1
Q
Most prevelant DSM problems
A
Anxiety/depression, chemical dependency, somatization, personality disorders
2
Q
disorders in DSM - IV
A
297
3
Q
Axis II Disorders - Clusters A,B,C
A
Weird, Wild, Worried
4
Q
Folstein Mental Exam Score of 15 indicates cognition that is, A) Normal B)Mildly Impaired C)Moderate D) Severe
A
C) Moderate
5
Q
Folstein Mental Exam Score of 24 indicates cognition that is, A) Normal B)Mildly Impaired C)Moderate D) Severe
A
B)Mild
6
Q
4 Depression Screening Tools
A
Hamilton Rating Scale (Ham-D), Patient Health Questionaire (PHQ-9), Geriatric Depression Scale (GDS), Beck Depression Inventory
7
Q
2 Anxiety Screening Tools
A
Hamilton Rating Scale (Ham-A), Patient Health Questionaire (GAD-7)
8
Q
3 ADHD Screening Tools
A
SNAP-IV (90), Vanderbilt Teacher (47), Vanderbilt Parent (35)
9
Q
Truthfullness, Degree of Accuracy of Predictive Statements, Does it test what it says it does
A
Validity
10
Q
Consistency of predictive statements, can be reproduced
A
Reliability
11
Q
Intelligence Tests
A
Binet, Stanford-Binet
12
Q
IQ equation
A
MA/CA X 100 = IQ
13
Q
Average IQ range
A
90-109
14
Q
Assess ability to recall and draw complicated picture
A
Rey Complex Figure
15
Q
MMPI
A
find psychopathological patterns that may not be apparent
16
Q
Personality Assessment Inventory
A
334 items, 4 point likert scale
17
Q
Mental Retardation associated with
A
Rubella, low SES, Cytomegalic Inclusion Body Disease, Syphilis, Toxoplasmosis, etc.
18
Q
2 major cause of mental retardation
A
FAS and Down Syndrome
19
Q
Fetal Alcohol Syndrome signs
A
Small, small eyes, smooth philthrum, small chin, poor coordination, hyperactive, LD, MR, sleep disturbances
20
Q
Downs signs
A
Flat head, little tone, flat face, slanty eyes, short nose, wide space fingers - toes, single palmar crease
21
Q
3 Types of Downs Syndrome
A
1) Full Trisomy 21 2) Mosaicism 3)Translocation 21 and 15
22
Q
Prenatal Test for Downs
A
Aminocentesis - look for HCG
23
Q
Secondary Problems of MR
A
low self esteem, neg. self image, psychiatric disorders
24
Q
Autism prevelance
A
11/1000
25
Characterstics of Autism
1)lack of relatedness 2)no social smile 3)babbling, clickin 4)expressive not receptive 5)exploratory play absent 6)rigid play pattern 7) insomnia
26
Asperbergers
1)solitary 2)impaired social interaction 3)impaired non-verbal communication 4)odd speech
27
Which is not aspect of Asperberger's speech A) stilted and repetitive B)obsessive with patterns, weather etc. C)Lack common sense D)Clicking E)Lucid speech
D)Clicking
28
Rare disorder only affects females with normal development to 6-18 months then regression
Rett Syndrome
29
Rare form of Autism, onset 3-4 years, loss of motor, language, social skills
Childhood Disintegrative Disorder
30
4 Types of child abuse
Physical, Sexual, Emotional, Neglect
31
Suspected child abuse requires verbal and written report within this time frame.
72 hours
32
Predictors of Perpetration a)victimized B)observed mother brutalized C)male D)adverse childhood experiences
A, B, D
33
3 types of symptoms of ADHD
Inattention, Hyperactivity, Impulsivity
34
NT in ADHD, #, firing rate, receptor #
Less, Low rate firing, fewer receptors
35
Arousal too high, can't detect between salient and stimuli
Hyperarousal
36
ADHD remission time
12-20 years
37
Ist line treatment for ADHD
stimulants, ritalin, adderal, amphetamines
38
2nd line treatment for ADHD
Strattera and Bupropion
39
Block Dopamine Uptake
Ritalin,concerat, focalin
40
Increase Dopamine in synapse
Adderal, Dexadrine, Vyvanse
41
Inhibit NET, DAT, SERT
Strattera and bupropion
42
Stimlant adjunct for ADHD
Catapres/Clonidine or Tenex/Guanfacine
43
Narcolepsy med, can be used for ADHD
Modanfil/Provigil
44
Procrastionation, low frustration tolerance, sense of flair and low self esteem all Sx of what?
Adult ADHD
45
Identity status based on presence or absence of these 2 factors
Crisis and Commitment
46
SCOFF
Sick because full, lost Control, lost One stone, believe to be Fat, Food dominates
47
Predisposition toward disorder
Diathesis
48
Diasthesis-Stress Model
Predisposition + stress - protective factors/resilience = disease expression
49
Is anorexia or bulimia more common?
