random disorders

Question 1

when a old aged person above 65 keeps on saying idk idk idk

Answer 1

pseudo-dementia

Question 2

puerperal psychosis

Answer 2

-acute sudden onset of psychotic symptoms
- maniac symptoms
- disinhibition
- confusion

usually present 2-4 weeks postpartum
it is a psychiatric emergency

RF-
- thyroid disorder
- previous episode
- being unmarried
- first pregnancy
- c-section
- perinatal death

Question 3

postnatal depression

Answer 3

onset 1-4 weeks postpartum

RF-
- family history of depression and anxiety
- complicated pregnancy
- traumatic birth
- relationship difficulties
- history of abuse
- lack of support
- financial difficulties

Question 4

Management of anxiety disorders

Answer 4

mild anxiety- CBT
unresponsive or moderate- severe
- SSRIs (sertraline, fluoxetine, fluvoxamine, citalopram)
- up to 12 weeks to effect
- continue for 1 year

Question 5

Management for depression

Answer 5

mild depression- watchful waiting for 2 weeks
CBT and supportive therapy for 2-3 months

unresponsive and moderate- severe
- individual CBT
- psychodynamic psychotherapy 4-6 sessions
- fluoxetine
- sertraline or citalopram

CBT IS THE FIRST CHOICE FOLLOWED BY MEDICATIONS IF NEEDED

Question 6

what to do if poor response to 2 SSRI in depression?

Answer 6

consider low dose antipsychotic
-quetiapine
-risperidone
-apripiprazole
-olanzapine

Question 7

for older groups what is considered an alternative for SSRI?

Answer 7

venlafaxine (SNRI)
Mirtazapine (tetracyclic)