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54 Cards in this Set

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How long do people have to meet the symptom criteria for major depressive episodes, manic episodes, and hypomanic episodes to meet full criteria for dx?
Major depression - 5+ s/s for 2 or more weeks.
Manic - 3+ s/s for 1 or more weeks.
Hypomanic - 3+ s/s for 4 or more days.
Mixed - depressive and manic w/w every day for at least one week.
MDD is twice as common in men or women? Avg age of onset? Concordance rate?
Women; 55-60% for ID twins and 20% for siblings; 20's
Major depressive episodes often occur after a major stressor, but when are major stressors most influential? Initial episodes (1st or 2nd) or later episodes?
1st or 2nd
Major depression is most prevalent in what age group? In pre-pubescent boys and girls, who has higher rates of depression?
25-44yo; boys and girls have equal rates.
T/F: Suicide prevention centers have relatively little impact.
True
Females ____ (attempt or complete) 3 times more than males, and males ____ (attempt or complete) 3 times more than females.
Females attempt 3 times more than males, but males complete 3 times more than females.
Whites commit suicide more than what other ethnic group?
All non-white groups.
High SES is associated with higher or lower suicide rates?
Higher
What is highest indicator of suicide?
hopelessness followed by hx, isolation, helplessness, poor impulse control, poor judgment, substance abuse, intent.
The highest rates of suicide are among the 25 - 44 yo group. What seems to mitigate suicide?
Marriage
Postpartum syndromes include: depression, blues, psychosis. What are their prevalance rates among new moms.
Depression - 10-15% of new moms.
Blues - 50 - 80% of new moms
Psychosis - .2% of new moms.
Depression tx includes what meds and what type of psychotherapy?
Meds: 1 - Tricyclic antidepressants (imipramine, disiprimine). 2, Mono-amine oxidase inhibitors (MAOI; parnate, nardil) 3. SSRI's (Prozac, zoloft, paxil)
Psychotx: CBT and IPT
What is required to consider MDD to be "chronic" or "full remission"?
Full remission = 2+ mos w/o s/s
Chronic = meet criteria for 2+ years.
Dysthymia is depression s/s present for nearly every day for at least 2 years without major depressive episode during 2 years time and no hx of manic, hypomanic, or mixed episode. What is the preferred psychotherapeutic approach?
Psychodynamic
What is the difference b/n bipolar I and bipolar II?
Bipolar I involves 1+ manic or mixed episodes and 0+ depressive episodes in past.
Bipolar II involves 1+ depressive episodes and 1+ hypomanic episodes in past.
Typically in treatment of bipolar d/o meds are expected to be lifelong b/c what % of those who had one episode will have another? And, do stressors correlate more highly with 1st or 2nd episodes or later episodes?
90%; just like with MDD, stressors are linked more strongly with 1st or 2nd episode.
Bipolar is more common in men or women? What is concordance rate?
Equally common in men and women; 80% concordance rate for ID twins and 20-25% in siblings.
What substances induce an anxiety or mood d/o?
Alcohol, amphetamines, cocaine, hallucinogens, inhalants, opioids, PCP and sedatives, hypnotics, and anxiolytics.
Cyclothymic d/o is...
Multiple hypomanic and depressive episodes for 2+ years.
Bipolar tx includes which meds...
Lithium, tegretol, and valproic acid - I think lithium is most effective???
What are differences between panic attack and agoraphobia?
Panic attacks are s/s that increase w/in 10 mins. Agoraphobia is anxiety/fear in places where escape might be difficult or embarrassing and the situations are either avoided, endured with intense anxiety, or requires presence of a companion.
Panic attacks are treated with what drugs most effectively?
TCA's like imipramine not anxiolytic meds.
In panic d/o w/ or w/o agoraphobia and agoraphobia w/o panic d/o, panic attacks are ________, but panic attacks that occur with a specific phobia, social phobia, OCD, or PTSD are ___.
unexpected or unpredicted; triggered or expected or predictable.
What are concordance rates for panic d/o without agoraphobia? What age group typically experiences panic d/o with agor onset?
In which gender is panic d/o with and without agor more common?
Panic d/o w/o agor = 25-30% in twins and 0-15% in siblings
Onset = adolesence - mid 30's
Women are twice as likely to get panic d/o w/o agor and 3times as likely to get panic d/o with agor.
Treatment for Panic d/o without agor?
Treatment for panic d/o with agor?
Treatment for agor?
1. panic control tx by Barlow (interoceptive exposure, cog restructure & breath training) & CBT
2. TCA's, in vivo exposure
3. Flooding, exposure with response prevent, massed in vivo more effective than graded.
Tx for specific phobia?
Exposure - in vivo exposure especially massed.
Tx for social phobia?
Social skills training, relaxation, exposure (most effective), cog tx.
OCD tx? Is it more common in men or women?
Prozac (SSRI), Anafanil/clomipramine (TCA), flooding and thought stopping helps with obsessions but exposure with response prevention is one of most effective. Equal in men and women
PTSD tx?
Debriefing, relaxation, working through trauma, EMDR
What is difference b/n PTSD and Acute Stress D/O?
