Week 13 Flashcards
Dx criteria for anorexia nervosa
- associated with?
- most commonly seen in?
- comorbid conditions
- excessive dieting w/ or w/out purging
- body weight <85% ideal body weight
Associated with
- decreased bone density
- severe weight loss
- metatarsal stress fractures
- amenorrhea
- electrolyte disturbance
Mostly in females
Commonly coexists with depression
Dx criteria for bulimia nervosa
- associated with
- most commonly seen in?
- binge +/- purging
- often followed by self induced vomiting or use of laxatives or emetics
- B.W. in normal range
- binge eating + inappropriate compensatory behavior occur at least 2x/week for 3 months
Associated with
- parotitis
- enamel erosion
- electrolyte disturbance
- alkalosis
- dorsal hand calluses from induced vomiting
ADOLESCENT GIRLS
Definition of binge
(1) Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
(2) A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
Alteration of which NT fx contributes to dysregulation of appetite, mood, and impulse control in AN and BN.
brain serotonin
Best tx for
- AN
- BN
AN - family based tx
BN - CBT
Only drug approved by FDA for BN
Drugs that are beneficial for AN
BN - fluoxetine (good for acute) = SSRI
AN - atypical antipsychotics except ziprasidone b/c it prolongs the QT interval
Which antidepressant is contraindicated in BN tx and why?
Bupropion - inc risk of seizure
DSM-IV-TR criteria for intermittent explosive disorder (3)
A. Several discrete episodes of failure to resist aggressive impulses that result in serious assaultive acts or destruction of property.
B. The degree of aggressiveness expressed during the episodes is grossly out of proportion to any precipitating psychosocial stressors.
C. The aggressive episodes are not better accounted for by any other mental disorder (e.g. Antisocial PD, Borderline PD, Conduct Disorder, ADHD, a Manic Episode, a Psychotic Disorder), are not due to the direct physiological effects of a substance, or a general medical condition (e.g. head trauma, Alzheimer’s disease).
What you see: a pattern of aggressive behavior & over-reacting.
Kleptomania DSM-IV-TR
Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value.
A. Increasing sense of tension immediately before committing the theft.
B. Pleasure, gratification, or relief at the time of committing the theft.
C. The stealing is not committed to express anger or vengeance and is not in response to a delusion or hallucination.
D. The stealing is not better accounted for by Conduct Disorder, a Manic Episode, or Antisocial Personality Disorder
Pyromania DSM-IV-TR
A. Deliberate and purposeful fire setting on more than one occasion.
B. Tension or affective arousal before the act.
C. Fascination with, interest in, curiosity about, or attraction to fire and its situational contexts (e.g. paraphernalia, uses, consequences).
D. Pleasure, gratification, or relief when setting fires, or when witnessing or participating in their aftermath.
E. The fire setting is not done for monetary gain, as an expression of sociopolitical ideology, to conceal criminal activity, to express anger or vengeance, to improve one’s living circumstances, in response to a delusion or hallucination, or as a result of impaired judgment (e.g. in dementia, Mental Retardation, Substance Intoxication)
F. The fire setting is not better accounted for by Conduct Disorder, a Manic Episode, or Antisocial Personality Disorder
Pathological gambling DSM-IV-TR
A.
Persistent and recurrent maladaptive gambling behavior as indicated by 5 or more of the following:
1) Is preoccupied with gambling (e.g. reliving past gambling experiences, planning the next venture, thinking of ways to get money to gamble with)
2) Needs to gamble with increasing amounts of money to achieve the desired excitement
3) Has repeated unsuccessful efforts to control, cut back, or stop gambling
4) Is restless or irritable when attempting to cut down or stop gambling
5) Gambles as a way of escaping from problems or of relieving a dysphoric mood (e.g. feelings of helplessness, guilt, anxiety, depression
6) After losing money gambling, often returns another day to get even (“chasing” one’s losses)
7) Lies to family members, therapist, or others to conceal the extent of involvement with gambling
8) Has committed illegal acts such as forgery, fraud, theft, or embezzlement to finance gambling
9) Relies on others to provide money to relieve a desperate financial situation caused by gambling
B. The gambling behavior is not better accounted for by a Manic Episode
Trichotillomania: DSM-IV-TR Criteria
A. Recurrent pulling out of one’s hair resulting in noticeable hair loss
B. An increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior
C. Pleasure, gratification, or relief when pulling out the hair
D. The disturbance is not better accounted for by another mental disorder and is not due to a general medical condition (e.g. a dermatological condition)
E. The disturbance causes clinically significant distressor impairment in social, occupational, or other important areas of functioning
equal in males and females
Most common comorbidity with anxiety disorders (2)
Depression and substance abuse
Panic disorder and generalized anxiety disorder linked with dysregulation of?
brain noradrenergic system
-fear and stress response
OCD linked with dysregulation of
serotonergic transmission