Bulimics outnumber anorexics 2:1
50
Eating disorder common to single white college students
Bulimia
51
Common complication of Bulimia
Dental erosion, esophagus rupture, aspiration pneumontis, arrythmias
52
Important screen for suspected bulimia
Low potassium
53
Pharmacological treatment for Bulimia
Antidepressants- TCA, MAO, Prozac
54
Physical Symptom unique to Anorexia
Amenorrhea
55
Immature, Need to be in control, Perfectionism, Neg. self view all common to what disorder?
Anorexia Nervosa
56
Clinical signs of Anorexia Nervosa
Hypothermia, cyanosis, bradycardia, hypotension, low WBC, prolonged QT
57
Common anorexia complications
Refeeding syndrome, lanugo, hair loss, infertility, pancytopenia
58
Treament for Anorexia includes A) Antidepressants B) Assess suicide risk C) Inv., family and cognitive therapy D) Correct Deficiencies
B,C,D
59
Mental Disorders most likely to have addiction disorders A. Bipolar I B. Anxiety C.Schizophrenia D. Antisocial Personality Disorder
D. Antisocial personality disorder
60
Drugs that mimic mental illness
Cocaine/Meth, Stimulants, LAS, Alcohol, PCP
61
Diagnose Substance Abuse Disorders if A) Symptoms where there before B) Symptoms persist during abstinence C) Close relative has SUD D)Symptoms began when SUD began
A, B
62
Why is treating a mental disorder important for a person with SUD?
It increases the chances of overcoming SUD
63
Pharmacotherapy for SUD
Methadone + Sertraline or benodiazepines
64
Dysfunction of Scizophrenia
Reward dysfunction (DA)
65
Danger of treating Schizophrenic for SUD.
Could tip them into a full blown episode
66
5 axes of DSM IV
1-diagnosis2-permanent psychological problems3-medical conditions4-stressors5-global assessment of functioning
67
disruptive mood dysregulation disorder
a new diagnosis of temper outbursts in children
68
attenuated psychosis syndrome
a new prodrome of psychoses
69
use disorder
new term for addiction
70
neurocognitive disorder
new term for dementia
71
paraphilias
group of psychosexual disorders
72
4 memory tests
rey figure
rey auditory (15 words)
CA verbal learning test
wechsler IX memory scale
73
2 neuropsychological tests
halstead-reitanluria-nebraska
74
rorschach test
personality test with 10 inkblots
75
thematic apperception test (murray)
personalitypicture-what happened?
76
MMPI test
most comprehensive and best personality.
77
szondi test
bullshit personality which picture do you relate to?
78
Scores of MMSE/Folstein
30 points possible23 points is cutoff
79
scores of wechsler intelligence scale
normed to 100 70 = 2 sds from 100= mental retardation
80
3 Intelligence tests used with kids
mccarthy scale BEST PRESCHOOL
wechsler preschool/primary
Bayley for infants
81
cultural-familial retardation
no organic brain damage
| Normal distribution of IQ<70
82
amniocentesis (4) for down's
alpha fetoprotein (low)HCGestriol (low)inhibin A
83
advanced language in autism
expressive language
84
gene with autistic assoc
HOXA1
85
onset of childhood schizophrenia
AFTER 5 years
86
childhood disintegrative disorder, CDDtype of disease2 symptoms
severe, later-onset autismloss of language, bowel, bladder
87
identity and intimacy development of males, females
males identity first, then intimacy
| females develop at the same time<
88
2 high yield questions to screen eating disorders
are you satisfied with your eating patterns?do you ever eat in secret?
89
anorexiafemale-male ratiomean year onset
10:117 years
90
2 types bulimia
purging typenonpurging type
91
bulimia female-male ratio
| weight
8:1
| average weight
92
russell's sign
callouses on dorsum of hand from self-induced vomiting.
