Psychiatric Disorders Flashcards
This is a common depressive disorder. It is the leading cause of disability worldwide.
Major Depressive Disorder (MDD)
Key Symptoms of MDD
Depressed mood
Loss of interest or pleasure
Fatigue
Inattention
Appetite changes
Decreased Libido
Psychomotor retardation
Agitation
Criteria for Diagnosis of MDD
A person must experience five or more of the following symptoms in two weeks to be diagnosed with a major depressive episode.
- Feeling low most of the day for most days
- Decreased interest in activities
- Substantial weight loss, significant change in appetite
- Fidgeting, random movement (i.e. pacing)
- Decreased energy
- Sense of guilt or worthlessness
- Lack of focus or ability to make decisions
- Repeated thoughts of death and suicide
MDD: Labs to rule out other conditions
CBC, CMP, vit D, vit B12, thyroid function test, and UDS
MDD: Tools
- Patient health questionnaire-2 or 9
- Depression inventory 2
- HAM-D
- GAS
- Cornell’s scale for depression or dementia
- Screening for suicide ideation and planning
- Suicidal ideation: more likely to visit their PCP within 6 months of their attempt.
o National institute on mental health Ask Suicide-Screening Questions (ASQ) assesses for ideation of suicide
Panic Disorder
occurs when a person experiences repeated panic attacks, usually accompanied by fears about future attacks. Anxiety about future attacks may lead to behavioral changes to avoid situations that might trigger attacks
Panic Attack
is a brief episode of acute anxiety during which an individual develops an intense fear of negative outcomes accompanied by a feeling of imminent danger.
Adjustment Disorder with Anxiety
presents with nervousness, worry, or jitteriness. Adjustment disorder occurs in the presence of a specific and identifiable stressor. The distress experienced is out of proportion to the severity of the stressor.
Examples of common stressors include loss of employment, getting married, a new disability, or a natural disaster. Symptoms begin within three months of the stressor and typically last no more than six months.
Social Anxiety Disorder
is a condition in which typical, everyday social interactions cause significant anxiety, self-consciousness, fear of embarrassment, or a feeling of being judged negatively by others.
Individuals may worry about the presence of physical symptoms that others may notice such as trembling or blushing. The anxiety can become so severe that derealization, or a feeling of “spacing out,” occurs.
SAD: R/O labs
CMP, thyroid function, UDS
Anxiety Rating Scales
GAD-7
Hamilton anxiety scale - The HAM-A is a clinician-rated anxiety screening tool
Clinical Presentation of Anxiety in Older Adults
Weaker autonomic nervous system responses: HR, BP, Resp,
Lifestyle Modification to Treat Anxiety
Mindfulness
Eliminate Caffeine
Limit Alcohol
Sleep Hygiene
Anti-Depressant Medications
SSRI
SNRi
NDRI
SARI
TCSA
MOA-I
Insomnia
is common in adults over the age of 60; disturbance of sleep quantity or quality with complaints of difficulty initiating or maintaining sleep. Inability to sleep can be transient but treatment is warranted if complaints are at least 3 nights a month or more.
