MH and Psych

Question 1

Diagnostic criteria for depression

Answer 1

5+ symptoms (including 1 & 2) in a 2 week period:
1. depressed mood or anhedonia
2. loss of interest in daily activities
3. change in weight/appetite
4. insomnia/hypersomnia
5. psychomotor agitation or retardation
6. loss of energy/ fatigue
7. inappropriate guild or sense of worthlessness
8. impaired concentration or indecisiveness
9. suicidal thoughts, ideation, or attempt

Symptoms cause significant distress or impairment
Episode is not attributable to substance or medical condition
Episode is not better explained by psychotic disorder
Patient has not had previous manic or hypomanic episodes

Question 2

Risk factors of depression

Answer 2

Increased risk of situational depression
- living alone
- lack of social support
Living in LT care
Diseases and medications
- parkinson’s
- alzheimer’s
- CVA

Question 3

Medical management of depression

Answer 3

Serotonin reuptake inhibitors (SSRIs)
- Cymbalta
- Zoloft
> Side effects of nausea, dizziness
Electroconvulsive therapy

Question 4

Bipolar Disorder

Answer 4

Much less common
Manic –depressive disorder
Bipolar I-typical
Bipolar II-not as manic
Cyclothymic-both milder
Substance related
Disease related

Question 5

Symptoms of bipolar disorder

Answer 5

Distractibility
Impulsivity
Grandiosity

Flight of ideas
Activity increase
Sleep deficit
Talkativeness

Question 6

Medical management for bipolar disorder

Answer 6

Mood Stabillizers
- Lithium
Antipsychotics
- Abilify
- Risperdal
Occupational Deficit
- Left over from adulthood
- Added issue of falls, safety with adgitation

Question 7

Generalized anxiety disorder

Answer 7

Feelings of excessive worry about events, activities, and situation

Question 8

Obsessive-compulsive disorder

Answer 8

Unwanted recurring thoughts and compulsive, repetitive behaviors

Question 9

Post-traumatic stress disorder

Answer 9

Extreme anxiety and distress symptoms due to being exposed to a traumatic event

Question 10

Panic disorder

Answer 10

Intense and recurring panic attacks that occur unexpectedly

Question 11

Social anxiety disorder

Answer 11

Feelings of extreme anxiety in social situations

Question 12

Specific phobias that may cause issues for the elderly

Answer 12

Agoraphobia: afraid to leave environments they know or consider to be safe
Sociophobia: fear of social gatherings, fear of embarrassment in social situations that is extremely intrusive and can have debilitating effects on relationships.
Trypanophobia: overwhelming, extreme fear of medical procedures that involve needles

Question 13

Late onset schizophrenia

Answer 13

Hallucinations often auditory
Off the wall delusions
Impaired executive function

Criteria:
- Onset after 60
- Presence of fantastic (new ruler of Russia), persecutory (being tracked) (, referential (t swift is bff), or grandiose (i’m the smartest person in the room) delusions, with or without hallucinations
- Absence of primary dementia
- Absence of primary affective disorder
- No clouding of consciousness
- No history of neurological illness/alcohol or substance abuse
- Normal hematological/biochemical screen

Question 14

Psychosis with dementia

Answer 14

Often occurs with Alzheimer’s disease, Parkinson’s or others.
Hallucinations tend to be visual
Delusions of:
- Harm
- Theft
- “Normal things” that aren’t true

Question 15

What is delirium?

Answer 15

Begins suddenly and develops quickly
Defined starting point
Temporary and reversible
Difficulty paying attention
Caused slowed and slurred speech

Question 16

What is dementia?

Answer 16

Begins gradually and progresses
Uncertain starting point
Permanent and worsens
Difficulty remembering
Causes forgetfulness of words

Question 17

Causes of delirium

Answer 17

(P)ain
(I)nfection
(N)utrition
(C)onstipation
(H)ydration

(M)edication
(E)lectrolytes

Question 18

Clusters of personality disorders

Answer 18

Cluster A:
- paranoid
- schizoid
- schitotypal

Cluster B:
- antisocial
- borderline
- histrionic
- narcissistic

Cluster C:
- dependent
- avoidant
- obsessive-compulsive

Question 19

Paranoid personality disorder

Answer 19

Excessive distrust and suspiciousness of others; pathologically jealous; interprets actions as demeaning, malevolent, threatening, or exploitative; ideas of reference (believes coincidences or innocuous events have strong personal significance)

Question 20

Schizoid personality disorder

Answer 20

detachment from social interactions without a desire for close interpersonal relationships; restricted affect

Question 21

Schizotypal personality disorder

Answer 21

Eccentric beliefs without frank delusions; cognitive and perceptual disturbances; impaired social interactions

Question 22

Antisocial personality disorder

Answer 22

Lack of empathy, with disregard for rights of others; deceitfulness, impulsivity, irresponsibility

Question 23

Borderline personality disorders

Answer 23

Unstable self-image; chronic feelings of emptiness; instability of interpersonal relationships; affective instability; self-harm behavior; hypersensitivity to rejection and fear of abandonment

Question 24

Histrionic personality disorder

Answer 24

Excessive attention seeking behavior and emotionality; often excessively impressionistic and shallow

Question 25

Narcissistic personality disorder

Answer 25

Need for admiration; grandiosity in speech and behavior; lack of empathy for others, interpersonally exploitative; arrogant and haughty

Question 26

Dependent personality disorder

Answer 26

Inability of extreme difficulty making own decisions; overly reliant on others; submissiveness; feelings of inadequacy; avoidance of confrontation

Question 27

Avoidant personality disorder

Answer 27

Feelings of inadequacy; hypersensitivity to rejection; social inhibition despite a desire to form close interpersonal relationships

Question 28

Obsessive-compulsive personality disorder

Answer 28

Preoccupation with details and rules; excessive organization; perfectionism, orderliness, miserliness; rigidity and stubbornness

Question 29

Types of elder abuse

Answer 29

Physical abuse
Emotional abuse
Sexual abuse
Financial exploitation
NEglect
Abandonment

Question 30

What is self neglect

Answer 30

When an elderly person becomes incapable of taking care of themselves, and even fails to take care of their basic daily needs, and refuses to tell anyone or hire anyone to take care of them and their needs.

Question 31

Role of OT in MH and psych

Answer 31

Mandated Reporter
Interventions based on Occupational Profile and current Occupational Performance
- Screens
Improve Occupational opportunity
Prevention, Health and Wellness
Adaptations
Self Care