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Sobe > week 1 > Flashcards

week 1 Flashcards

1
Q

What is an explanatory model?

A

How the patient understands the disease through: Different across cultures. They guide thinking about psych processes.

  • etiology
  • illness belief
  • symtom expression
  • effective treatment
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2
Q

What is harmful dysfunction?

A

Harmful- is a term based on social norms

Dysfunctional- is a scientific term referring to failure

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3
Q

What is a psychiatric disorder?

A

Lies at the boundary between the natural biological world and constructed social world.
- both social and biological

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4
Q

Major Depressive Disorder DSM-5 basis?

A

At least 5 of following 9 symptoms that last at least 2 weeks. There must be patient reported depressed mood or anhedonia!
- depressive episodes may last 6-12 months

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5
Q

What the 9 symptoms of depression?

A

SIG E CAPS

  1. Depressed mood
  2. Sleep disturbance (increase/De)
  3. Loss of Interest (anhedonia)
  4. Guilt or feeling of worthlessness
  5. Energy loss and fatigue
  6. Concentration problems/indecisiveness
  7. appetite/weight changes
  8. Psychomotor retardation or agitation
  9. SI
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6
Q

What is Persistent Depressive disorder (DYSTHYMIA)?

A 
Depression which is usually more mild and last a least 2 years.
Plus symptoms:
-Under or over-eating
-Insomnia or hypersomnia
-Low energy
-Low self-esteem
-Poor concentration or indecision
-Hopelessness
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7
Q

What were the cognitive map of depressive symptoms across culture groups?

A
  1. Pacific northwest american indian psych clinic outpatients
  2. middle class adult psych clinic outpatients
  3. psych residents
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8
Q

What did the cognitive map show?

A

That all 3 groups had a different description of depression even their psychiatrists. This means that the all have different explanatory models for explaining illness and distress.

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9
Q

Etiology of MDD?

A
  • Major depressive disorder is the result of a biochemical imbalance
  • Results from interaction of psychic trauma and physiological mechanisms
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10
Q

What do Haitian Blacks and Pentecostalist Catholics believe causes MDD?

A
  • Supernatural intervention

- gods retribution for moral transgression

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11
Q

Example of MDD as a symptom vs a disorder?

A

Hmong usually take a year to grieve the loss of a loved one. With behavioral and dietary proscriptions

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12
Q

what are precipitating circumstances?

A

Certain situations that expose a person to pathogens or agents of illness
- for Depression you have job loss, divorce, family conflict and chronic illness

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13
Q

what is the biomedical model for treatment of MDD?

A

Anti-depressant meds and psychotherapy

  • CBT
  • SSRI’s
  • SNRI’s
  • Mirtazapine
  • bupropion
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14
Q

What are some alternative models of treatment for MDD?

A

Asians: acupuncture and herbs
Europeans: homeopathic/naturopathic meds
Christian- Faith healing

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15
Q

Biobehavioral health comorbidities?

A
  • Schizt and substance about are the norm

- SA, trauma, depression and SI for american indians

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16
Q

ADHD 4 vs 5?

A

4- before the age of 7
5- several were present before the age of 12
- multiple settings
- no psychosis, depression or anxiety

17
Q

What are the types of ADHD?

A
  1. Inattentive- struggles to sustain focus
  2. Hyper/impulsive- talks loud, interrupts, jumps around
    Most common is mixed for boys and inattentive for gils
    - hyper/impulsive= least
    - 3:1 boys to girls
18
Q

Family or genetic precursors to ADHD?

A
  • In utero exposures to (Nicotine/EHOH/Weed)
  • Birth Traumas (nuchal chord/extended hypoxia
  • Frontal lobe trauma (TBI, mercury, heavy metals)
19
Q

What is Oppositional defiant disorder (ODD)?

A

Enduring a pattern of hostile, defiant behavior toward authority figures in the absence of serious violations of social norms.
-TREAT: CBT or other psychotherapy

20
Q

What is conduct disorder?

A

Repetitive and pervasive behavior violating the basic rights of others or societal norms.
Ex: Aggression to people and animals, destruction of property or theft.
-After 18 many of the pts meet the criteria for antisocial personality disorder
TREAT: CBT or other psychotherapy

21
Q

What is separation anxiety disorder?

A

Common age between 7-9.
Fear of separation from home or loss of attachment figure. May lead to factitious physical complaints to avoid going or staying at school.
TREAT: CBT, play therapy and family therapy

22
Q

What is the DDX for ADHD?

A 
Learning disorders
behavior disorders
anxiety disorders
mood disorders
psychotic
23
Q

Medical work up for ADHD?

A
  1. Neuro, EEG, seizures, TIC/Tourettes, migraines
  2. BMB for endocrine, thyroid and DMD
  3. drugs
  4. sleep disorders
24
Q

What is tourettes syndrome?

A

Onset b4 18- ADHD/OCD association
Sudden, rapid, recurrent, nonrhythmic, stereotypes motor and vocal tics that persist for > 1 year!
TREAT: psychoeducation, behavioral therapy

25
Q

What is Coprolalia?

A

Involuntary obscene speech.

Present in only 10-20% of Tourettes syndrome pts

26
Q

What are some tests for ADHD?

A

Self report from ideally 3 teachers.

Processing speed and working memory vs IQ!

27
Q

What are Cloninger Dimensions for ADHD?

A

Increased risk taking
decreased harm avoidance
Reward dependence

28
Q

ADHD can present with other disorders, what are they?

A
  1. depression
  2. anxiety
  3. aggressive behaviors
  4. tic disorders
29
Q

What the stages of treatment for ADHD?

A 
Stage 0-6
0- Nonpharm
1- methylphenidate and amphetamines
2- the other
3- atomoxetine or A +amp
4- Buproprion or TCA
5- the other
6- alpha agonist
30
Q

Pharmacotherpy for ADHD?

A
  • Ritalin or long acting Concerta
  • Dextroamphtamine sulfate like DEXEDRINE
  • Amphetamine and dextroamphetamine (mixed amphetamine salts) (ADDERALL)
  • Dexmethylphenidate (FOCALIN XR) which just an isomer of methyphenidate
31
Q

What are some long acting biphasic products for ADHD?

A

Adderall XR
Ritalin LA/SR
Metadate
Focalin

32
Q

What are some continuos treatments for ADHD?

A

Concerta
Daytrana patch
Vyvanse

33
Q

What are some non-stimulant treatment and what stages are they used to treat?

A 
3 and 4
- Atomoxetine (strattera)
-non FDA atypical antidepressants
- Bupropiron (Wellbutrin/Zyban)
- Venlafaxine (Effexor) 
- Duloxetine (Cymbalta) 
of note Effexor has a more potent and shorter action on 5-HT thus he choses Cymbalta for SNRI's
34
Q

What are used to treat stages 4 and 5?

A

TCA’s where 20-80% present with cardiac arrythmias and chlingergic SE

35
Q

What are cholinergic SE’s?

A

What happens with you block cholinergics or parasympathetics.
Present with dry mouth, constipation, sedation and orthostatic HoTN
- desipramine
-imipramine
-amitriptyline and nortriptyline
-Mirtazepine

36
Q

What is used to treat stage 6?

A

Alpha 2 Agonists: blood pressure agents used to calm hyperactivity, impulsivity and little focus
- Clonidine (Catapres)
Guanfacine (Tenex)

37
Q

What can be used to treat both anxiety and ADHD?

A

Atomoxetine

Sobe (12 decks)

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