93
bulimia prognosis NOT affected by (2)
age of onset
| duration of symptoms
94
two types anorexia
restricting
| binge eating/purging
95
refeeding syndrome
low electrolytes in response to anorexia. life threatening
96
pancytopenia
low RBC's, WBC's in response to anorexia
97
female athlete's triad (3)
disordered eating
amenorrhea
osteoporosis
98
2 disorders in ADHD
executive functionself-regulation
99
3 parts of PF cortex with ADHD associations
dorsolateral - attention
PF motor - motor activity
orbital - impulsivity
100
orbital PF cortex to ganglia and back (name of circuit)
impulsivity circuit
101
function dorsal anterior cingulate, ACC
motivation
102
tx for hyperarousal (2)(more common with adults Include MOA
amoxetine - NE inhibitor
| guanfancin - alpha 2A adrenergic receptor agonist
103
2 types stimulants for ADHD
methylphenidate
| amphetamine
104
3 brand names methylphenidate
ritalin
concerta
focalin
105
mechanism methylphenidate (stimulant)
DA reuptake inhibitor
106
3 brand names amphetamine
Adderall
Dexedrine
Vyvanse
107
MOA of amphetamine
increases presynaptic release of DA
108
brand name atomoxetine
Strattera
109
MOA and benefit atomoxetine
NE reuptake inhibitor first then DA, then 5HT
| takes time but low abuse potential
110
MOA of Buproprion
NDRI
111
3rd line for ADHD
TCA antidepressants
112
4th line tx ADHD (2)
Clonidine Guanfacine
113
MOA Clonidine, Guanfacine
alpha 2A adrenergic receptor agonist
Guanfacine has fewer side effects
Clonidine decreases BP
114
CV contraindications for stimulants (3)
congentical heart defects
arrhythmias
syncope
115
if you have substance use patient, the odds that they have a psychiatric disorder
50%
116
patient with depression
| how many have SUD?unipolar?bipolar?
unipolar 30%
| odds bipolar 60%
117
schizophrenia & borderline antisocial personality disorder% SUD
50%
| 85%
118
PCP and ketamine abuse cause what type of symptoms
antisocial behaviors
119
therapy type which is particularly useful for bipolar
group therapy
120
SCID
assessment tool for personality disorders
| structured clinical interview
121
"W" words describing cluster A-C personality disorders
weird
wild
worried
122
3 descriptors for cluster A
accusatory
aloof
awkward
123
2 descriptors for cluster B
big emotions
| bad to the bone
124
3 descriptors for cluster C
cowardly
compulsive
clingy
125
3 cluster A disorders
paranoid
schizoid
schizotypal
126
2 treatments for cluster A disorders
social skills training
| Haloperidol
127
summary of schizoid PD
distant (negative symptoms)
128
summary of schizotypal PD
magical thinking(positive symptoms)
129
4 cluster B disorders
antisocial
borderline
histrionic
narcissistic
130
2 characteristics borderline
unstable
| suicidality
131
2 characteristics histrionic
attention seeking
| sexually seductive
132
3 cluster C disorders
avoidant
dependent
obsessive-compulsive PD
133
2 tx for avoidant personality
social skills training
| Sertraline
134
3 strong beliefs of OCD personality disorder
order
perfectionism
control
135
4 stages sexual cycle
desire
arousal
excitement
orgasm/resolution
136
dyspareunia
genital pain during sex
137
2 sexual desire disorders
hypoactive sexual desire
| sexual aversion
138
female sexual arousal disorder a reduction of (2)
lubrication
| swelling
139
vaginisumus
involuntary muscle spasm of vaginal control
140
4 steps of PLISSIT model of sex therapy
permission
limited information
specific suggestions
intensive therapy
141
difference
viagra
levitra
cialis
4 hour duration
12 hour duration
2+ day duration
142
Alprostadil
used for penile injections, transurethral
143
Bremelanotide
malanocortin agonist not yet on market
| aphrodisiac
144
3 treatments for SRI induced sexual problems
| besides dose reduction and switching agents
augment with Buproprion cyproheptadine (antihistamine)
| weekend drug holiday (but not Fluoxetine)
145
2 interventions to reduce alcohol demand for adolescents
life skills training
| motivational interviewing
146
4 types schizophrenia
paranoid
disorganized
catatonic
undifferentiated
147
3 perinatal infections ++schizohrenia
toxoplasmosis
influenza
borrelia
148
2 birth months of ++schizo
feb/march
149
expressed emotion theory
increased shouting, etc in families- ++schizo
150
3 NTs (and amts) implicated in schizophrenia
+DA
+5HT
-glutamate
151
anosognosia
poor insight found in schizophrenics(lack of awareness of disability)
152
schizophreniform disorder
<6 months
153
schizoaffective disorder
w/mono or bipolar depression
154
gold standard of schizo drugsand negative component
Clozapine
| agranulocytosis
155
unique components of Risperidone
part typical, part atypical
156
two atypicals with less weight gain
ziprasidone
| ariprazole
157
hysteriabriquet's syndrome aka
somatization disorder
158
somatization prevalence (incl gender)onset
2% women 0.2% men
adolescent onset.
