Psych Geriatrics Flashcards
is GAD episodic
NO
how long must you be sx to be diagnosed with GAD
6 mos
dx of GAD
anxiety/worry are associated with at least 3 of the following 6 sx w sx present more often than not
- restlessess or on edge
- easily fatigued
- difficulty concentrating/mind going blank
- irritability
- muscle tension
- sleep disturbance
tx GAD
psychotherapy + pharmacotherapy
SSRIs and SNRIs
Buspirone can be adjunct
dysthymia is also called
persistent depressive disorder
dx dysthymia
chronic depressed mood for at least 2 years
at least 2 of the following - insomnia, hypersonic, fatigue, low self-esteem, decreased/increased appetite, hopelessness, poor concentration, indecisiveness
patient is not sx free for > 2 months during the 2 year period
never had a manic episode
tx dysthymia
psychotherapy + pharmacotherapy
SSRIs, SNRIs, Bupropion
what is adjustment disorder
occurs when maladaptive behavioral or emotional sx develop after a stressful or non-life threatening event - relationship issues, death of a loved one, work issues, etc
sx adjustment disorder
marked distress out of proportion to the severity of stressor or significant impairment in function
depressed mood, lack of enjoyment, anxiety, hopelessness, disturbance of conduct, nervousness, overwhelmed etc
dx adjustment disorder
maladaptive emotional or behavioral reaction to an identifiable stressor that causes a disproportionate response than would normally be expected within 3 mos of the stressor and resolves usually within 6 mos of the stressor
tx adjustment disorder
psychotherapy
can use meds but not first line
what neurotransmitters may be affected in MDD
serotonin
epinephrine
norepinephrine
dopamine
acetylcholine
histamine
dx MDD
at least 2 distinct episodes of at least 5 associated sx (must include either depressive mood or anhedonia) almost every day for most of the day for at least 2 WEEKS
tx MDD
psychotherapy
SSRIs first line medical
strongest RF for bipolar disorder
1st degree relative - FHx
dx bipolar I disorder
at least 1 manic or mixed episode (only requirement) - lasts at least 1 week or less if hospitalization is required + marked impairment of social/occupational functioning
tx bipolar I disorder
lithium first line
dx bipolar II disorder
at least 1 major depressive episode + at least 1 hypomanic epidote
hypomania = abnormal & persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days – episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization
tx bipolar II disorder
lithium first line
neuroleptic malignant syndrome is due to blockade of what neurotransmitter
dopamine
what meds are commonly associated with neuroleptic malignant syndrome
typical antipsychotics (MC)
atypical antipsychotics
sx neuroleptic malignant syndrome
Fever + ALTERED
Autonomic instability - tachycardia, tachypnea, hyperthermia, fever, hyper salivation, incontinence
Lead-pipe muscle rigidity
Tremor
Elevated WBC
Regular-sized pupils
Excessive sweating (diaphoresis)
Delirium + Decreased DTR
tx neuroleptic malignant syndrome
d/c antipsychotic
benzodiazepines (lorazepam or diazepam) + dantrolene
can also add dopamine agonists - bromocriptine, amantadine
what is serotonin syndrome
life-threatening due to increased serotonergic activity in the CNS
