Specialty Disciplines Part 2 Flashcards
Syndrome characterized by gross impairments in the ability to assess reality, and behave coherently
Psychosis
There are 6 clinical features of psychosis. What are they, and how many do you need to be diagnosed with psychosis?
you only need 1
- Hallucinations
- Delusions
- Disorganized speech
- Disorganized behavior
- Disorganized motor behavior
- Negative symptoms
Disorder characterized by psychosis, and disintegration of abilities to think logically and maintain normal social behavior
Schizophrenia
How long must you exhibit schizophrenic symptoms to be diagnosed with schizophrenia?
6 months
Are schizophrenia related hallucinations typically auditory or visual?
Auditory
What are great about using atypical anti-psychotics for schizophrenics?
They treat both positive and negative symptoms
They work immediately
Schizophreniform disorder is from ______ month(s) to ________ months(s)
1 to 6
Brief psychotic disorder is classified as ______ day(s) to ________ month(s)
1 day to 1 month
A disorder characterized by a baseline of psychosis with inter-episode mood symptoms
Schizoaffective disorder
In schizoaffective disorder there will be intervals of JUST psychotic symptoms – how long are those intervals?
2 weeks
Disorder involving delusions about plausible events, such as being persecuted, having a serious illness, or having a secret relationship with another person.
Delusional disorder
Bipolar has a _______ percent recurrence rate
90
Episodes of bipolar are associated with ________ ______ loss.
brain tissue
The average person with bipolar disorder does not receive proper diagnosis for nearly ______ years after first episode
10
Characterized by a decreased need for sleep; restlessness, don’t necessarily feel tired; may look agitated or euphoric; very edgy, compulsive.
Manic episodes
What is the big difference between mania and hypomania?
Hypomania you are FUNCTIONAL
Bipolar I patients are symptomatic about ______ their lives; majority being ________ state.
Bipolar II patients are symptomatic ________ of their lives
half, depressed
most
What are some disadvantages to using Lithium for BPD treatment?
Slow onset of 14 days
Narrow therapeutic index
What is the advantage to using Valproate for BPD?
Fast onset
Less cognitive impairment than lithium
Why does Lamotrigene have a black box warning?
SJS and TEN
We use SIGECAPS to diagnose depression. What does it stand for?
Sleep! Interest! Guilt! Energy! Concentration! Appetite! Psychomotor! Suicidality!
Patients with _______ are more likely to experience depression and are 4 times more likely to experience an MI
CVD
BPD isn’t so much a disorder of too much or too little of a neurotransmitter, it’s more of a disorder of?
synapses and circuits
What is the triad of ADHD?
Hyperactivity, Inattention, Impulsivity
What hormone is dysfunctional in binge eating?
Ghrelin
Expect __________ to decline as child gets older. ________ symptoms tend to persist into adulthood.
hyperactivity, inattentive
IQ less than _______ is considered mental retardation
70
Mental retardation, abnormal facial features, intractable hyperactivity
Fetal Alcohol Syndrome
In addition to sub-average IQ, what other aspects must be present to be diagnosed with mental retardatin
Impairment in present adaptive functioning in at least 2 domains
Onset before age 18
Impairment in social interaction, impairment in communication-language delays, repetitive pattern of behavior. Think of?
Autism
How is Asperger’s different than autism?
No language delays
What other comorbid disorders are often associated with ADHD?
Learning disabilities, ODD, anxiety, depressive disorder, bipolar disorder, and tourette’s
What two scales are commonly used to assess/diagnose ADHD?
Vanderbilt Scale and Connors’ Rating Scale
We often treat ADHD with stimulants, how do these drugs work?
Reuptake inhibition of norepinephrine and dopamine
How effective are stimulants in treating ADHD?
Very! Up to 90% response rate
what are some common side effects of psychostimulants?
Decreased appetite, weight loss, insomnia, GI complaints, headaches
In reference to tic disorders, what are the 3 P’s?
