Psych 13 Flashcards
Time frame for ADHD diagnosis
6 months
What is the diagnosis: Apparently normal development throughout the first 2 years of life, followed by clinically significant loss of acquired skills
Autism spectrum disorder (childhood disintegrative disorder)
Rett Syndrome
Regression: loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing
Regression occurs earlier than in childhood disintegrative disorder (maybe around 6 months old)
Most common reason for an adolescent to go to psych ed
Suicidality
Physical features of fetal alcohol syndrome
Facial dysmorphology (smooth philtrum, short palpebral fissures, thin vermillion border)
Tx of choice for eneuresis
Classic condition with a bell and a pad
Tx for Tourette
o Behavioral intervention – habit reversal therapy
o Medications:
♣ Alpha-2 agonists – Guanficine, Clonidin
♣ Antipsychotics
Severe side effects of stimulants
Tics
Most common reason for malpractice claims in psychiatry
Improper treatment
Drugs to treat OCD
SSRI = first line
Clomipramine (TCA) if SSRI doesn’t work
Time frame of separation anxiety in children/adolescents and in adults
> 4 weeks in children/adolescent
> 6 weeks in adults
What do you call belief that cues in the external environment are uniquely related to the individual (i.e. TV characters talking directly to me)
Ideas of reference
Describe delusion vs. illusion vs. hallucination
Delusion = false belief
Illusion = misinterpretation of an external stimulus
Hallucination = perception in the absence of external stimulus
Somatic sx associated with GAD
Fatigue, muscle tension
Time frame for specific phobia / social anxiety disorder
> 6 months
DSM Criteria for GAD
- Excessive anxiety/worry about various daily events/activities >6 months
- Difficulty controlling the worry
- Associated >3 sx: restlessness, fatigue, impaired concentration, irritability, muscle tension, insomnia
Time frame for selective mutism
> 1 month
THINK: You SELECT a single (1) choice
Tx of social anxiety disorder
CBT = Tx of choice
SSRI = 1st line medication if needed
Benzos PRN, Beta blocker
Diagnostic criteria of adjustment disorder
- Emotional or behavioral sx within 3 months in response to an identifiable stressful life even
- Sx are not of normal bereavement
- Sx resolve within 6 months after stressor has terminated
Time frame (onset and duration) of Acute Stress Disorder
Trauma occurred < 1 month ago
Symptoms last < 1 month
Tx for body dysmorphic disorder
SSRI and/or CBT
Components of mania
DIGFAST
D = distractibility I = insomnia/impulsive behavior G = grandiosity F = flight of ideas A = activity/agitation S = pressured Speech T = thoughtlessness
Avg IQ
85-115
DSM-5 criteria of panic disorder
- Recurrent, UNEXPECTED panic attack without an identifiable trigger
- One or more panic attacks followed by > 1 month of continuous worry or avoidance behaviors
- Not caused by substance, other mental disorder, or medical condition
Differentiate between Bipolar I and Bipolar II
- Bipolar I = 1 manic episode +/- a hypomanic or depressive episode
- Bipolar II = Hypomanic episode + major depressive episode
DSM Criteria of Schizoaffective Disorder
- Meet criteria for either a major depressive or manic episode during which psychotic sx consistent with schizophrenia are also met
- Delusions or hallucinations for 2 weeks in the absence of mood disorder sx (to differentiate from mood disorder with psychotic features)
Time frame for delusional disorder
One or more delusions for at least one month
Tx of delusional disorder
Difficult to treat
Antipsychotics, supportive therapy
Average age of onset of delusional disorder
After age 40
Vs. Schizophrenia which occurs in 20s
Intense anxiety that penis will recede into body, possibly leading to death
Koro
Sudden unprovoked outburts of violence, often followed by suicide
Amok
What classifies as atypical features of MDD
Hypersomnia, hyperphagia, reactive mood, leaden paralysis, and hypersensitivity to interpersonal rejection
What classifies as melancholic features of MDD
