for suicide in combo with drugs
2 types of bipolar
- at least one manic episode
2. recurrent MDD with at least one hypomanic episode
bipolar epi
1%
M=F
high risk for suicide
def. of manic episode
period of abnormally or persistently elevated, expansive, or irritable mood
3 or more assoc. Sx
assoc. sx
thoughts - grandiosity - pressured speech - flight of ideas behav. - decreased need for sleep - increased goal directed act. - activities lacking judgment
what is associtaed with greater risk of BP
- recurrent ADHD, CD, dep/anx
- fam hx
- NOT severe mood dysregulation
main treatment of BP
lithium
- not much evidence for anti-convulsants
3 key features of psychosis
- delusions
- hallucinations
- disorganized speech
sx of schizo
- pos and neg. sx
- social and occup dysfunction
heritability of schizo
pretty there
main risk for schizo (env)
early THC use
average duration of untreated psychosis and total illness
psychosis - 1 year
total - 3 years
2 other types of psychotic disorders
- schizo spectrum
2. delusional disorders
3 disorders with psychosis and a Sx
- depression
- cognitive (dementia/delerium)
- borderline
2 types of antipsych and their SEs
typical - movement disorders
atypical - metabolic
what is best evidence for use of anti-psych drugs
in ASD
which anti-psych is best
seem equal - all have bad SE and no one tends to stay on them
mech and major SE of risperidone
- DA and 5HT antag
- TD
mech and major SE of olanzipine
- DA and 5HT antag
- metabolic
mech and major SE of clozapine
- DA antag
AGRANUlocytosis
what is suicide epi
more in males
- 90% have diagnosis
- 50% have more than 2
- most common is depressiokn
risk factors for suicide
SADPERSONS Sex-male Age - 15-24 Depression Previous attempt Ethanol use Rational thnking loss Suidide in fam Organized plan No supports Serious illness
what is suicidality in schizo
50% will attemp
10-15% complete