Pain, personality (child is teased and ashamed), and/or performance
How do depressive symptoms differ between adults and kids?
Adults will be in a depressed mood most of the day, somatic complaints
youth will be irritable or cranky most of the day and complain of persistent boredom
**there are many other differences
What is the single most predictive risk factor for depression?
Genetic family loading
between the ages 10-24, suicide is the ______ leading cause of death?
third
What are the two key suicide risk factors?
- The presence of one or more diagnosable mental disorders
2. A prior suicide attempt
studies have shown that a combination of ________ and ________ ______ ________ results in significant clinical improvement in 71% of moderately to severe depressed adolescents
fluoxetine and cognitive behavioral therapy
Anxiety disorders are divided into 3 categories. What are they?
- Anxiety disorders
- Obsessive-Compulsive and related disorders
- Trauma and stressor-related disorders
Excessive or persistent anxiety surrounding leaving the caregivers, fantastic worries, school refusal, academic difficulties, and co-morbid depression.
Separation Anxiety Disorder
How do we treat separation anxiety disorder?
Identify the trigger through therapy — help the child understand the trigger and coping with the trigger in other ways
A condition where the child fails to speak in certain venues where there is an exception of speaking despite talking into other situations
Selective mutism
How long do selective mutism symptoms have to last in order to be diagnosed?
1 month
what are our two ways of treating specific phobias?
- Systematic desensitization (feared stimuli are paired with relaxation training)
- Flooding (massive exposure to a feared stimulus until anxiety subsides)
How do we treat social anxiety disorder?
Cognitive behavioral therapy – particularly assertiveness training
May have to use pharmacological treatment to get people out of the house
Recurrent, unexpected panic attacks or abrupt surges of intense fear and discomfort that peaks in 1 minute or so, and during which the patient experiences 4 of the 13 symptoms listed in the DSM-V?
Panic disorder
excessive, poorly controlled anxiety about routine life circumstances that continues for more than 6 months, where the person finds it difficult to control the worry and the worry impairs daily functioning
Generalized anxiety disorder
Recurrent obsessions and/OR compulsions that are disruptive to the patient’s life, and greatly interferes with daily functioning
Individual recognizes these are unreasonable and bothersome
Obsessive-compulsive disorder
How do we treat OCD?
SSRI’s and behavioral therapies
A normal-appearing individual has excessive preoccupation with an imagined physical defect
Body dysmorphic disorder
How do we treat body dysmorphic disorder?
Serotonergic drugs are effective at maximal doses
CBT may be helpful
Persistent difficulty in discarding or parting with possessions regardless of actual value
Hoarding disorder
Do people having insight with hoarding disorder?
Sometimes – insight can be good to poor
“hair pulling disorder”
Trichotillomania
Recurrent skin picking disorder
Excoriation disorder
What is reactive detachment disorder?
A consistent pattern of inhibited and emotionally withdrawn behavior toward adult caregivers where the child seeks minimal comfort when distressed
Pattern of behavior in which a child approaches and interacts with unfamiliar adults
Disinhibited social engagement disorder
How do we diagnose Post-Traumatic Stress Disorder
1+ “intrusion symptoms”
1+ “avoidance symptoms”
2+ “negative cognitions”
2+ “arousal symptoms”
Most cases of PTSD resolve in how long?
3 months
cases can last a lifetime
What type of therapy is particularly helpful in treating PTSD?
Group psychotherapy
why should we be hesitant to use pharmacological treatment to treat PTSD?
PTSD sufferers have an increased propensity to abuse medications
Short-version of PTSD, symptoms last less than 1 month
Acute Stress Disorder
Diagnostic clues to diagnosing this disorder include a “nervous breakdown”, inability to manage life problems, and overwhelming anxiety or depression associated with life stressors
Adjustment disorders
Adjustment disorders must occur within _______ months of the stressor
3
