Peds Behavioral/psych Flashcards
what is the diagnostic criteria for generalized anxiety disorder
- excessive worry more days than not
- worry about multiple things
- present for at least 6 months
- difficult to control
what are the somatic s/s related to GAD
- muscle tension
- HA
- neck and back pain
what are screening tools for GAD
- GAD-7
- beck anxiety inventory
what is the treatment of GAD
SSRI + CBT
what are the SSRIs
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Fluvoxamine (Luvox)
SCEFF P
what is a panic disorder
recurrent episodes of panic attacks
what is the criteria for panic attack
- abrupt surge of intense fear or discomfort that peaks within minutes
- associated with 4 other symptoms
what is the criteria for panic disorder
1+ attack followed by 1 month of worry about additional attacks or change in behavior
treatment of panic disorder
SSRI (paroxetine) + CBT
what is the definition of agoraphobia
anxiety about or avoidance of situations where escape may not be available or leaving would be difficult if the patient were to develop incapacitating or embarrassing symptoms
what is the criteria for agoraphobia
6 months of marked fear or anxiety of a place or situation
what is the treatment of agoraphobia
SSRI + CBT
what is the criteria for social anxiety disorder
6 months of anxiety about 1+ social situations
what is the treatment of social anxiety disorder
SSRI + CBT
what is the definition of acute stress disorder
acute stress reaction occurring in the initial month after an individual experiences a trauma
what is the criteria for acute stress disorder
- exposure to threatened death, serious injury, or sexual violation
- 3 days to 1 month after trauma
what is the treatment of acute stress disorder
trauma oriented CBT with exposure therapy
what is the diagnostic criteria for for PTSD
- exposure to actual or threatened death, serious injury, or sexual violation
- symptoms lasting 1 month
what is the treatment of PTSD
trauma oriented CBT + SSRIs
what are obsessions vs compulsions
- obsessions: recurrent intrusive thoughts
- compulsions: repetitive acts that patient feels driven to perform
what is good vs poor vs absent level of insight into illness
- good: patient recognizes OCD beliefs are definitely or probably not true
- poor: patient thinks OCD are probably true
- absent: completely convinced that beliefs are true
what is the treatment of OCD
CBT with exposure therapy + SSRI
what is the criteria of phobic disorder
6 months of marked fear/anxiety about a specific situation or object
what is the treatment of phobic disorder
CBT with exposure therapy
what is ADHD
diminished sustained attention and high levels of impulsivity or hyperactivity
what are types of ADHD
- hyperactive/impulsive
- inattentive
- combined type
What is the etiology of ADHD
- impaired catecholamine (nor-epi and dopamine) metabolism in brain.
- genetics
- possibly environmental etiology
what are the criteria for ADHD
- 6+ months of symptoms
- before age 12
- clear functional impairment in 2+ settings
what is non-pharm treatment of ADHD
- behavioral interventions (schedules, charts, minimal distractions)
- cognitive therapy
what is pharm treatment of ADHD
- stimulants (vyvanse, ritalin, adderal, Desoxyn)
- strattera (SNRI)
- clonidine
child must be how old to be on ADHD medication
6 years
autism is most commonly recognized around what age
2 years
what are the s/s of autism
- impaired social skills
- language delay
- social reciprocity
- joint attention
- difficulty with nonverbal communication
- poor social relationships
- stereotyped behaviors
what is screening for ASD
MCHAT
what is the treatment of ASD
- functional and behavioral interventions
- routine screening and preventative care
- treat other conditions
what is good vs poor prognosis of ASD
- good: higher cognitive abilities, less severe symptoms, early identification, functional play skills
- poor: severe symptoms, seizures, lack of joint attention by age 4 or functional speech by age 5
what is amnesia
recurrent gaps or other defects in the memory
depersonalization
sense of detachment or disconnection from ones self
derealization
sense of disconnection from familiar people or one’s surroundings
identity confusion
inner struggle about ones sense of self/identity
identity alteration
sense of acting like a different person some of the time
dissociative amnesia
potentially reversible memory impairment that primarily affects autobiographical memory
dissociative fuge
unexpected travel or wandering in a dissociative state, with subsequent dissociative amnesia for the episode
what is the treatment of dissociative amnesia
psychotherapy
what is depersonalization/derealization disorder
a dissociative disorder marked by the presence of persistent and recurrent episodes of depersonalization, derealization, or both
treatment of depersonalization/derealization disorder
SSRIs + psychotherapy
dissociative identity disorder
multiple personalities
criteria for dissociative identity disorder
- two or more distinct identities or personality states
- amnesia must occur
treatment of dissociative identity disorder
psychotherapy
stages of impulsivity
- Urge
- Tension
- Act
- Relief
- Guilt
what is Intermittent Explosive Disorder
discrete episodes of losing control of aggressive impulses that are out of proportion to the stressor and then feels regret after
treatment of intermittent explosive disorder
-psychotherapy and SSRIs
what is oppositional defiant disorder
disobedient behavior towards adults and authority figures
what are types of oppositional defiant disorder
- angry/irritable
- argumentative/defiant
- vindictive
what is the criteria for ODD
angry/irritable/argumentative/defiant behavior or vindictiveness for at least 6 months during interactions with at least 1 individual who is NOT a sibling
How do you rate severity of ODD
- mild: symptoms confined to 1 setting
- Moderate: symptoms in 2 settings
- Severe: 3+ settings
what is the treatment of oppositional defiant disorder
psychotherapy
25% of ODD progresses to what
conduct disorder
what is conduct disorder
aggression and violation of the rights of others
what is the criteria for conduct disorder
patters of behavior in which basic rights of others or major ago appropriate social norms/rules are violated.
3+ criteria in 12 months (at least 1 in the past 6 months)
including aggression to people/animals, destruction of property, deceitfulness or theft, serious violation of rules.
treatment of conduct disorder
- psychotherapy
- antipsychotics or SSRIs (risperidone shows most promise)
what is major depressive disorder
- at least one major depressive episode lasting at least 2 weeks
- either depressed mood or anhedonia
what is used for screening for major depressive disorder
- PHQ-2
- PHQ-9
what is the management of major depressive disorder
- therapy
- SSRIs
inpatient vs outpatient tx for MDD
- outpatient: mild/mod
- inpatient: severe
what is the criteria for MDD
Depressed mood OR anhedonia for >2 weeks AND >4 of the following
best treatment for severe, refractory depression
electroconvulsive therapy
what is dysthymia
2+ years of depressed mood with no more than 2 months free of s/s
what is the treatment of dysthymia
SSRIs + therapy
what is avoidant restrictive food intake disorder
avoiding or restricting food intake and failing to meet nutritional or energy needs
what drug is CI in bulimia and anorexia patients? and why?
- wellbutrin
- can lower seizure threshold and cause patients to have seizures
remember this cuz bulimic patients are more likely to be alkalotic due to vomiting and getting rid of stomach acid. Alkalosis increases risk of seizure. So theyre already at increased risk and you wouldnt wanna increase the risk more.