duration = year
159
5 diagnostic criteria somatization
```
onset <
30 years
4 different sites pain
2 GI1
sexual pseudo-neuro
```
160
conversion disorder
| age of onset
kids to 35
161
couvade
male pregnancy, a conversion disorder
162
comptocormia
flexion of spine, a conversion disorder
163
body dysmorphic disorder
preoccupation with a real or imagine defect of body
164
hypochondriasis
prevalence
gender
4-9% of population
| males=females
165
difference between malingering and factitious
```
malingering = external motivations
factitious = for medical tx
```
166
disorder associates with factitious
borderline
167
peregrinating factitious disorder
munchausen
168
profile of munchausen patient
single male
| 40'santisocial
169
treatment model for conduct disorder
| include unacceptable treatment
multisystemic family therapy
| NOT GROUP THERAPY
170
2 comorbidities of conduct disorder
SUD
| ADHD
171
2 treatments ODD
positive parenting program
| problem-solving communication training
172
3 internalizing disorders (adolescent)
anxiety/depression
OCD
phobias
173
3 externalizing disorders (adolescent)
conduct disorder
ODD
ADHD
174
CRAFFT questions for adolescents SUD
```
car?
relax?
alone?
family friends?
forget?
trouble?
```
175
3 depression screenings for kids
PHQ-9
beck depression inventory
children's depression inventory
176
tx for adolescent depression
| include unacceptable
SSRIs
| TCAs are contraindicated - toxic + prolongs QT interval
177
5 pediatric antidepressants with FDA approval
4 SSRI
1 exceptional TCA
fluoxetine, sertraline, fluvoxamine, escitalopram
| clomipramine
178
black box warning for pediatric antidepressants
| Include follow up schedule
suicide risk
| follow up:weekly-1 month,biweekly - 1 month,then quarterly
179
length of time for adolescent antidepressant treatment
6-9 months
180
prevalence suicide
12/100,000
181
3 uniqe risk factors for adolescents and suicide
exposure
triggers
past attempts
182
% of suicides with a diagnosis
| include most common
90%
| mood disorders
183
4 high yield suicide screening questions
do you have suicidal thoughts?plan?means?past attempt?
184
double depression
major depression and dysthymia
185
treatment course for depression
9 months - 1 year
186
neurotransmitters reduced in depression (3)include increased receptor
LOW levels of 5HT, NE, DA+5HT2 binding sites
187
frequency of episodes for SAD
2 years, 2 episodes
188
prevalence SAD
1-4%
189
2 tx SAD
10,000 lux for 30 minutes/day
| SSRIs
190
MOA Venlafaxine
SNRI
191
MOA Buproprion
DNRI
192
1st line tx for depression (3 but 1 is a class)
SSRIs
Venlafaxine
Buproprion
193
2nd line tx depression
Duloxetine
194
MOA Duloxetine
SNRI
195
3rd line tx depression (2)
TCA
| Mirtazapine
196
4th line tx. depression
MAO inhibitor
197
prevalence of bipolar disorder
<1% (.6%)
198
bipolar 1 vs. bipolar 2
bipolar 1 - 1 week manic + 3 symptoms
| bipolar 2 - hypomanic (perceived as positive)
199
genetics of bipolar
weak correlation;
1st degree relatives 10% assoc.
2nd degree relatives 5% assoc
200
occam's razor
use as few dx as possible to explain all symptoms
201
personality disorders often confused with bipolar
cluster B
202
only 2 agents proven to have anti-suicidal effects
Clozapinelithium
203
activation syndrome
a manic-like syndrome caused by anti-depressants.NOT MANIA!
204
tx for impulsivity and emotional liability in bipolar disorder
Olanzapine (zyprexa)or other anti-psychotics
205
proposed phenotype system of DSM V for bipolar (4 levels)
narrow phenotype
phenotype 1
phenotype 2
broad phenotype
206
% of SUD patients that have a mental disorder
50%
207
2 substances that can cause antisocial behaviors
ketamine
| PCP
208
therapy better than meds? for bipolar
group therapy
209
pharm therapies for anxiety disorders
SSRIs
210
two decent SSRIs for anxiety and SUD
Paroxetine
| Sertraline (PTSD)
211
1st line treatment for GAD (with or without SUD)
Buspirone
212
yerkes-dodson curve
performance v anxiety
213
base rate
rate found depends where you found it (psych wards, etc)
214
female/male ratio of panic disorder AND agoraphobia
4:01
215
2 qualities for diagnosis OCD
impairment
| patient recognizes unreasonableness
216
3 requirements for PTSD diagnosis
re-experience
avoidance
hyper-vigilance
217
2 components of behavioral model of anxiety
| 2 factor learning theory
neutral stimulus avoidance behavior
| positively reinforced
218
3 regions of brain overactive in panic disorder
amygdala
temporal cortex
hippocampus
219
2 regions of brain overactive in OCD
caudate
| orbital gyrus
220
best treatment for OCD
behavioral therapy
221
Buspirone MOA
partial 5HT agonist
222
diagnosing SUD in adolescents
2 or more of (4)
(4 things that cause probs)
```
SOLS (save our leaky ship)
obligations
hazardous
legal
social
```
Social Behavioral Mindi
flashcards
Decks in class (3)
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