PTSD s/s for 3+ mos.
Acute stress d/o s/s w/in 4 weeks of trauma and last 2days to 4 weeks. Same tx for acute stress as PTSD though.
How do you tx GAD? Is is more common in men or women? What is age of onset?
Tx = Beh. tx (progressive muscle relax or behavior activation) but CBT is better.
More common in women.
Age of onset is any age.
What is a somatoform d/o?
Presence of physical s/s but not fully explained by a general medical d/o.
Somatization is more common in women and involves positive criteria in what domains?
Pain, GI s/s, sexual (not pain though), and neurologic.
A conversion d/o involves 1+ s/s affecting what two physical functions?
voluntary movement and/or sensory perception.
Somatization d/o typically begins at what age?
What population is conversion d/o most prevalent?
1. <30 yo.
2. Rural, low SES women
Body dysmorphic and hypochondriasis d/o's occurs more frequently in men or women?
Both occur equally in men and women
What is a factitious d/o?
Intentionally produced physical or psychological illness.
A dissociative d/o involves a disturbance in normally integrative functions of consciousness, identity, memory or perception. The four dissociative d/o's are dissociative amnesia, diss fugue, diss ID d/o, and depersonalization. What are the differences?
Dissociative amnesia - memory loss
Diss fugue - unexpected travel from home with inability to recall past.
Diss ID d/o - multiple person.
Depersonaliz - feeling detached from one's mental process or body. Reality testing remains in tact.
What are 4 types of sexual d/o's?
Sexual desire d/o (hypoactive desire or aversion), sexual arousal d/o's (female sex arousal d/o & male erectile d/o), orgasmic d/o (Female orgasmic d/o, premature ejac), sexual pain d/o( vaginismus, dyspareunia in men or women involves pain in genitals)
Tx for premature ejac involves start-stop tx, but for many of the other sexual d/o's Sensate Focus tx is best... what is that?
Touching in increasingly sexual manner without having sex. Build sexual tension.
Paraphilias are unusual sexual urges for > 6 mos with disturbance to ones life. Do men or women experience these more frequently and what is tx?
Men almost exclusively are dx'd with these.
TX: aversive counderconditioning but high rates of recidivism. The most effective method for decreasing recidivism rate among those behaviors that are illegal is inprisonment.
Bulimia onset is a little bit older than bulimia but both occur in adolescence and early adulthood. What are the best tx's fro anorexia and bulimia?
ANorexia: multidisciplinary team, behavioral tech's like contingency mgt to increase eating, CBT to address distorted thoughts about food and body, psychodynamic to address control and inadequacy, structural family tx, meds for depression.
Bulimia: SSRI's
What are differences b/n dyssomnias and parasomnias?
Dyssomnias are disturbances in amount, timing, or quality of sleep and include insomnia, hypersomnia, narcolepsy, breathing related probs, circadian rhythm sleep d/o (tx with melatonin).
Parasomnias are abnormal behavior in sleep like nightmares, sleep terror, sleep walking.
What are some examples of impulse control d/o's?
Intermittent explosive d/o, kleptomania, pyromania, pathological gambling, trichotillomania
Adjustment d/o is maladaptive rxn to psychosocial stressor w/in ___ mos. of stressor onset with s/s decrease w/in ___ mos. after stressor d/c'd.
3 mos, 6 mos.
Personality d/o's manifest in 2+ areas. What are possible areas?
Cognition, affect, interpersonal functioning, or impulse control.
Cluster A includes odd or eccentric d/o's including....
Paranoid personality, schizoid, schizotypal.
What is the difference b/n schizoid and schizotypal?
Schizoid is detached and indifference to social relations with restricted range of affect. Schizotypal involves discomfort and reduced capacity for relations.
Cluster B includes dramatic, emotional, and erratic d/o's including...
Antisocial, borderline, histrionic, narcisistic
What is the difference b/n histrionic and bordlerline?
Borderline - Instable moods, relations, and self image with significant impulsivity.
Histrionic - Excess emotionality and attention seeking.
Cluster C involves anxious and fearful d/'s including...
Avoidant, Dependent, Obsessive Compulsive
What are differences b/n avoidant and dependent pd.
Avoidant - social discomfort, hypersensivity to negative evaluation, feelings of inadequacy. Almost like social phobia.
Dependent - need to be taken care of - clingy - separation anxiety
What is difference b/n OCD and Obsessive Compulsive PD?
OCD - obsessions and compulsions to ease anxiety
Obs compulsive PD - perfectionistic
The following are med induced d/o's. What are their s/s?
A. Neuroleptic induced parkinsonism.
B. Neuroleptic induced malignant syndrome.
C. Neuroleptic induced acute dystonia.
D. Neuroleptic induced akathisia.
E. Neuroleptic induced tardive dyskinesia.
F. Med-induced postural tremor.
A. Tremor, muscle rigidity, akinesia.
B. Muscle rigidity, increased temp, labile BP, change in consiousness.
C. Muscle spasms
D. restless/rocking
E. Movements of limbs
F. Fine tremor when maintaining posture