Anhedonia, early morning awakenings, depression worse in morning, psychomotor disturbance, excessive guilt, anorexia
What classifies as mixed features of MDD
Manic/hypomanic sx present during the majority of days of MDE: elevated mood, grandiosity, talkativeness/pressured speech, flight of ideas/racing thoughts, increased energy/goal-directed activity, excessive involvement in dangerous activities, and decreased need for sleep
Triad for Seasonal affective disorder
Triad for seasonal affective disorder:
(1) Irritability
(2) Carbohydrate craving
(3) Hypersomnia
Effective treatment for catatonia
Electroconvulsive therapy (ECT)
Best treatment for a pregnant woman who is having a manic episode
ECT
What classifies as rapid cycling of bipolar
At least 4 mood episodes (manic, hypomanic, depressed) within 12 months
Diagnostic criteria of Persistent depressive disorder (dysthumia)
- Depressed mood for the majority of time most days for at least 2 years (vs. MDD which is episodic)
- At least 2 of the following: poor concentration, hopelessness, poor appetite or overeating, insomnia or hypersomnia, low energy or fatigure, low self-esteem)
- During the 2 year period, pt has not been without the above sx for > 2 months at a time
- May also have MDD
- Must never have had a manic or hypomanic episode (this would make diagnosis bipolar or cyclothymic disorder)
THINK: Persistent Depressive Disorder (DD) = 2 Ds
- 2 yrs depression
- 2 listed criteria
- Never asymptomatic for > 2 months
Diagnostic criteria for cyclothymic disorder
Hypomania + dysthymia
- Numerous periods with hypomanic sx (but not a full hypomanic episode) and periods with depressive sx (but not full MDE) for at least 2 years
- Pt must have never been sx free for > 2 months during those 2 years
- No history of MDE, hypomania, or manic episode
Tx of cyclothymic disorder
Anti-manic agents (mood stabilizers and SGA) as used to treat bipolar
Describe in basic language Disruptive Mood Dysregulation Disorder (DMDD)
Chronic, severe, persistent irritability occurring in childhood and adolescence
Diagnostic criteria of Disruptive Mood Dysregulation Disorder (DMDD)
- Severe recurrent verbal and/or physical outbursts out of proportion to the situation
- Outbursts >3 per week ad inconsistent with developmental level
- Mood between outbursts is persistently angry/irritable most of the day nearly every day
- Sx last for at least 1 year and no more than 3 months without sx
- Symptoms in at least 2 settigs
- Sx must have started before age 10
- No episodes meeting full criteria for manic/hypomanic episode lasting longer than 1 day
Tx of Disruptive Mood Dysregulation disorder (DMDD)
- Unsure because new diagnosis
- Psychotherapy (parent management training = first line)
- Stimulants, SSRIs, mood stabilizers, and SGA can treat sx
Diagnosis of mania
Manic sx 7 days minimum
Or manic sx + psychosis
Or manic sx + hospitalization
Time frame for dysthymia
2 years adults
1 year kids
How many SIG E CAPS are needed for dysthymia vs. MDD
MDD = 5 or more Dysthymia = 2 or more
Can Bipolar II disorder have psychotic features
Yes, only if psychotic features ONLY present during depressed state of Bipolar II
If psychotic features present during hypomanic state, that hypomania is bumped up to mania, which means BPII becomes BPI
Akathisia vs. RLS - which one resolves with movement
RLS
Akithisia urge does not improve with movement
Which antipsychotic is known for Breast formation (increases prolactin via blocking dopamine)
Risperidone
THINK: you whisper when you are trying to be sexy aka boobz
Which antipsychotic is known for QTc prolongation
Ziprasidone
Which 2 antipsychotics are known for Highest weight gain; sedating
Olanzapine and Quetiapine
THINK: O and Q are both really round
How does Aripiprazole affect weight
Averages of weight change are “weight neutral” (individuals can gain or lose weight)
What SGA causes the least weight gain
Ziprasidone
THINK: You are able to actually ZIP up pants because you are skinny
What is Zyprexa
Olanzapine
What is Seroquel
Quetiapine
What is Abilify
Aripiprazole
